What are the key symptoms of shingles on the back of the neck. How is shingles on the neck diagnosed and treated. What complications can arise from untreated shingles on the neck. How can you prevent shingles from developing on the back of your neck.

Understanding Shingles: Causes and Risk Factors

Shingles is a viral infection caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. While it commonly affects the torso, shingles can develop anywhere on the body, including the back of the neck. But what exactly triggers this painful condition?

The primary cause of shingles is the reactivation of the dormant varicella-zoster virus in individuals who have previously had chickenpox. After recovering from chickenpox, the virus remains inactive in nerve tissue near the spinal cord and brain. Years later, it may reactivate, traveling along nerve pathways to the skin and causing the characteristic shingles rash.

• Previous chickenpox infection
• Age (risk increases after 50)
• Weakened immune system
• Certain medications
• Stress
• Recent illness or surgery

Can stress alone trigger shingles? While stress is a known risk factor, it typically doesn’t cause shingles on its own. Instead, high stress levels can weaken the immune system, making it more susceptible to viral reactivation. Maintaining a healthy lifestyle and managing stress can help reduce the risk of developing shingles.

Recognizing Shingles Symptoms on the Back of the Neck

Identifying shingles on the back of the neck can be challenging, especially in its early stages. However, recognizing the symptoms promptly is crucial for timely treatment and prevention of complications. What are the telltale signs of shingles on the neck?

Early Warning Signs

Before the characteristic rash appears, you may experience:

• Tingling or burning sensations
• Sensitivity to touch
• Mild to severe pain in the affected area
• Headache
• Fatigue

These prodromal symptoms typically occur 1-5 days before the rash emerges. If you experience these symptoms, particularly if you’re in a high-risk group, consult a healthcare professional promptly.

Visual Symptoms

As the infection progresses, visual symptoms become apparent:

• A red, inflamed stripe or band on one side of the neck
• Fluid-filled blisters that eventually crust over
• Skin discoloration (may appear purple or brown on darker skin tones)

Is the shingles rash always painful? While pain is a common symptom, some individuals may experience mild discomfort or itching instead of severe pain. However, any unusual rash on the neck warrants medical attention, especially if accompanied by other shingles symptoms.

Diagnosing Shingles on the Back of the Neck

Accurate diagnosis of shingles is crucial for appropriate treatment. How do healthcare professionals diagnose shingles on the back of the neck?

1. Physical examination: A healthcare provider will visually inspect the rash and ask about your symptoms.
2. Medical history: Information about previous chickenpox infection and risk factors is crucial.
3. Tzanck smear: A sample from a blister is examined under a microscope for characteristic cell changes.
4. Viral culture: Fluid from a blister is tested to confirm the presence of the varicella-zoster virus.
5. PCR test: This highly sensitive test can detect small amounts of viral DNA.

Early diagnosis is key to effective treatment. Seeking medical attention within 72 hours of symptom onset can significantly improve outcomes and reduce the risk of complications.

Treatment Options for Neck Shingles

Effective treatment of shingles on the back of the neck involves a multi-faceted approach. What are the primary treatment options available?

Antiviral Medications

Antiviral drugs are the cornerstone of shingles treatment. They help shorten the duration of the infection and reduce the severity of symptoms. Common antiviral medications include:

• Acyclovir: 800 mg, five times daily for 7-10 days
• Valacyclovir: 1000 mg, three times daily for 7 days
• Famciclovir: 500 mg, three times daily for 7 days

For optimal effectiveness, antiviral treatment should begin within 72 hours of rash onset. However, it may still be beneficial if started later, especially in severe cases or in patients with compromised immune systems.

Pain Management

Managing pain is a crucial aspect of shingles treatment. Options include:

• Over-the-counter pain relievers (acetaminophen, ibuprofen)
• Prescription pain medications for severe cases
• Topical analgesics (lidocaine patches or creams)
• Nerve blocks for severe, persistent pain

Topical Treatments

To soothe the rash and reduce itching, consider:

• Calamine lotion
• Colloidal oatmeal baths
• Cool, wet compresses
• Prescribed corticosteroid creams for inflammation

How long does it take for shingles on the neck to heal? With proper treatment, the rash typically clears up within 2-4 weeks. However, some individuals may experience residual pain (postherpetic neuralgia) for months or even years after the rash has healed.

