Shingles pain can often begin with burning upper back pain. Other people will complain of itching or tingling for stinging type of pain. Your upper back and flank are common but shingles can develop anywhere on your body.
When people describe their pain as a burning or stinging pain it always makes us think of nerve pain such as neuropathy or shingles.
When the pain is located in the upper back herpes zoster is something that must be considered.
The Chickenpox Virus
Herpes Zoster, also known as Shingles or Zona, is a viral disease that is caused by Varicella Zoster which is the same virus that causes chickenpox.
Most people experience chickenpox as a child. It is a viral infection that causes blisters and a rash that usually goes away without treatment after several days.
The Virus Lies Dormant for Decades
When you get over chickenpox the virus is not eliminated from the body, it only becomes dormant or inactive.
This virus can remain inside of the nerve cells for many years or decades before it is re-activated in a way that we do not understand.
Image thanks to NIAID via Wikimedia Commons
When the virus becomes active again it travels down the nerve causing nerve pain and a blistering rash in the dermatome or area that that nerve serves. When the nerves come out of your spinal cord they always go either to the right or to the left side.
Because of this the symptoms of shingles will only occur on your right or left side. If you have a rash that crosses the midline of your body and is on your right side and on your left side, it is probably not shingles.
May be Complicated by Infection
Shingles commonly occurs on one side or the other of your back. It may extend around onto your flank and abdomen. It can also occur in other areas such as your head or face. The rash and blisters of shingles will usually clear up after 3-5 weeks and may leave some residual scarring.
Infections that involve the eye can become very serious and do need to be evaluated by an ophthalmologist or eye doctor.
The nerve pain of shingles is often described as severe burning, stinging or tingling pain and may be felt before any signs of shingles appear on your skin. The pain will generally start to subside after the rash has cleared but in some cases it will persist for months or even years.
Post Herpetic Neuralgia from Nerve Damage
When the nerve pain continues after the rash and blisters have healed it becomes postherpetic neuralgia. This can happen when the shingles virus causes nerve damage. This can lead to episodes of severe nerve pain that will sometimes last for months.
Treatment for shingles should always begin with antiviral medications from your doctor. If medications such as acyclovir or famcyclovir can be started within 72 hours it will greatly decrease your risk of developing post herpetic neuralgia.
Antiviral medications can also help to limit the duration and the severity of your shingles pain.
Pain medications that may be helpful:
Topical preparations, such as capsaicin or lidocaine ointment, can be applied to unbroken skin.
Anti-depressant (Cymbalta or Effexor) and anti-seizure medications (Neurontin or Lyrica) can help shingles pain because they affect the nerves.
Narcotic pain medications like Oxycodone or Hydrocodone do not always help neuropathic pain but when your pain is severe they may be worth a trial.
You can limit your shingles symptoms and avoid complications that can sometimes last for months by starting treatment as soon as the symptoms begin.
If you think you may be developing shingles see your doctor right away.