Nerve Damage after a Shingles Outbreak

If you've ever had chickenpox, your chances of developing shingles increases as you age. That's because shingles is the result of a reactivation of the same virus that causes chickenpox, the Varicella-Zoster virus (VZV). You're probably familiar with the common rash and blisters that develop from a shingles outbreak. But did you know that anywhere from 10-70% of these outbreaks can end with painful nerve damage that lasts anywhere from a few weeks to several months?

Shingles at a Glance

The symptoms of a shingles outbreak occur when the latent VZV becomes reactivated in response to stress, aging, or other immuno-compromising conditions. The virus travels from its hiding place (the dorsal root ganglia) in the spinal cord out to peripheral nerves in the skin. This causes a vague burning or painful sensation that later materializes as fluid-filled blisters that burst, crust over, and eventually heal. The whole outbreak usually lasts about 4 to 5 weeks.

An Unwanted Parting Gift

Some people continue to feel pain long after a shingles outbreak. They may feel a sharp and jabbing pain, or a deeper ache or burning in the area once affected by a shingles outbreak. Some report headaches, itchy skin, or an extreme sensitivity to touch and temperature changes. Such symptoms lasting longer than 3 weeks after a shingles outbreak is called postherpetic neuralgia or PHN.

Postherpetic Neuralgia

The symptoms of PHN are thought to be caused by several things. It could be that when nerves were repaired after the initial shingles outbreak they were done so incorrectly, creating exaggerated impulses which when sent to the brain are interpreted as pain. It may also be that inflammation in the spinal cord caused by shingles causes nerve scarring and long term damage.

Risks for Developing PHN

There is a clear connection between the development of PHN and age. Those who experience a shingles outbreak over the age of 60 have a 40% chance of developing the condition while those under 60 have only a 10% chance. The length of PHN also appears to increase with increasing age. It has also been noted that those with a distinct prodromal stage (the tingling or burning sensations felt just before a shingles outbreak) had a higher incidence of PHN development. Women also seem to have a higher chance for developing PHN, but it may just be that they report symptoms more often than men.

Treating Postherpetic Neuralgia

Because pain is the name of the PHN game, most treatments for this condition are centered on soothing pain. There are a variety of methods for treating nerve pain, some more natural than others. The chronic pain caused by PHN can also lead to depression which can further inhibit immune function and healing. A combination of natural pain relief methods as well as self-help for depression can make living with PHN much more bearable.

Sources:

http://www.fda.gov/FDAC/features/2001/301_pox.html

http://adam.about.com/reports/Shingles-and-chickenpox-Varicella-zoster-virus.htm

http://www.mayoclinic.com/health/postherpetic-neuralgia/DS00277/DSECTION=3

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