In many cases, the first sign of shingles is pain in one particular location on only one side of the body. The severity of the pain can range from mild to intense. For most people, it subsides within three to five weeks. However, sometimes shingles pain persists long after the rash has healed. This long-lasting type of pain occurs more frequently in older people.
An Overview of Shingles Pain
Shingles (herpes zoster) is an outbreak of rash or blisters on the skin. It 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 an itch, in one particular location on only one side of the body. After several days, a shingles rash may appear.
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 this pain and its associated rash is a band, called a dermatome, spanning one side of the trunk around the waistline. Shingles symptoms are less common on the lower body.
For most healthy people, the lesions heal and shingles pain subsides within three to five weeks. It is possible, however, for this pain to continue well after the rash has healed.
Sometimes, particularly in older people, shingles pain persists long after the rash has healed. This is known as postherpetic neuralgia. Postherpetic neuralgia can be mild or severe -- the most severe cases can lead to insomnia, weight loss, depression, and disability.
Postherpetic neuralgia is not directly life-threatening. About a dozen medications in four categories have been shown in clinical trials to provide some pain relief. These include:
- Tricyclic antidepressants (TCAs)
- Anticonvulsants (anti-seizure medicine)
- Pain medicines, such as opioids
- Anesthetics applied directly to the skin
- Postherpetic itch.