WHAT IS SHINGLES?
Herpes Zoster is caused by Varicella-zoster virus, the same virus that causes the chickenpox
The virus remains dormant in the spinal cord region, and is usually activated in immunocompromised
patients or under a lot of stress. The virus usually occurs in adults, especially ovver the age of 50.
The virus causes localized vesicular skin lesions confined to the one side of the body and causes
severe pain to the affected nerves.
SIGNS & SYMPTOMS
Herpes Zoster usually begins with fever and discomfort, i.e., numbness and tingling. Within 2 to 4 days,
severe deep pain, itching, numbness, orhypersensitivity may occur. This is usually on the trunk of the body,
but may occur on the arms, legs, or even on the face. The burning, sharp, stabbing pain may be intermittent
or it may be continuous. This lasts 1 to 4 weeks in most people, but in approximately 15% of the population
the pain may remain for years. Up to 2 weeks after the first symptoms, small, red skin lesions erupt on painful
areas. The lesions occur only on one side of the body. The vesicles quickly become filled with clear fluid
and pus. About 10 days later the vesicles dry and form scabs. Intense pain may occur before the rash appears
and after the scabs form.
TREATMENT
The pain of shingles usually does not respond to customary pain medications. Often the patient will be given
an anti-viral medication to shorten the duration, and anti-depressant medications or anti-seizure medications to
decrease the nerve pain. Often this is not enough to control the pain of shingles as it is usually a very intense
pain. If the pain is not resolved with medication, shingles may be treated with injection therapy directly to the
area where the virus lies. The use of injections, such as epidural steroid injections, often helps reduce the severe
pain caused by shingles and decrease the duration of the virus. Quick and aggressive treatment of shingles often
prevents it from becoming a long term problem.
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