Preventing Complications of Neck Shingles

While shingles itself can be uncomfortable, the potential complications can be even more severe. What complications should you be aware of, and how can they be prevented?

Postherpetic Neuralgia (PHN)

PHN is the most common complication of shingles, characterized by persistent pain after the rash has healed. To reduce the risk of PHN:

• Start antiviral treatment early
• Manage pain effectively during the acute phase
• Consider preventive medications if you’re at high risk

Bacterial Skin Infections

Open blisters can become infected with bacteria. To prevent this:

• Keep the rash clean and dry
• Avoid scratching or picking at blisters
• Apply antibiotic ointment as recommended by your healthcare provider

Neurological Complications

Shingles on the neck can potentially affect nearby nerves, leading to complications such as:

• Facial paralysis
• Hearing or balance problems
• Vision issues

Prompt treatment and close monitoring by a healthcare professional can help prevent or manage these complications.

Living with Shingles: Coping Strategies and Lifestyle Adjustments

Dealing with shingles on the back of the neck can be challenging. What strategies can help you cope with the condition and promote healing?

Pain Management Techniques

• Practice relaxation techniques (deep breathing, meditation)
• Apply cool or warm compresses as tolerated
• Wear loose-fitting, soft clothing to avoid irritating the rash
• Consider acupuncture or transcutaneous electrical nerve stimulation (TENS) for pain relief

Dietary Considerations

While no specific diet can cure shingles, certain nutritional strategies may support healing:

• Consume foods rich in vitamins A, B12, C, and E
• Include lysine-rich foods (fish, chicken, eggs)
• Stay hydrated
• Limit arginine-rich foods (nuts, chocolate, gelatin) which may promote viral replication

Stress Management

Reducing stress can support your immune system and potentially speed healing:

• Practice mindfulness or meditation
• Engage in gentle exercise as tolerated
• Seek support from friends, family, or support groups
• Consider counseling if you’re struggling to cope

Can lifestyle changes prevent future shingles outbreaks? While they can’t guarantee prevention, maintaining a healthy lifestyle, managing stress, and getting vaccinated can significantly reduce your risk of developing shingles again in the future.

Shingles Vaccination: A Key Prevention Strategy

Vaccination is the most effective way to prevent shingles and its complications. What should you know about shingles vaccines?

Available Vaccines

Two vaccines are currently approved for shingles prevention:

• Shingrix: A recombinant zoster vaccine, recommended for adults 50 and older
• Zostavax: A live vaccine, no longer available for use in the United States as of November 18, 2020

Vaccination Recommendations

The Centers for Disease Control and Prevention (CDC) recommends:

• Adults 50 and older should get two doses of Shingrix, 2 to 6 months apart
• Vaccination is recommended even if you’ve had shingles before
• You should get Shingrix even if you previously received Zostavax

Is the shingles vaccine 100% effective? While highly effective, the vaccine doesn’t guarantee complete protection. However, vaccinated individuals who do develop shingles typically experience milder symptoms and fewer complications.

By understanding the causes, symptoms, and treatment options for shingles on the back of the neck, you can take proactive steps to manage the condition effectively and prevent future outbreaks. Remember, early intervention is key to minimizing discomfort and avoiding potential complications. If you suspect you have shingles, don’t hesitate to seek medical attention promptly.

Shingles on Back of Neck: Symptoms and Getting Treatment

While shingles is most common on your torso, such as your chest and back, you may develop a shingles rash anywhere on your body, including the back of your neck.

Shingles, which results from the herpes zoster virus, is a condition that causes painful, burning rashes.

A healthcare professional should examine any unusual rash on the back of your neck. If you suspect shingles, prompt treatment is especially important to shorten the amount of time you have the condition and to help prevent complications.

Read on to learn more about shingles on the back of your neck, including the key symptoms and how a healthcare professional can treat it.

Shingles is known for causing a painful rash that tends to develop on one side of your body. It’s caused by the herpes zoster virus, which affects nerve cells. Damage to these nerves can lead to skin symptoms in the affected area.

