Shingles is the name frequently used to describe a herpes zoster infection which occurs when the chicken pox virus that has been lying dormant in a patient’s spinal cord is reactivated and develops a painful skin rash with blisters that are limited to one side of the body and often appear in a linear pattern. Shingles can be severely painful and resistant to conventional treatment including antibiotics, antiviral agents, steroids and narcotics.
The History of Shingles
The varicella zoster virus (HZV) is responsible for causing the acute illness that many of us had as children and young adults known as chicken pox. Following the initial acute infection where the chicken pox virus covers the patient from head to toe, the chicken pox virus can lie dormant for years before reactivating. Currently the chicken pox vaccination offered to many children have significantly reduced the occurrence of chicken pox. However, millions of patients who did not have the chicken pox vaccination will often experience recurrent episodes of infection known as shingles.
When dormant, HZV lives in the spinal nerve cell bodies; the dorsal root cells, and the cranial nerves without causing any signs or symptoms. The virus can reactivate years later in patients who experience stress or who become immuno compromised (sick).
The virus will spread from its site of hibernation from one or more ganglia along the nerves from the spine to the front of the chest typically on one side and infect the corresponding skin (dermatome) causing a painful rash.
For most patients the rash usually heals within 2-4 weeks. Some patients experience residual nerve pain for months or years. This residual nerve pain is known as post hepatic neuralgia. The exact process is not clearly understood.
Early symptoms of shingles are vague, such as headache, fever and malaise. Patients will often think they are getting the flu or a viral illness. Even when patients go to see their family physician the physician may often arrive at an incorrect diagnosis as the symptoms of recurrent shingles can be vague. These initial nonspecific viral symptoms are frequently followed by burning pain, itching, and increased sensitivity in the area of the recurrent infection. The pain may be mild to extreme in the affected dermatome (linear line of skin starting near the patient’s spine and moving around to the anterior chest with sensations that are often described as stinging, tingling, aching, numbing or throbbing). Other patients may experience rapid fire sensations of severe pain.
The initial phase of symptoms is most often followed by the appearance of a classic skin rash. The pain and rash most commonly occur on the patient’s trunk but can appear on the face, eyes or other parts of the body.
At first the rash appears similar to the first appearance of hives. However, unlike hives, shingles causes skin changes typically resulting in a stripe or belt-like pattern that is limited to one side of the body and does not cross the mid-line. Shingles (zoster) is a term used to describe a patient who has all the symptoms of herpes zoster including the characteristic rash.
In many patients the rash becomes vesicular (blisters) as the condition progresses forming small blisters filled with fluid. A fever and malaise may also continue. The painful vesicles eventually become cloudy or darkened as they fill with blood and crust over within 7-10 days. The crust usually falls off and the skin heals but sometimes after severe blistering, scarring and discolored skin remain.
The rash and pain usually lasts 3-5 weeks but 1 in 5 patients develops a painful condition called post herpetic neuralgia. Complications resulting from post herpetic neuralgia result in chronic severe pain and disability.
The incidents of herpes zoster ranges from 1.2 to 3.4 per 1,000 person years among healthy individuals. Herpes zoster increases 3.9 to 11.8 per 1,000 person years among those older than 65 years. Herpes zoster affects an estimated 500,000 American’s each year. In the United States a chicken pox vaccination program began in 1995 which would reasonably be expected to decrease the infection rate in the future. However, as the American population is aging there has been no significant change in the occurrence of zoster. A zoster vaccination is now being offered to the aging American population and again would reasonably be expected to reduce the incidents of shingles in the future. However, at this time this still has not occurred.
Complications of Herpes Zoster
Herpes zoster may have additional symptoms depending on the level of the spine in which the chicken pox virus is residing. One of the areas involves the eyes. Ten (10) percent of cases will have eye involvement affecting the orbit of the eye. Additionally, a number of patients will report symptoms of conjunctivitis, keratitis, uveitis and optic nerve palsies. Additionally patients can experience chronic ocular inflammation, loss of vision and debilitating pain. Herpes Zoster can also effect the ear. It is thought to be caused by spreading the virus from the facial nerve to the inner ear vestibulocochlear nerve. Systems include hearing loss and dizziness.
Medical Therapeutic Laser
Multiple studies in the United States and Europe have demonstrated the effectiveness of medical therapeutic lasers on the treatment of herpes zoster. Medical therapeutic lasers are effective in treating pain, swelling and inflammation. Additionally medical therapeutic lasers can reduce the development of post-herpetic neuralgia. Patients experiencing post-herpetic neuralgia can experience significant pain free living after an appropriate treatment by medical therapeutic lasers using infra-red and red light.
The case of TJ. A 72 year old Australian male presented to the office of Sollay Laser Center with severe chest wall pain on the right side which had been present for several years following the development of an acute right side shingles infection. The patient’s acute shingles infection had been treated with narcotics, antibiotics, anti-viral agents and opioids. The patient developed chronic pain of such severity that he was not able to wear a shirt or allow anyone to touch the right side of his chest.
Mr. TJ presented to the Sollay Laser Center office for evaluation and treatment. A specific plan of treatment was designed for Mr. PJ including treatment on Monday, Wednesday and Fridays for 40 minutes using red and infra-red light.
Soon after starting treatment, Mr. TJ was able to begin wearing a loose outer shirt. His symptoms improved over the course of several weeks to the point that he was able to wear a loose t-shirt and outer shirt. Continued treatment was arranged for Mr. TJ by providing him with a home treatment unit which he could continue to use to treat and maintain the tremendous results which he had experienced in the office. Today Mr. TJ is pain free and has returned to living an active life in Australia.
Consider Medical Therapeutic Laser as a treatment option for your shingles
Approximately 1 out of 3 individuals living in America will develop shingles during his or her lifetime. As people age, the incidence of developing shingles occurs with over one half of all shingles cases occurring in patients age 60 or older.
Photobiomodulation also known as medical therapeutic laser treatment offers a non-invasive effective treatment for shingles. There are multiple research papers demonstrating the effectiveness of medical therapeutic laser treatment for treating both acute and chronic shingles.
Medical Therapeutic Laser Therapy has proven to be an effective treatment for shingles patients and can result in resolution of the acute outbreak as well as healing the patient who suffers from post-herpetic neuralgia (PHN). Patients who are suffering with PHN can experience significant reductions in their pain through the use of photobiomodulation laser application.
Call today for a free consultation with our certified staff at Sollay Laser Center, (410) 644-7655.
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