Shingles awareness can prevent pain

Dear Dr. Roach: I am 77 and developed shingles in December 2016.

Although my blisters are long gone, I still have pain and topical discomfort, which I know are from the nerve endings.

My doctor says I will probably live with this the rest of my life. I have seen doctors, including pain management.

I tried gabapentin (300 mg three times daily), tramadol and Lyrica, with no help. Vicodin doesn’t relieve pain but does calm me. — P.S.

Shingles is a reactivation of the chickenpox virus from natural infection or, less commonly, from vaccination.

The virus travels down the nerve endings and causes a fluid-filled blister, which is contagious only to people who have never had chickenpox. The rash may be preceded by a period of itching or pain.

If the rash is recognized in time, treatment with antiviral medicine can reduce the likelihood of developing the complication you have, which is called post-herpetic neuralgia.

Many people describe the pain as burning, but it can also be sharp and stabbing. It may be constant or intermittent, and variable in severity, all the way to excruciating. Light touch on the area can be painful.

The older a person is, the more likely she or he is to develop post-herpetic neuralgia, and the longer it may last.

Without treatment, almost 20 percent of people over 70 years old will develop this complication. In people over 65, it lasted a mean of 3.3 years. There is still hope it will go away on its own.

PHN is associated with profound problems, including depression, loss of function, loss of libido, poor sleep and loss of appetite with weight loss.

Because treatment for PHN is not very good, prevention is a high priority. The new shingles vaccine is excellent, but sadly, still in short supply.