Dear Readers,

T. Brown is a 72-year-old woman who says she was quite active up to a year ago when she came down with a case of shingles on the left side of her chest. She says the rash caused her much pain. She had to lie down in bed for months. Mrs Brown said that painkillers just didn't seem to help. She was given non-steroid anti-inflammatory drugs (NSAIDS), examples of which are voltoran, motrin, aleve, cataflam, etc.

Nearly a year later, Mrs Brown says she had good days and bad days when the pain confines her to bed. The shingles pain is the worst she has ever experienced and she has lost a lot of weight because of it. She asks Lifeline what treatment is ideal for shingles pain.

virus

Shingles is caused by the virus, Herpes zoster, which also causes chickenpox. Once a person has chickenpox, even after they recover, the herpes virus remains in the body, usually lying dormant in a nerve root. It could be many years later, during a time of emotional or physical stress when the persons immune response is depressed, when the virus reactivates. It flares up, this time causing shingles.

Shingles usually begins with extreme pain and itching over one side of the body, generally either the face or the trunk and less commonly the limbs and pelvis. The pain is soon followed by a vesicular rash (blisters or cold sores). Both pain and rash occur over a specific area of skin. Severe pain, scarring of the skin and numbness can persist for up to a year after the lesions heal. Shingles can also occur near the eyes, affecting vision adversely. This phenomenon of prolonged shingles pain is referred to as post-herpetic neuralgia.

Shingles cannot be cured although antiviral medication can possibly shorten the time for healing and lessen the pain experienced, especially if the drugs are started early in the course of the illness. Some antiviral sare cycovir (zovirax) and valtrex. Very bad cases of shingles may require hospitalisation and treatment with intravenous antiviral drugs.

The old remedy, calamine lotion, can be applied topically anaesthetics such as mild ointments can also be very useful to decrease both itching and pain to the skin, or skin hypersensitivity. The NSAIDS can be used where pain is mild to moderate. Sometimes the nerve damaged by the herpes virus causes severe pain. This pain is sometimes even worse when the area is touched by clothing or bed linen.

treatment

When NSAIDS don't work and pain is prolonged and intense, another set of drugs also used in the treatment of nerve-seizure disorders may be tried, often with significant success. Examples of these drugs would be Tegretol (carbamazepine), Neurontin and Lyrica. These drugs reduce pain by reducing the electrical signals going to the damaged nerves. Dolo-neurobion-N, an NSAID combined with Vit B preparation, is also useful for pain relief.

Sometimes a mild sedative or anti-depressant can also be taken when the illness is prolonged. Most of the medications used for the treatment of shingles and post herpetic pain are prescription items and a physician should be consulted before use.

Write to: Lifeline

PO Box 1731

Kgn 8