While the torso is the most common place for shingles to develop, the rash may sometimes extend from your chest and back to your shoulders and neck.

Herpes zoster is related to varicella zoster, the virus that causes chickenpox. Chickenpox tends to cause rashes all over your body. Having chickenpox earlier in life increases your chance of developing shingles as an adult.

A shingles rash on the back of your neck can be difficult to identify by sight. If you can see your neck in a mirror, you may notice a stripe that is pink or red on lighter skin and purple or brown on darker skin.

In addition to the back of your neck, you might develop a rash on other areas on the same side of your body, such as your shoulder, cheek, or chest.

Shingles is also known for causing fluid-filled blisters along the rash. These eventually scab over and may temporarily scar.

One difference between shingles and other types of skin rashes is that it can cause significant pain and discomfort. Shingles can also be itchy. If you have this type of rash on the back of your neck, you might experience:

• pain in the affected area
• burning sensations
• tingling that may come and go

These symptoms may occur 1 to 2 days before the rash appears on the back of your neck.

Regardless of where you develop a shingles rash, it’s also common to experience flu-like symptoms when you have this type of viral infection. These can include:

• fever
• headache
• chills
• fatigue
• muscle aches
• upset stomach

The pain and burning sensations that accompany the rash set shingles apart from other types of skin rashes. Shingles also tends to occur on only one side of your body.

An inflamed, blistering, red-to-brown rash like the one common in shingles could also be a symptom of:

• cellulitis
• chickenpox
• drug reactions
• ecthyma, a type of skin infection that’s similar to impetigo but occurs deep inside your skin
• erysipelas
• folliculitis
• herpes simplex
• insect bites
• irritant contact dermatitis
• lichen striatus, a rare skin rash that occurs mainly in children, presenting as pink, raised spots that join together to make a scaly linear band

If you have a severe or painful rash on the back of your neck, consult a medical professional right away. They can determine whether it’s related to shingles or another condition.

In fact, it’s important to get medical help within 3 days of developing a shingles rash to help prevent complications such as postherpetic neuralgia. This complication leads to chronic nerve pain in the area of the shingles rash.

A prompt shingles diagnosis can help you get the right treatments to clear up the rash on the back of your neck and prevent complications.

Healthcare professionals treat shingles with oral antiviral medications such as:

• Acyclovir: 800 milligrams five times per day for 5 days
• Famciclovir: 500 milligrams three times per day for 7 days
• Valacyclovir: 1 gram three times per day for 5 days

These treatments help clear up your rashes and decrease symptoms such as pain and itching. They can also help decrease the amount of time you have a shingles rash and accompanying symptoms.

Severe inflammation from shingles may also be treated with corticosteroids such as prednisone.

Antivirals do not treat acute pain from shingles. To help with this, a doctor may recommend taking over-the-counter pain medications such as ibuprofen (Aleve, Advil) or acetaminophen (Tylenol).

Topical treatments may help soothe a shingles rash on the back of your neck. A doctor may prescribe a topical pain cream or recommend an over-the-counter lidocaine ointment.

You can also try applying colloidal oatmeal or calamine lotion to the back of your neck throughout the day, as needed. Applying a cool, wet compress to the area may bring temporary relief as well.

Shingles commonly develops along your torso, including areas of your chest and back. It can also affect the back of your neck in some cases, causing an inflamed rash and severe pain, burning, and tingling.

If you think you might have a shingles rash on the back of your neck, seek medical help right away. The sooner you begin antiviral treatment, the less likely you are to experience long-term symptoms or complications.

Shingles – Symptoms & causes

Overview

Shingles is a viral infection that causes a painful rash. Shingles can occur anywhere on your body. It typically looks like a single stripe of blisters that wraps around the left side or the right side of your torso.

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you’ve had chickenpox, the virus stays in your body for the rest of your life. Years later, the virus may reactivate as shingles.

Shingles isn’t life-threatening. But it can be very painful. Vaccines can help lower the risk of shingles. Early treatment may shorten a shingles infection and lessen the chance of complications. The most common complication is postherpetic neuralgia. This is a painful condition that causes shingles pain for a long time after your blisters have cleared.

