Back and Abdominal Pain Ch 3

Shingles or Herpes Zoster

A virus can cause back and abdominal pain.

Herpes zoster is caused by the same virus that causes chickenpox, varicella zoster. If you have ever had chickenpox, the virus can lie dormant in the nerve, and then years or even decades later, reactivate, causing an outbreak of shingles.






"unexplained, itching, burning, or tingling"

Because the virus inhabits a nerve, it will cause symptoms in the specific dermatome, or area that the nerve reaches. A very distinctive feature of herpes zoster is that the symptoms do not cross the midline, because the nerve does not cross the midline. The rash and pain will stop abruptly at the center of the abdomen and the center of the back.

The pain will often begin as an unexplained, itching, burning, or tingling pain on one side of the back, then begin to radiate around onto the flank and abdomen. As it becomes more severe, people often complain of a needles and pins sensation, or a hypersensitivity to light touch, and occasionally interspersed sharp stabbing pains. In some cases these symptoms can become very severe, and cause agonizing pain.

Shingles or Herpes Zoster Day 4

Image thanks to Yesyouisnot via Wikimedia Commons

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This Cause of Back and Abdominal Pain can be Difficult to Diagnose

Often the initial diagnosis is very difficult, because of a lack of other signs or symptoms. Then, after anywhere from a few days to a few weeks, a red rash will develop, which will be followed by painful blistering. Over the next 1-2 weeks, the blisters will crust over, and the rash begins to resolve. In most cases the skin will heal, but in severe cases there may be scarring and permanent skin discoloration.

"the key to effective treatment"

As always, the key to effective treatment is early diagnosis. When antivirals such as acyclovir or famciclovir are administered in the first 72 hrs, the pain and rash can often be minimized. Your doctor may also prescribe over the counter pain medication. In severe cases, narcotics, antidepressant, or anticonvulsants, may be required. For the blistering, calamine lotion is often advised.

After an episode of shingles has resolved, you may continue to experience pain in that same area. This is postherpetic neuralgia, and it can be very difficult to treat, often with pain lasting for years. This also may require narcotic pain medication, as well as anticonvulsants, and antidepressants. Topical agents such as capsaicin, and lidocaine patches may help. In severe cases a rhizotomy(severing the nerve) may be considered.

"So, to avoid disaster..."

When you are having back and abdominal pain, it may be a sign of a serious disease or other process in your back or in your abdomen, or both. It would be foolish to ignore such symptoms, because these things are not likely to cure themselves.

So, to avoid disaster, get in to see your doctor for an evaluation. Early diagnosis and treatment is the key to the best possible outcome.



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