Shingles

Shingles

The rash of shingles is caused by the varicella zoster virus, the same one that causes chickenpox. Once the virus enters the body, it hibernates in the nerve roots of the spinal column, only to emerge sometime in the future. The rash is diagnostic as it follows the nerve root as it leaves the back, and circles to the front of the chest, but not crossing the midline.

Once the rash appears, the diagnosis is relatively easy for the healthcare provider. Unfortunately, the pain of shingles may begin a few days before the rash emerges and can be confusing to both patient and healthcare provider, since the pain and burning may seem out of proportion to the findings on physical examination.


The treatment for shingles includes antiviral medications like acyclovir (Zovirax) along with pain control medication. Since it is the nerve that has become inflamed, the pain can be quite severe. Some patients may develop postherpetic neuralgia, or chronic pain from the inflamed nerve, which may persist long after the infection has cleared. A variety of pain control strategies are available from medication to pain stimulators to surgery. For more, please read the Shingles article.




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