Posted on 07 May 2011 20:00
By Nathan Wei
The term "shingles" refers to a condition caused by the varicella zoster virus, the same virus that causes chicken pox disease. After a person has had the chicken pox, the virus remains dormant, residing in nerve cells. Later on, as a result of many different factors, the virus may reactivate and leave the nerve cell and this is what causes herpes zoster, or shingles.
Reactivation usually occurs as a result of immune function abnormalities. Age, the presence of disease such as rheumatoid arthritis, or the use of immunosuppressive drugs all are risk factors.
Symptoms of shingles consist of an early prodrome or "time before the storm". A patient will experience flu-like symptoms, headache, and possibly a low grade fever and chills.
Shortly thereafter, the patient will notice an itching, burning, uncomfortable sensation. This discomfort usually takes place on the chest or back, but it may also occur on the abdomen, head, face, neck, or an arm or leg.
Swelling of the lymph nodes near the area of discomfort may also be present.
The next phase after the prodrome is the active phase when the rash appears. The rash is fairly typical in its appearance. It presents as a small area or band of reddish, slightly raised bumps. While the rash can occur in a number of locations as mentioned above, shingles only affects one side of the body. As the rash evolves it becomes blister-like.
Shingles (Herpes Zoster) rash on chest
image by fisle via wikipedia
During this period of time the pain may intensify and if it occurs on the upper back can cause pain radiating into the shoulder blades.
If the rash presents on the forehead or face, the danger is eye involvement which can lead to blindness.
Over a period of days, the blisters open up, ooze, and then begin to crust over. While the healing process can take a few weeks, some patients are left with scarring.
The unfortunate issue is if a patient goes into the chronic phase which is called post-herpetic neuralgia. This is a dreadful complication which may last years. The key symptoms are persistent burning, stabbing pain in the area where the shingles rash was present. Because the pain is chronic and persistent, it interferes with activities of daily living.
One fact is that shingles can occur without producing a typical rash. However, the other symptoms of burning pain are present.
There is a shingles vaccine. It is a live vaccine meaning it contains live virus and shouldn't be given to patients who are on biologic drugs. While the vaccine is not effective for everyone, it is highly recommended for the following situations according to the CDC…
"The vaccine for shingles (Zostavax®) is licensed for use in people 60 years old and older to prevent shingles. The older a person is, the more severe the effects of shingles typically are, so all adults 60 years old or older should get the shingles vaccine."
Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis Treatment Center. For more info: Back Pain Middle Shoulder Blades Special site with free instructive video and transcription on the topic of back pain upper middle shoulder blades.