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Symptoms

Shingles symptoms usually affect only a small section on one side of your body. These symptoms may include:

• Pain, burning or tingling
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching

Some people also experience:

• Fever
• Headache
• Sensitivity to light
• Fatigue

Pain is usually the first symptom of shingles. For some people, the pain can be intense. Depending on the location of the pain, it can sometimes be mistaken for problems with the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.

Most commonly, the shingles rash develops as a stripe of blisters that wraps around either the left or right side of the torso. Sometimes the shingles rash occurs around one eye or on one side of the neck or face.

Shingles

Shingles is characterized by pain or a tingling sensation in a limited area on one side of the face or torso, followed by a red rash with small, fluid-filled blisters.

When to see a doctor

Contact your health care provider as soon as possible if you suspect shingles, especially in the following situations:

• The pain and rash occur near an eye. If left untreated, this infection may lead to permanent eye damage.
• You’re 50 or older. Age increases your risk of complications.
• You or someone in your family has a weakened immune system. This may be due to cancer, medications or chronic illness.
• The rash is widespread and painful.

Causes

Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. Anyone who’s had chickenpox may develop shingles. After you recover from chickenpox, the virus enters your nervous system and stays inactive for years.

Sometimes the virus reactivates and travels along nerve pathways to your skin — producing shingles. But not everyone who’s had chickenpox will develop shingles.

The reason for shingles is unclear. It may be due to lowered immunity to infections as people get older. Shingles is more common in older adults and in people who have weakened immune systems.

Varicella-zoster is part of a group of viruses called herpes viruses. This is the same group that includes the viruses that cause cold sores and genital herpes. As a result, shingles is also known as herpes zoster. But the virus that causes chickenpox and shingles isn’t the same virus that causes cold sores or genital herpes, which is a sexually transmitted infection.

Shingles affects the nerves

The shingles rash is associated with an inflammation of nerves beneath the skin.

Are you contagious?

A person with shingles can pass the varicella-zoster virus to anyone who isn’t immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, though, the person will develop chickenpox rather than shingles.

Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious. Avoid physical contact with anyone who hasn’t yet had chickenpox or the chickenpox vaccine. That includes people with weakened immune systems, pregnant women and newborns.

Risk factors

Anyone who has ever had chickenpox can develop shingles. Most adults in the United States had chickenpox when they were children. That was before the availability of the routine childhood vaccination that now protects against chickenpox.

Factors that may increase your risk of developing shingles include:

• Age. The risk of developing shingles increases with age. Shingles typically occurs in people older than 50. And people over the age of 60 are more likely to experience more-severe complications.
• Some diseases. Diseases that weaken your immune system, such as HIV/AIDS and cancer, can increase your risk of shingles.
• Cancer treatments. Radiation or chemotherapy can lower your resistance to diseases and may trigger shingles.
• Some medications. Drugs that prevent rejection of transplanted organs can increase your risk of shingles. Long-term use of steroids, such as prednisone, may also increase your risk of developing shingles.

Complications

Complications from shingles can include:

• Postherpetic neuralgia. For some people, shingles pain continues long after the blisters have cleared. This condition is known as postherpetic neuralgia. It occurs when damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain.
• Vision loss. Shingles in or around an eye (ophthalmic shingles) can cause painful eye infections that may result in vision loss.
• Neurological problems. Shingles may cause inflammation of the brain (encephalitis), facial paralysis, or problems with hearing or balance.
• Skin infections. If shingles blisters aren’t properly treated, bacterial skin infections may develop.

Prevention

A shingles vaccine may help prevent shingles. People who are eligible should get the Shingrix vaccine, which has been available in the United States since its approval by the Food and Drug Administration in 2017. The Zostavax vaccine is no longer available in the U.S., but other countries may still use it.

Shingrix is approved and recommended for people age 50 and older, whether they’ve had shingles or not. People who’ve had the Zostavax vaccine in the past or don’t know whether they’ve had chickenpox may also receive the Shingrix vaccine.

Shingrix is also recommended for people who are 19 years of age and older who have weakened immune systems due to disease or medication.

Shingrix is a nonliving vaccine made of a virus component. It’s given in two doses, with 2 to 6 months between doses. The most common side effects of the shingles vaccine are redness, pain and swelling at the injection site. Some people also experience fatigue, headache and other side effects.

