What Is the Shingles Virus?

When it comes to identifying types of pain, there are two types: acute and chronic. Acute pain comes on quickly and can be severe, but only lasts a relatively short time. It is typically experienced after an injury or trauma, and self-resolves.

Unlike acute pain, chronic pain is pain that lasts for a long time, and doesn't seem to get better or go away. This time period can vary but is typically defined as a three- to six-month period after symptoms begin. Chronic pain is often a debilitating symptom of many diseases and is considered a disease itself when it persists beyond recovery from an injury or illness. Chronic pain is a frequent component of many neurological disorders.

Pain warns you that something is not quite right in your body and can cause you to take certain actions and avoid others. Pain can significantly affect your quality of life—by adversely affecting your physical and emotional well-being; upsetting relationships with family, coworkers and friends; and limiting your mobility and participation in daily activities.

Hundreds of pain syndromes or disorders make up the spectrum of pain. One cause of pain is shingles. Shingles, also called herpes zoster, is a disease that triggers a painful skin rash. It is caused by the same virus as chickenpox, the varicella-zoster virus. After you recover from chickenpox (usually as a child), the virus continues to live in some of your nerve cells. Postherpetic neuralgia results from nerve fibers getting damaged during an outbreak of shingles.

For most adults, the virus is inactive and never leads to shingles. But, for about one in three adults, the virus will become active again and cause shingles. Postherpetic neuralgia is pain that lasts in the areas of the skin where you had shingles.

Types of Shingles

In addition to postherpetic neuralgia, shingles, or herpes zoster, can lead to serious complications involving the eye, including vision loss.

The shingles rash can also become infected with bacteria. Very rarely, shingles can also lead to:

  • Infection of the lungs (pneumonia)
  • Hearing problems
  • Brain inflammation (encephalitis)
  • Death

Cause of Shingles

Shingles is caused by the same virus as chickenpox, the varicella-zoster virus. After you recover from chickenpox (usually as a child), the virus continues to live in some of your nerve cells. The virus can reactivate later in life and cause shingles. Most people who develop shingles only have it one time during their life. However, you can have shingles more than once.

Everyone who has had chickenpox is at risk for developing shingles. Researchers do not fully understand what makes the virus become active and cause shingles. But some things make it more likely:

  • Older age. The risk of developing shingles increases as you age. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70.
  • Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can HIV, cancer, cancer treatments, too much sun, and organ transplant drugs.
  • Stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles.

Most people only have shingles one time. However, it is possible to have it more than once.

Screening for & Preventing Shingles

The most promising prevention of shingles is a vaccine. The current shingles vaccine (brand name Shingrix) is a safe, easy and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90 percent effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctor’s office and at some pharmacies.

You should get the shingles vaccine if you:

  • Have already had chickenpox, the chickenpox vaccine or shingles
  • Received the prior shingles vaccine called Zostavax
  • Don’t remember having had chickenpox

Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.

You should not get vaccinated if you:

  • Currently have shingles
  • Are sick or have a fever
  • Had an allergic reaction to a previous dose of the shingles vaccine

If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.

Signs & Symptoms of Shingles

Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.

Most people with shingles have one or more of the following symptoms:

  • Fluid-filled blisters
  • Burning, shooting pain
  • Tingling, itching or numbness of the skin
  • Chills, fever, headache or upset stomach

For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. It’s important to talk with your doctor if you notice any shingles symptoms.

If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain (encephalitis) can also occur.

Diagnosing Shingles

If you think you might have shingles, talk to your doctor as soon as possible. It’s important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test.

Treating Shingles

Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.

Most cases of shingles last three to five weeks.

  • The first sign is often burning or tingling pain; sometimes it includes numbness or itching on one side of the body.
  • Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
  • A few days later, the rash will turn into fluid-filled blisters.
  • About one week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs clear up.

Living with Shingles

Most cases of shingles last three to five weeks.

  • The first sign is often burning or tingling pain; sometimes it includes numbness or itching on one side of the body.
  • Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
  • A few days later, the rash will turn into fluid-filled blisters.
  • About one week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs clear up.

After the shingles rash goes away, some people may be left with ongoing pain called postherpetic neuralgia, or PHN. The pain is felt in the area where the rash occurred. The older you are when you get shingles, the greater your chances of developing PHN.

The PHN pain can cause depression, anxiety, sleeplessness and weight loss. Some people with PHN find it hard to go about their daily activities, such as dressing, cooking and eating. Talk with your doctor if you are experiencing PHN or have any of these symptoms. Usually, PHN will lessen over time.