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What is shingles and how can it be treated?
Shingles, or Postherpetic Neuralgia, is a painful nerve condition that is caused by the varicella-zoster virus, one of the many herpes viruses. This is the virus that causes the common childhood illness called chicken pox. Typically, after a chicken-pox infection passes, the virus lies dormant in the body or ‘asleep’ in the nerve roots, mainly in the chest and upper abdomen, but sometimes in the cervical and facial nerve roots as well.
Later, in adulthood, the virus can be reactivated during a low level of immunity, possibly triggered by high stress or a common cold. When the virus reactivates, it replicates along those nerve roots it lied dormant in and damages the protective covering of the nerve fibers, causing the classic burning, shooting and electrical-type pain that is well-known. A red and erythematous vesicular rash will form along the nerve pattern that is affected as well. The rash typically resolves in seven to 10 days, but the nerve damage, which can be frustrating and painful, can last for months or years. This disease can cause significant suffering and reduced quality of life.
With prompt diagnosis, treatment during the initial stages can include antivirals, nerve-pain medications, topical medications, and oral opiate pain medications. Other treatments include nerve-block procedures and pulsed radiofrequency ablative procedures to help reduce the chronic nerve-related pain. I take a holistic approach with these patients, setting functional goals, and using a combination of medications and interventional procedures to form a comprehensive treatment plan to reduce pain and improve quality of life.
(Editor’s note: The Centers for Disease Control and Prevention recommends a shingles vaccine for people 60 and older, which can reduce the chance of developing shingles by half.)
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