Shingles, or herpes zoster, is a painful viral infection of one or more sensory nerves. The infection causes an itchy rash on the area of skin supplied by the affected nerve. Although shingles pain is typically felt in the nerve endings, the pain can also manifest internally in the abdomen, joints, head, and lymph glands.
Cause
Shingles is caused by the varicella zoster virus, the same virus that causes chicken pox. Shingles only occurs in individuals who have already had chicken pox. After recovering from chicken pox, the virus lays dormant in the nervous system. Doctors do not know why the virus recurs in some individuals, but according to the Mayo Clinic, it may be due to a lowered immune system.
Course
The shingles rash may be preceded by internal pain in the back or chest. A prickly sensation, along the nerve path, may develop next. The skin over the affected area can be tender or have sharp, shooting pains. A rash then develops in a band along the nerves, typically ending at the middle of the body. The rash is characterized by raised, reddened areas that turn into blisters. The shingles blisters rupture and crust, and can be intensely painful. The rash can involve large areas of skin. The rash lasts for about two to three weeks, and the pain can last for another three to four weeks.
Internal Pain
The pain associated with the shingles rash is due to nerve involvement. The presence of the virus, however, can cause pain throughout the body and affect multiple internal sites. The virus may cause the lymph glands to swell, causing pain in the neck, armpits, and groin. There may be an overall feeling of malaise, including a tender abdomen and headache. The joints may be affected, with stiffness and soreness. In rare cases, shingles can cause encephalitis, an inflammation of the brain.
Treatment
Shingles pain is treated with both over-the-counter analgesics and prescription pain medications, depending on the severity of the pain. Antihistamines or steroids may be prescribed to reduce inflammation. Anti-viral medications, such as acydovir, may help limit the severity and course of the virus. Antidepressants and anticonvulsants may also be prescribed. Lidocaine, a topical numbing agent, may be helpful to reduce itching.
Considerations
In some people, shingles pain can last for months or even years after the rash has disappeared, a condition called postherpetic neuralgia. Postherpetic neuralgia can cause deep and aching pain, an extreme sensitivity to touch, and headaches. Postherpetic neuralgia is more common in individuals over 60.
Tags: lymph glands, pain last, Postherpetic neuralgia, shingles pain, shingles rash
