An Overview Of The Treatment Alternatives For Shingles

Roughly a third of Americans will get shingles at some point in their life

. For older Americans who live up to age 85, the odds increase to 50%. The likelihood is highest for those 65 and older and occurs when the varicella zoster virus causes the dormant chickenpox virus to reactivate. The Centers of Disease Control recommend that patients over the age of 60 get the Zostavax vaccination to avoid health problems related to shingles. Treatment for shingles should not be put off for another day, doctors say, because approximately half of patients will come down with an agonizing and painful condition known as post-herpetic neuralgia (PHN) if they do not get antiviral medication at the onset.

When asked how bad the pain is, Dr. Robert Dworkin, PhD, of the University of Rochester Medical Center explains: "For some patients, even the light touch of a Q tip on their skin is excruciating." He said most of his patients feel the pain first and then a rash appears on one side of the chest or face. Even though the outbreak itself lasts just three or four weeks, the pain can extend for months.

Treatment for shingles pain can speed the healing of the painful rash, decrease the pain of the rash and make PHN less likely to occur. Within 72 hours of the rash's appearance, doctors typically prescribe antivirals (like acyclovir) to combat the virus itself. Effective medicine for pain may include opioids (like morphine, codeine, oxycodone or fentanyl), anti-inflammatory medicine (like ibuprofen), anticonvulsants (like gabapentin or pregabalin) or anti-depressants (like amitriptyline or nortryptyline). The most common side effects of oral medication are drowsiness, nausea and constipation.

If it isn't treated, sufferers increase their chances of experiencing chronic pain that may carry on for months or even a year after the first flare up. This happens because the nerves often become damaged when the reactivated herpes zoster virus travels throughout the system.

A recent study established that an innovative surgical treatment provides pain management for those who suffer from PHN. In a short procedure, surgeons implanted a small pump system beneath the abdominal skin, with a small tube placed into the spine to deliver pain relieving medicine like morphine. This treatment resulted in a substantial improvement in pain, and no side effects were reported.

Seventy-five is the average age of candidates for the pain pump treatment for shingles, and the patients who benefit most are those who cannot be helped by oral pain medication. Some patients respond to opioid medications but suffer severe nausea and debilitating drowsiness with the oral method, whereas there have been no side effects from the pump. It is, however, a surgical, invasive procedure, so patients should consider other options before receiving this type of medication treatment.

by: Matthew Cullen

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