The shingles vaccine doesn’t guarantee that you won’t get shingles. But this vaccine will likely reduce the course and severity of the disease. And it will likely lower your risk of postherpetic neuralgia. Studies suggest that Shingrix offers protection against shingles for more than five years.

Talk to your health care provider about your vaccination options if you:

• Have had an allergic reaction to any component of the shingles vaccine
• Have a weakened immune system due to a condition or medication
• Have had a stem cell transplant
• Are pregnant or trying to become pregnant

The shingles vaccine is used only as a way to prevent shingles. It’s not intended to treat people who currently have the disease.

More Information

Postherpetic neuralgia – treatment, symptoms, causes, diagnosis

Postherpetic neuralgia is a condition that is accompanied by pain and usually follows an episode of herpes zoster. The term itself refers to the condition (pain after herpes).

Shingles (herpes zoster) – the cause is the reactivation of the varicella-zoster virus, which is in the human body in a latent state and, for unknown reasons, is activated and causes an episode of herpes zoster (herpes zoster). The exact reasons for the activation of the virus are not yet known.

The reactivated virus spreads along the course of the nerves, causing pain and rashes or small blisters on the skin. Typically, the shingles rash and pain usually occur on one side of the torso or head. Most often, rashes occur in the chest area. The disease usually proceeds within a few weeks and passes without a trace. But sometimes the virus damages the nerve fibers, which is manifested by pain and other manifestations after the disappearance of the rash. This is postherpetic neuralgia0003

Symptoms of postherpetic neuralgia vary (depending on the individual characteristics of a particular person) and may include severe pain, numbness, tingling, paresthesia in the area that has undergone a viral infection. Postherpetic neuralgia can negatively affect both daily life and work capacity. But, at present, there are quite effective ways to treat this condition (physiotherapy, drug treatment).

Risk factors

Only those who have had chickenpox can get shingles. But there are certain groups that are more prone to postherpetic neuralgia:

• Age – the chance of postherpetic neuralgia is higher in the older age group. (30% of herpes zoster survivors over 60 develop postherpetic neuralgia in the future) and only 10% in the younger group develop postherpetic neuralgia.
• Localization of the rash – the symptoms of neuralgia are more pronounced if the rash was in the forehead or eyes.
• Comorbidity – The presence of a suppressed immune system, (after chemotherapy or immunosuppressive drugs) or diseases such as AIDS.

Early treatment of herpes zoster is important. Treatment started within 2 to 3 days of the onset of the rash may help reduce symptoms and avoid the risk of postherpetic neuralgia.

Causes

Postherpetic neuralgia has a specific pathogenesis. In their structure, nerves are similar to electrical wires that run throughout the body and conduct impulses from the central nervous system and back, with information about the state of organs and tissues. Sensory nerves transmit pain, temperature, tactile sensations.

Postherpetic neuralgia occurs when the herpes zoster virus damages sensory nerves. Damaged nerves begin to function poorly and send pain impulses to the central nervous system. This leads to chronic pain or sensory disturbances in certain areas of the body.

Symptoms

Symptoms of postherpetic neuralgia are usually found only in the area of ​​the body affected by herpes zoster and include:

• Pain (may be sharp, cutting, throbbing, burning),
• Numbness, tingling, itching
• Headaches if shingles is localized on the head or face
• Rarely, muscle weakness or paralysis if the nerve supplying a particular muscle is damaged.

Patients sometimes have allodynia. Allodynia is a reaction out of proportion to the stimulus (that is, the patient reacts to minor stimuli such as a slight change in temperature or touching clothes with severe pain).

Diagnosis

If pain occurs after an episode of rash or sensory disturbance, you should consult a doctor. Diagnosis is based on medical history, physical examination and laboratory tests (needed to rule out other diseases). Instrumental diagnostic methods (CT, MRI, EMG, ultrasound) are prescribed only if there is a need for differential diagnosis.

Prognosis

Physical therapy, physiotherapy and drug treatment in most cases help to reduce symptoms and restore quality of life. Especially if the treatment is carried out in a timely manner.

