Shingles is caused by the Varicella Zoster virus, the same one that probably gave you chicken pox as a kid. More than 99 percent of U.S. adults over the age of 40 have had the disease. The virus lies dormant for decades, until stress, age or a weakened immune system trigger a shingles outbreak. Shingles pain management can come in many forms.
More than a million people a year in the United States alone break out with the telltale rash on one side of their face or body. The painful blisters usually lie atop an inflamed nerve, and they last two weeks or a month. What can you do for shingles pain treatment to make the disease more bearable?
Shingles Pain Management & Treatment
Call your doctor as soon as you think you might have shingles. If your healthcare professional can give you an antiviral within 72 hours of the rash appearing, the length of the outbreak will be shortened and the pain, which is intense, may be lessened.
Your doctor will probably recommend one or some combination of the following shingles pain management treatments:
1. Acetaminophen (Tylenol). Relieves muscle pain and reduces fever.
2. Ibuprofen (Advil). In addition to easing pain, Ibuprofin has the added benefit of reducing swelling and inflammation.
3. Anti-convulsants gabapentin (Neurontin) or pregabalin (Lyrica).
4. Antivirals acyclovir, valacyclovir or famciclovir. These drugs kill the herpes virus during the shingles phase. Most patients take the oral antiviral for seven days, or until the rash has healed.
5. Opiods tramadol, oxycodone or fentanyl. Oral prescription pain relievers. When taken as prescribed, they are not addictive.
6. Oral corticosteroids methylprednisolone or prednisolone. Early shingles pain management and treatment with one or two weeks of steroids has been shown to decrease the intensity and duration of pain.
7. Tricyclic antidepressants amitriptyline or nortriptyline to prevent PHN. However, adverse effects are a major concern, especially among elderly patients.
Shingles Pain Management and Treatment: PHN
One out of five patients will develop postherpetic neuralgia (PHN), an excruciating consequence of shingles that can last for years. Pain is often burning, stabbing or throbbing in the location where there were blisters, and affected skin can become hyper-sensitive to heat and cold (allodynia). Some patients report intense itching.
The following shingles pain management treatments are used with PHN:
1. Anticonvulsants gavapentin, phenytoin, carbamazepine or pregabalin. These oral medications work to relieve pain in the central nervous system.
2. Opioids tramadol, fentanyl or oxycodone.
3. Oral corticosteroids methylprednisolone or prednisolone. To be initiated only in conjunction with antiviral therapy.
4. Transcutaneuos electrical nerve stimulation (TENS). However, be careful that it isn’t turned up too high or left on too long, as it can actually worsen the condition.
5. TCAs amitriptyline, nortriptyline or desipamine.
6. Topical capsaicin or lidocaine patch. Lidocaine delivers an anesthetic, while a high-dose capsaicin patch dulls receptors for up to a month after application.
7. Biofeedback. Monitors are used to deliver physiological information to the patient of which they are normally unaware, allowing them greater control.
8. Spinal cord stimulator. Implantable medical device that alters a patient’s perception of pain by generating an electric impulse that creates a tingling sensation.
9. Relaxation therapy. Helpful if the patient’s PHN is worsened by stress.
10. Ice or cold compresses. These provide temporary, topical relief.
11. Acupuncture. Needles are inserted into body points and manipulated to improve energy flow, according to this ancient Eastern art.
There are several forms of shingles pain management, talk to your doctor about what plan is right for you.
