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Preventing Shingles

By Lee W. Erlendson, MD, DABIPP

Our focus is to promote well-being and not ignore painful disorders that can be prevented. The benefits of knowing about shingles and doing something before it strikes can help alleviate pain that may alter your life and leave you with severe chronic pain.

Herpes zoster, or shingles, is a viral disorder that can strike at any time, but especially with advanced age. This painful malady can occur anywhere in your body but is most common around either side of the torso. Sometimes, it may be seen around one side of the face or eye.

Symptoms of shingles usually begin with a painful episode over a specific region of your body, which may suddenly become more visual. Painful, pus-filled blisters, clumped together and scattered over that specific area develop from what was simply burning, shooting pain a day or two earlier. You now have shingles caused by the varicella-zoster virus.  And unfortunately, it could mean chronic pain in that region for the remainder of your years.

You actually may have been acquainted with the herpes varicella-zoster virus when you got chicken pox as a child (commonly at the age of 6 or 7).  As your healthy immune system mounted a defense, the virus began to be eradicated.  Unfortunately, a few of them found protection in your nervous system. Most commonly they can hide in the dorsal root ganglion of your spinal nerves, and they stay there until your sixth or seventh decade of life.  As your immune system becomes weaker or less sensitive to the antigen markers that identify the chicken pox virus, they can break out of their captive cell.

Once it reactivates, it can shoot down that nerve tearing almost every nerve fiber in that spinal or cranial nerve with viral particles produced just from those few hiding chicken pox virus that have been isolated for decades. 

Prevention and Treatment

The shingles vaccine is recommended for those 60 +, but has also shown to be about 70% effective in preventing the disease in those in their 50s. Studies also found that even when vaccinated 50-somethings did get shingles, they suffered far less pain and far shorter bouts of the sometimes disabling disease.

If you get an acute shingles attack, it is best to see your doctor, urgent care center, or pain physician, and get started on antivirals; antibiotics targeting bacterial infections will not work.  Treatment needs to be early to lessen the severity of the illness.  Evolution of a chronic pain syndrome can occur in as many as 40% of elderly patients who get an acute shingles attack. Chronic pain management then becomes highly advised.

Being forewarned is forearmed.  Get your shingles vaccine and prevent a chronic and often debilitating pain syndrome!  And if you get an acute shingles attack, do not wait; see a health care provider ASAP.

Dr. Erlendson is a pain management physician with Rancho Mirage Pain Associates and can be reached at (760) 773-3075. For more information on shingles visit www.CDC.gov/shingles.

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