Treatment

Medication:

• Analgesics such as acetaminophen (Tylenol, Panadol, Tempra) and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen and Celebrex.
• Opioids – A physician may prescribe opioid analgesics for severe pain that is not relieved by conventional analgesics, but these drugs should be used with caution because of the risk of serious side effects. For example: this group includes tramadol or oxycodone. Some research suggests that oxycodone may also help reduce allodynia.
• antidepressants – These drugs are effective in the presence of derpression. In addition, they improve sleep (for example, amitriptyline, simbalta, etc.).
• Anticonvulsants – Preparations of this group are intended mainly for the prevention of convulsive conditions. But sometimes they are quite effective in postherpetic neuralgia (Neurontin, Lyrica, Topamax, Carbamazepine).
• Blockades – Injections of a corticosteroid into the paravertebral points sometimes result in a significant reduction in pain.
• Local anesthetics – ointments, gels containing analgesics or anesthetics (lidocaine). Helps temporarily relieve symptoms.

Prevention

Certain antiviral drugs can help prevent or reduce the effects of shingles, thus reducing the risk of post-herpetic neuralgia:

• Varicella vaccine – the varicella-zoster virus vaccine (Varivax) is now a common childhood vaccination, but also may be recommended for older children and adults who have never had chickenpox. This vaccine does not guarantee that a person will not get chickenpox or shingles, but may reduce the duration and severity of symptoms and the risk of complications such as post-herpetic neuralgia.
• Shingles vaccine – (Zostavax) may be given to people over 60 years of age (who have had chickenpox but not shingles). Zostavax is not recommended for use in certain groups of people (eg, those undergoing cancer treatment or who are immunocompromised).
• Antiviral drugs – Antiviral drugs such as acyclovir, valocyclovir, famciclovir, when taken within the first 72 hours of a zoster rash, may help reduce the duration of zoster and reduce the chance of developing postherpetic neuralgia.

Physiotherapy helps reduce pain and inflammation. Various methods are used (including transcutaneous electrical stimulation).

Exercise therapy helps to restore the elasticity of ligaments and muscles. Exercises can be carried out both on simulators and in the form of gymnastics.

Acupuncture. This method is quite effective for restoring conductivity and reducing pain.

Postherpetic neuralgia – causes, symptoms, diagnosis and treatment

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Chicken pox

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17 September

Postherpetic neuralgia: causes, symptoms, diagnosis and treatment.

Definition

Postherpetic neuralgia is pain or abnormal sensory sensations associated with damage to the nervous system by the varicella zoster virus.

Causes of postherpetic neuralgia

After chicken pox (chickenpox), the human herpes virus type 3 – Varicella zoster virus ( Varicella zoster ) – from rashes on the skin and mucous membranes can move to sensitive ganglia (nodes consisting of clusters of neurons) of the spinal nerves of the thoracic, lumbar levels or trigeminal nerve. There, the virus can remain in a latent (inactive) state for decades. With a decrease in immunity (for example, against the background of viral diseases, chemotherapy, oncological diseases, therapy with glucocorticosteroid hormones for systemic connective tissue diseases (rheumatic diseases)) the virus can become activated and cause the development of herpes zoster (shingles, Herpes zoster ) or trigeminal neuralgia.

The disease begins with unilateral pain, burning sensation, increased skin sensitivity, after which, sometimes after 1-2 weeks, redness appears, and then blistering rashes on the skin. In 50% of patients, rashes are localized on the trunk (as a rule, along the intercostal spaces at the level of the thoracic spine, sometimes in the lumbar region, sacrum), in 20% – on the head (with damage to the trigeminal nerve, damage to the eyes, ears is possible), in 15% – on the hands, and 15% – on the legs. In most cases, over time, the pain goes away on its own – recovery occurs after 2-3 weeks, but sometimes (in about 20% of patients) a complication of herpes zoster develops – postherpetic neuralgia.

Postherpetic neuralgia is rarely seen in children and young adults, but its frequency increases significantly in old age.

The real prevalence of postherpetic neuralgia is unknown, since there is no single point of view on the time interval between rashes, the onset of pain, and the duration of the pain syndrome.

