What is Shingles?
What is Shingles?
Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain, or sometimes numbness or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with the varicella-zoster virus, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.
Is there any treatment?
The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants, and topical agents.
In 2006, the Food and Drug Administration approved a VZV vaccine (Zostavax) for use in people 60 and older who have had chickenpox. When the vaccine becomes more widely available, many older adults will for the first time have a means of preventing shingles. Researchers found that giving older adults the vaccine reduced the expected number of later cases of shingles by half. And in people who still got the disease despite immunization, the severity and complications of shingles were dramatically reduced. The shingles vaccine is only a preventive therapy and is not a treatment for those who already have shingles or postherpetic neuralgia.
What is the prognosis?
For most healthy people, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters leave no scars. However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system.
A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles. A person with chickenpox cannot communicate shingles to someone else. Shingles comes from the virus hiding inside the person’s body, not from an outside source.
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct shingles research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Current research is aimed at finding new methods for treating shingles and its complications.
Select this link to view a list of studies currently seeking patients.
Related NINDS Publications and Information
Pain: Hope Through Research
Chronic pain information page compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
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Culebrilla: Esperanza en la Investigación
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Tension Headaches Eased With Therapy Without Drugs
Several types of nonpharmacologic treatment, including physical exercise, relaxation training, and acupuncture can provide long-lasting improvements for patients with chronic tension-type headaches, physical therapists in Sweden report.
Because the frequent use of pain medications can lead to chronic headaches, it is important that analgesics are discontinued as a first step in treating tension headaches, Dr. Elisabeth Soderberg and her associates report in the current issue of the journal Cephalalgia.
The research team, at Sahlgrenska Academy, Goteborg University, designed a study in which 90 patients, who had chronic tension-type headaches for an average of 7 years, were randomly assigned to physical training, relaxation training, or acupuncture. Chronic tension-type headache was defined as headache occurring at least 15 days per month for at least 6 months.
The trial began with a 4-week pretreatment period, during which time the subjects used diaries to document headache characteristics. They also kept diaries in the 4 weeks immediately after the training sessions and again 3 and 6 months after treatment.
Acupuncture was administered at recommended sites using 10 to 12 needles during 30-minute weekly sessions for 10 to 12 weeks.
Physical training included five exercises focused on the neck and shoulder muscles, repeated about 100 times each, along with ergometric cycling and stretching.
The patients who were taught relaxation also learned “breathing techniques, stress coping techniques, how to relax during activity and how to relax in everyday living.”
Immediately after the last treatment, the only significant between-group difference was a higher number of headache-free periods in the relaxation group compared with the acupuncture group. Otherwise, “there were no long-lasting differences between the interventions.”
Compared with initial measures, acupuncture significantly reduced headache intensity at 3 months and 6 months. Physical training was associated with reduced headache intensity and more headache-free periods immediately after the last treatment and after 6 months. Relaxation training led to significant improvements in headache intensity and frequency immediately after the training and at 3 and 6 months.
Soderberg and her associates suggest that a combination of all three techniques may provide the best outcome.