Shingles, also known as herpes zoster, is a virus that can affect an individual’s nerves. It typically affects the nerve endings in the spinal column and brain, which is why it’s often referred to as “shingles” or “postherpetic neuralgia.” The condition usually starts with a rash on one side of the body followed by intense pain, tingling, numbness, and extreme sensitivity to light. In this blog post, we’ll discuss how shingles affects your nerves and what you should do if you have been diagnosed with shingles.
Introduction to shingles
After one has had chickenpox, the varicella-zoster virus lays dormant in the nerve cells for decades without causing any illnesses. However, the virus sometimes reactivates later in life, causing shingles.
While the exact mechanism that causes reactivation is unknown, we do know that some people are more prone to getting shingles than others. This includes, but is not limited to, people with weakened immune systems, those who are over 50 years of age, and people with chronic medical conditions. It is also gaining prevalence, and it is said that about 1 in 3 people in the United States will develop shingles within their lifetime (CDC, 2020).
While shingles rashes can appear on any part of the body, most shingles sufferers have a painful inflammation on one side of the body, such as on the trunk or torso. The location where the rashes appear is dependent on which nerve in your body the virus spreads from. The rash is typically contained in one or two areas of your skin because the condition affects the nerves, and each nerve is associated with a dermatome.
What is a dermatome?
A dermatome is defined as an area of the skin supplied by one spinal nerve. There are 31 spinal nerves on each side of the body, and each one is connected to a dermatome. The C5 spinal nerve, for example, is located on the right side of the body and is responsible for sending signals all the way from the right collarbone and upper shoulder to the spinal cord and brain. This area of skin is known as one dermatome. Therefore the location of the rashes is directly related to the nerve which is affected. We also see the phenomenon of having rashes only on one side because each spinal nerve only supplies sensations for the left or right side of the body (Yetman, 2021).
How does shingles affect the nerves?
Reactivation of the varicella-zoster virus causes damage and inflammation to the nerves. Leaving shingles untreated may lead to severe pain and itchiness, even after your rash disappears. This is also known as postherpetic neuralgia. It is one of the most common long-term complications of shingles. While it usually lasts for about one year, there are known cases of permanent postherpetic neuralgia.
The nerves that help with muscle movement can also be affected, and this is known as segmental zoster paresis. Patients with segmental zoster paresis suffer from muscle weakness around the site of the rash.
If the virus is active in the cranial nerves (one of the major nerves of the head), it can lead to a condition called Ramsay Hunt syndrome. Symptoms will be seen on various parts of the head, including facial paralysis on one side, ear pain, blisters in the ear, altered sensation of taste, dry eyes, hearing loss, vertigo, and tinnitus.
What are some of the treatments available for shingles?
Antivirals such as acyclovir or famciclovir are often prescribed to patients who are infected with shingles. Acyclovir is most effective when it is taken within the first 72 hours of noticing any symptoms.
Painkillers (ranging from over-the-counter painkillers such as ibuprofen and acetaminophen to prescription-only painkillers like opioids), anticonvulsants (such as gabapentin and pregabalin) and tricyclic antidepressants can help deal with the intense nerve pain that shingles sufferers experience. Additionally, there are also topical creams like lidocaine and capsaicin, which can help to numb the nerve pain and itchiness.
There are also several lifestyle changes that one can make to help with the healing process. These include getting plenty of rest, drinking lots of water, eating nutritious food, and staying hydrated. Wearing loose-fitting clothing and bathing in cold water/bathing in water with ground oatmeal mixed in can help reduce skin irritation.
Shingles is a condition that is caused by the varicella-zoster virus. It spreads from the nerves to the rest of your body, although it is often confined to one area because each nerve is associated with a dermatome. Shingles can lead to complications like postherpetic neuralgia, segmental zoster paresis, or Ramsay Hunt syndrome, depending on the nerve affected. Fortunately, many treatments can help manage symptoms, such as antivirals, painkillers, topical creams, anticonvulsants, and antidepressants. One should take shingles seriously because it does affect the nerves in your body and can cause harmful long-term effects if left untreated. If you are experiencing any symptoms or have family members who may be at increased risk for developing shingles (such as people who have weak immune systems), it is best to consult with a doctor.
CDC. (2020, October 5). Clinical overview of Herpes Zoster (shingles). Centers for Disease Control and Prevention. Retrieved November 6, 2021
Yetman, D. (2021, August 19). Nerve paths that shingles follows, their impact on the condition. Healthline. Retrieved November 12, 2021