Classification of postherpetic neuralgia

0120 Herpes zoster .

1. Acute herpetic neuralgia in which the pain lasts up to 30 days from the onset of the rash.
2. Subacute herpetic neuralgia lasting 30-120 days after onset of rash.
3. Postherpetic neuralgia in which pain persists for more than 120 days after the onset of the rash.

Most patients recover completely within one year of the onset of pain, but some patients experience pain for years.

Symptoms of postherpetic neuralgia

The main complaint of patients is pain. It is characterized by varying intensity and frequency – from mild to extremely painful, from short-term to permanent. With herpes zoster, pain can spread beyond the localization of the rash. In the clinical picture of postherpetic neuralgia, the following types of pain can be distinguished:

• constant pain, which patients describe as dull, pressing or burning;
• paroxysmal (paroxysmal) pain that comes on suddenly, sharp, shooting, stabbing;
• allodynia – pain that occurs in response to even very weak stimuli that under normal circumstances do not cause pain, such as a light touch with a cold hand.

Often patients note constant fatigue, lack of appetite, decreased mood, sleep disturbances.

Some patients complain of intense itching, which is localized, as a rule, in the head and neck.

Diagnosis of postherpetic neuralgia

At the onset of herpes zoster, when patients are only concerned about pain, the doctor may suspect heart disease, intercostal neuralgia, osteochondrosis. However, with the appearance of rashes, the diagnosis becomes obvious.

The persistence of the pain syndrome after resolution of the rash indicates postherpetic neuralgia.

Instrumental and laboratory diagnostics, as a rule, are not carried out.

In atypical cases, a serological test 256 may be prescribed in combination with test No. 257 (IgM antibodies) for the diagnosis of chickenpox. In addition, these studies may be required to assess immunity to the virus.

Antibodies of the IgG class to the Varicella-Zoster virus (Varicella-Zoster Virus IgG, anti-VZV IgG, antibodies of the IgG class to the varicella-zoster virus and shingles)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

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RUB 965

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Antibodies of the IgM class to the Varicella-Zoster virus (Varicella-Zoster Virus IgM, anti-VZV IgM, antibodies of the IgM class to the varicella-zoster virus and shingles)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

chickenpox; Human herp…

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Which doctors to contact

Management of patients with postherpetic neuralgia is carried out

neurologists

,

internists

, general practitioners, less often infectious disease specialists.

Treatment of postherpetic neuralgia

Early antiviral therapy, especially in the first days after the onset of rashes, can reduce the severity or even prevent the development of postherpetic neuralgia.
In the treatment of herpes zoster, various painkillers are also used. Note that the more severe the period of rashes, the greater the likelihood of chronic pain.

Effective pain relief can positively influence the further course of postherpetic neuralgia.

Strictly under the supervision of a doctor! In addition to traditional analgesics, anticonvulsants (anticonvulsants), tricyclic antidepressants are used to relieve pain at the stage of herpes zoster and postherpetic neuralgia.
To restore the functions of the affected nerve, neurotropic vitamin preparations of group B are prescribed.

Complications

Like any chronic pain syndrome, the course of postherpetic neuralgia is complicated by a significant decrease in the quality of life of patients. Most of them note depressed mood, irritability, disturbed night sleep, general weakness.

Prevention of postherpetic neuralgia

Vaccination may be recommended for the prevention of herpes zoster and postherpetic neuralgia in people over 50 years of age, especially those at risk for developing the disease. Vaccines against Herpes zoster are not included in the National Immunization Schedule, and the decision on the appropriateness of their use in each individual patient is made by the doctor. In some cases, vaccination may be recommended for persons under 50 years of age.

Sources:

1. Federal clinical guidelines for the management of patients with herpes zoster. Russian Society of Dermatovenerologists and Cosmetologists. 2015.
2. Mendelevich E.G., Mendelevich S.V. Postherpetic neuralgia: therapeutic and prophylactic aspects and therapy with pregabalin // Neurology, neuropsychiatry, psychosomatics. 2014(2). pp. 57-61. DOI.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes over time, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Recommendations

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Fungus

Herpes

Vasculitis

Tuberculosis

Heart attack

Cardiac tamponade

Pericarditis

Pericarditis: causes, symptoms diagnostics and methods of treatment.