Shingles is caused by the varicella virus that entered our body as a child, hiding in the nerves and reappearing when the immune system is weakened. It is very important to take antiviral drugs in the early stages (within 72 hours) to prevent complications because it creates a band-shaped herpes along the nerve bundle and destroys the nerve. The larger the skin lesion is because it cannot prevent viral replication, the more likely it is that pain will remain following recovery.
Since shingles usually starts with mild pain and herpes, patients are first treated by a dermatologist. As a result, it is very rare to visit a pain clinic. Although not clearly established, it is suspected that the virus destroys nerve bundles. Therefore, there are reports that receiving pain blocking injections within one month of the onset can improve neuroinflammation and help relieve pain. This is why early detection of shingles and treatment from the pain point of view are important.
In particular, in the case of the elderly, there are many cases of complaining of ‘post-herpetic neuralgia’, in which pain persists even following shingles treatment is over. In some cases, it lasts for several months to several years. In order to reduce extreme pain, you can see the effect of performing treatment that is suitable for the area, such as stellate ganglion block, which blocks the sympathetic nerve mentioned above.
Several months following the onset of shingles, there are many sad times when there is no sharp point other than drug treatment. The longer the treatment period, the more likely it is that the postherpetic pain will last longer. This is why pain control is recommended along with dermatological treatment immediately upon detection of shingles. Vaccination is also highly effective in reducing complications, so it is recommended that you get it right.
Seonmin Kim, Specialist in Anesthesiology and Pain Medicine
