Shingles: Treatment Alternatives

Q:  I read your column that appeared in the Journal-Sentinel of February 12 and would like to comment on the advice you gave to the woman with herpes zoster. The patient specifically asked you to advise her on a nerve block or acupuncture as a mode of treatment. In the column you listed many of the medical treatment alternatives for her condition, including various medications, creams and electrical stimulation. I found it very disturbing that at the end of the article you suggested that "a nerve block is more likely to be successful than acupuncture."

I do not doubt that a procedure leading to permanent paralysis of the affected area would be the most effective way of getting rid of the patient's pain. My problem is that by the way you make this statement, you suggest a radical procedure be tried before a safe alternative method such as acupuncture is explored. You have expressed this type of opinion in other articles and I am compelled to write and urge you to change your thinking.

I realize that you are not an expert in alternative health care methods, but the medical community must recognize that these methods exist and are effective. I estimate that about 70% of my practice consists of patients who have found no solution to their health problems from allopathic medicine. In almost every case, his or her medical doctor tells the person that nothing can be done or that some high-risk procedure is warranted. About 80% of these people eventually leave my office greatly improved or without any symptoms at all. The people who do not get the desired results are free to explore other options without the complications brought on by drugs and surgery.

I hope that in the future, you will keep in mind that there are other paths to good health. Chiropractic, acupuncture, and homeopathy are just a few choices suffering people have to find relief. I hope that you will let your readers know that there are safe alternatives outside of traditional medicine that might be tried before drastic procedures are contemplated. If you are unable to effectively comment on these choices within the scope of your column, please state that you cannot do so when these questions arise. I think people will appreciate your honesty and it will leave them free to explore other options when the medical route is not working.

A:  I appreciate your candor and I also agree with your view that less radical procedures should be tried first. Any physician should recognize that allopathic (traditional western) medicine does not have all the answers or a cure for disease, but neither does alternative medicine.

Prescription drugs have side-effects, but there have also been reports of serious reactions to herbs.

I am open to a variety of options for patients to get relief, but I do try to base my decisions on the available evidence. In the case of shingles, there have been published reports of relief from nerve blocks, but no reports on acupuncture for shingles--hence my response. Believe-it-or-not, I am not opposed to considering "alternative" methods, and I have referred my own patients to chiropractors with good results. A recent article in the New England Journal of Medicine (a major research publication) found that patients with acute low back pain had similar outcomes whether they received care from primary care physicians, chiropractors or orthopedic surgeons. The only difference was that the care was the least expensive from the primary care practitioners.

My main concern with alternative medicine is when patients choose to have colonic irrigation or acupuncture for diabetes or a cancer for which there are effective medical treatments available.

Dr. Rebekah Wang-Cheng is a former Professor of Medicine at the Medical College of Wisconsin. Her medical advice column, which answers health-related questions from readers, also appeared in the Milwaukee Journal-Sentinel.