Shingles

Q:  I would like very much if you could write something about the Shingle Syndrome. I have had this for eight years now and my internist and everyone else tells me that there is no help. I have tried everything and still get no relief. My husband suggested a nerve block, but my doctor said it could leave me in a wheelchair.

Could you please give me some advice on a nerve block or acupuncture. Is there any hope at all of ever looking forward to less pain? I sure could use some help!

A:  Shingles, medically called herpes zoster, is caused by the varicella-zoster virus, the same one that gave you chickenpox as a child. The virus remains dormant in the body for years. However, in 20% of people, it gets reactivated. It usually occurs in people over the age of 50. The virus travels from the nerve root to the skin and causes a painful eruption of blisters that eventually crust and scab over in a few weeks. For most people that's the end of it.

Unfortunately people over 60 have about a 50% chance of having continuing pain, even after the lesions heal. This complication is called "postherpetic neuralgia" and can last from a few months to a few decades.

There are a variety of treatments available that are not consistently successful. You may have already tried the options I'm going to mention. Some people get relief from creams like Capsaicin cream or Aspercreme. Medications like amitriptyline and carbamazepine may help, but do have side effects. If you haven't used a "transcutaneous electrical nerve stimulation" (TENS) unit yet, you should give it a try. Finally nerve block injections can be done safely (there is really no risk that you will end up paralyzed) and may provide temporary or even permanent relief. A specialist who is skilled in these techniques should do these blocks. A nerve block is more likely to be successful than acupuncture.

Don't despair -- I do think there is a good chance you will be able to get more pain relief than you have so far.

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.