Shingles: Pain Management and Effective Treatments

Herpes Zoster

Hello Dr.
Tsai,
Recently, I developed shingles on the inner side of my left arm and on my back, which are localized to small areas.
The pain has become unbearable, so I visited a dermatologist.
After taking the medication, although the lesions feel somewhat improved (with slight reduction in swelling), the neuropathic pain symptoms have not improved at all, and I am still in so much pain that I cannot sleep.
The doctor told me that the medication he prescribed would completely eliminate the symptoms within three days, but it doesn't seem to be that effective.

I have attached the names of the medications and would like to ask Dr.
Tsai about the functions and effects of the following medications:
1.
Acyclovir 400 mg
2.
Brufen 100
3.
Tozy
4.
Keamalin
Additionally, how can I improve the condition of the neuropathic pain? Thank you.

Nique, 20~29 year old female. Ask Date: 2005/07/19

Dr. Huang Ruiyun reply Dermatology

Shingles will take about a month to heal, not just three days.
Acyclovir is an antiviral medication for herpes viruses.
Brufen is a pain reliever.
Tozy is another type of pain medication.
Kearnalin or Keamalin? There is no record of such a medication name.
If the pain persists, consult a doctor again to adjust the medication.

Reply Date: 2005/07/19

More Info

Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain dormant in the nerve tissues and may reactivate later in life, leading to shingles. The hallmark symptoms of shingles include a painful rash that typically appears on one side of the body, often accompanied by severe nerve pain known as postherpetic neuralgia (PHN).

In your case, it seems that you are experiencing significant pain associated with your shingles outbreak, which is not uncommon. The pain can be debilitating and may persist even after the rash has healed. Let's discuss the medications you mentioned and their roles in managing shingles and associated pain.

1. Acyclovir 400 mg: This is an antiviral medication that is commonly prescribed to treat shingles. Acyclovir works by inhibiting the replication of the varicella-zoster virus, which can help reduce the severity and duration of the shingles outbreak. It is most effective when started within 72 hours of the rash appearing. While it can help with the rash and reduce the risk of complications, it may not directly alleviate the nerve pain associated with shingles.

2. Brufen 100 (Ibuprofen): This is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation and relieve pain. It can be effective for managing mild to moderate pain associated with shingles. However, if your pain is severe, you may need additional pain management strategies beyond NSAIDs.

3. Tozy (Gabapentin): Gabapentin is often used to treat nerve pain, including pain from shingles. It works by stabilizing electrical activity in the brain and affecting the way nerves send messages to the brain. Gabapentin can be particularly helpful for managing postherpetic neuralgia, and it may take some time to find the right dosage to effectively manage your pain.

4. Keamalin (Pregabalin): Similar to gabapentin, pregabalin is another medication used to treat nerve pain. It is often prescribed for conditions like neuropathic pain and can be effective for shingles-related pain as well. Pregabalin works by inhibiting certain calcium channels in the nervous system, which helps to reduce the release of neurotransmitters involved in pain signaling.

In addition to these medications, there are several strategies you can consider to help manage your nerve pain:
- Topical treatments: Capsaicin cream or lidocaine patches can provide localized pain relief for nerve pain. These treatments can be applied directly to the affected area.

- Physical therapy: Engaging in physical therapy may help improve mobility and reduce pain through targeted exercises and modalities.

- Pain management specialists: If your pain persists, consider consulting a pain management specialist who can offer additional treatment options, including nerve blocks or other interventional procedures.

- Stress management techniques: Practices such as mindfulness, meditation, and relaxation techniques can help manage the psychological aspects of chronic pain.

- Adequate sleep: Since pain can interfere with sleep, focusing on good sleep hygiene can help improve your overall well-being and pain tolerance.

It's essential to communicate openly with your healthcare provider about your pain levels and the effectiveness of your current treatment plan. They may need to adjust your medications or explore additional therapies to help you find relief. Remember that managing shingles and its associated pain can take time, and a comprehensive approach is often necessary for effective treatment.

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