Shingles Can Greatly Reduce Quality of Life, But There are Treatment Options
Herpes zoster is the virus behind shingles, and the same virus that causes chicken pox. If you had chicken pox as a child, the virus is still inside your tissue. Specifically, herpes zoster prefers to hide in the nerves, though it remains inactive for most people.
However, the virus reactivates in some people, and this secondary infection is what doctors term shingles. Researchers don’t know exactly what causes herpes zoster to reactivate, but when it does, it can cause debilitating pain and other quality-of-life-reducing symptoms. Further, shingles can produce complications that are themselves a challenge to handle.
There are treatment options, though – both western and eastern in origin. Together, they can provide relief and reduce the likelihood of developing complications.
Shingles: Causes, Symptoms and Risk Factors
Again, researchers aren’t completely sure why herpes zoster “wakes up” and produces a second infection. Currently, doctors believe that an important factor is immunity. In people with reduced cell-mediated immunity, shingles is more likely to occur. In addition to age, which is the single biggest risk factor for shingles, the following could cause a compromised immune system:
- Receiving an organ (liver, kidney, heart or lung) or bone marrow transplant
- Cancers – particularly lymphomas and leukemia
- Certain medications, such as steroids or chemotherapy
There are other risk factors, too, that aren’t well-explained. Women are more likely to experience a herpes zoster infection, for example, as are Caucasians.
When shingles flares up, it presents as a rash with a single stripe-like pattern. Why this presentation? Because shingles innervates a single nerve or region, the resulting rash branches across the skin in the same way.
The rash typically appears on the trunk or face, where it can threaten the patient’s vision. Before the rash and pain manifest, it’s common for the infected area to produce sensations like burning, itching or tingling. Other symptoms of a shingles infection may include fever, chills, headache and GI upset.
These symptoms can be severe, to the point where quality of life suffers. Further, shingles can spread herpes zoster to others, though anyone who catches the virus this way will develop chicken pox, and not shingles. Still, it’s important to manage the rash when around young children, the elderly, and other vulnerable people.
Complications Due to Shingles Can Also be Severe, or Even Life-Threatening
Shingles is a serious illness on its own, but its complications are potentially worse. By far, the most common is postherpetic neuralgia (PHN), a complication that affects around 15 percent of patients.
PHN is characterized by long-term nerve pain, emanating from the same area that was infected. It’s essentially a continuation of the same shingles pain, only it can last for years. For some people with PHN, the pain is severe enough to limit activities. PHN is more common in older shingles patients, and it tends to be more severe in older patients, as well.
Other complications include blindness (if the infection presents on the face), hearing problems, encephalitis and pneumonia. While shingles itself isn’t fatal, its complications certainly can be. Again, fatal complications are much more likely in the elderly – about 1 in 1,000 patients over 70 years old will die due to complications from the infection.
Prevention Through a Vaccine is the Most Effective Way to Stop Shingles
Given the debilitating and potentially life-threatening nature of shingles, Houston doctors highly recommend prevention first. This means taking the vaccination.
The vaccine is called Shingrix and it’s recommended for people 50 years and older. It is administered in two doses, with a gap of two to six months between doses. The vaccine is highly effective and prevents infection in 90 percent of people. And this elevated immunity remains for several years following the second dose.
People over 50 can even receive the vaccine if they have experienced a shingles infection in the past.
Western Treatments Focus on Antivirals and Pain Medications
If you have developed shingles, though, vaccination is clearly not an option – at least not until the virus has run its course. When this is the case, western (allopathic) doctors typically turn to the following treatment options:
- Antivirals – Antiviral medications include acyclovir and valacyclovir, and both work using the same mechanism of action. Specifically, they interfere with the virus’s DNA and prevent viral replication. In terms of efficacy, medical research shows that both medications can reduce rash and pain severity, compared to placebo. The only significant difference between the two is how well they are absorbed by the body. Valacyclovir is taken up by the body more efficiently, and therefore requires fewer doses to work.
Given their mode of action, time is a critical consideration. Both medications are most effective if they are taken within 72 hours of symptoms appearing.
- Pain medications – Pain is the primary symptom of shingles, so controlling it is a primary objective for doctors. For many patients, over-the-counter pain medications like Tylenol and ibuprofen are sufficient. If they aren’t, second-line pain medications like hydrocodone may be prescribed.
Antivirals are time-limited and pain medications can produce significant side effects, so many patients also integrate eastern (naturopathic) practices into their treatment regimen.
Eastern Modalities Include Herbal Therapy and Acupuncture
Eastern medicine has developed treatment options for shingles, including herbal therapies and acupuncture. An herbal mixture known as Long Dan Xie Gan Tang is the preferred first option for shingles.
In a meta-analysis that considered 15 trials and 1,811 patients, Long Dan Xie Gan Tang was found to be more effective than drug therapy in reducing shingles symptoms and preventing the occurrence of complications.
Acupuncture is also a popular form of shingles treatment, as it can reduce pain severity and reduce the chances of developing complications. Acupuncture points of interest are those associated with the gallbladder and liver channels.
Whether your Houston practitioner recommends herbal therapy or acupuncture (or both), the Houston practitioner’s goal is to identify how the body’s health is out of balance. Immune issues can result from age, stress, and other health conditions. Eastern medicine practitioners consider these factors when developing treatment.
A Combination of Western and Eastern Modalities Can Optimize Shingles Treatment
Shingles is a potentially debilitating, potentially chronic health condition that can lead to serious complications. As such, slowing the infection and managing its symptoms are important to preserving long-term health in patients.