Shingles

Shingles is a disease caused by the varicella-zoster virus. This is the same virus that causes chickenpox. The virus stays in your body after you develop chicken pox. It may never resurface and cause problems, or it may resurface many years later as shingles. As you get older, the risk of the virus reappearing as shingles increases. Shingles, unlike chickenpox, is not contagious.

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Symptoms of shingles include burning, pain, tingling, and itching, which usually occurs on one side of the body or face. The pain can range from mild to severe. Blisters then form and commonly last for one to 14 days.

Shingles must be treated immediately with a specific antiviral medication to decrease the risk of developing postherpetic neuralgia. Postherpetic neuralgia is pain, burning or itching that persists after the blisters have disappeared. The pain or itching of postherpetic neuralgia may be severe and may last for weeks, months or even years after the blisters have healed. Aggressive treatment with specific nerve blocks and non-narcotic (non-opiate) painkillers should be instituted immediately to decrease the likelihood of postherpetic neuralgia lasting for years. The pain of postherpetic neuralgia is irreversible once scarring of the nerves affected occurs on a microscopic level. Once scarring occurs, the pain intensity may be decreased with a spinal cord stimulator. Biofeedback and behavior modification therapy as modes to decrease the pain of postherpetic neuralgia.

A vaccine may prevent shingles or decrease the severity of the outbreak. The vaccine is for people 60 or over and for those younger than 60 who have weakened immune systems.

Jose Veliz MD is the medical director of Palomar Spine & Pain, in Escondido, CA (North San Diego County).

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