Shingles is a very painful skin rash that can often leave patients in pain long after the rash itself has cleared. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you have had chickenpox, the virus becomes dormant and lies – inactive – in your nervous system. Later in life, certain triggers can cause the virus to become active again, and this is when shingles occurs. Because the virus lies dormant in the nerve roots, the red and painful shingles rash appears along a specific nerve pathway – usually in a defined band on one side of the body – the head and torso are common places that people experience a shingles rash.
As with so many pain conditions, acupuncture and Chinese Herbal Medicine can be a very effective therapeutic treatment for symptoms of shingles or post-herpetic neuralgia.
What triggers shingles?
Basically, anything that weakens the immune system can cause the varicella zoster virus to become active again. This means that stress, prolonged periods of lack of sleep, aging, or other chronic illness make shingles more likely. This is another example of why maintenance care is so important – we all have viruses and other pathogens that can flare up when we don’t take care of ourselves. Eating well, getting enough sleep, exercising, and getting regular acupuncture and massage can go a long way to preventing episodes of shingles or other common illnesses.
What are the symptoms of shingles?
When someone first comes down with shingles, they often experience flu-like symptoms such as headaches and body aches. Then they will experience itching, numbness, tingling, or pain along the band where the rash will then appear. The rash is usually red and raised and will eventually form painful blisters that will fill with fluid and then crust over. During this time, acupuncture can be used to deal with the symptoms of itching and pain, and help limit the duration of the rash. Chinese Herbal Medicine can also be used during this time to expel the pathogen from the body, limiting the duration and severity of symptoms substantially. Chinese Herbs are especially good for the symptoms of itching and pain with the shingles rash.
What is post-herpetic neuralgia?
In about 20% of patients, the pain along the nerve pathway continues after the shingles rash has cleared (usually 2-4 weeks). This enduring pain comes from damage or irritation of the nerve itself, and the nerve sends faulty pain signals despite there not being an impetus for the pain. This pain is often described as burning, searing, or stabbing. It is an intense form of pain that is often treated with prescription pain medication and/or tricyclic antidepressants. Acupuncture can also be helpful in moderating the intensity of this pain. As with any treatment, the acupuncture will be most effective when treatment begins as soon as possible following the shingles rash – once the body has learned to be in pain for many months, those patterns are harder to undo.
This is an area where more clinical research is needed. There are not many high-quality studies that look at the effects of acupuncture on postherpetic neuralgia pain specifically. The Cochrane Collaboration is working on a review of neuropathic pain in adults, which will hopefully shed some light on this topic from a biomedical perspective. For now, we can go off of the clinical experience and observations of thousands of acupuncturists over thousands of years.
Acupuncture is documented to lessen many forms of chronic pain, and we use the same principles when presented with residual pain from shingles. Treatments for post-herpetic neuralgia are often multi-faceted – we treat the local area and site of pain, and also treat acupuncture points on the same channels located farther away from the site of pain. We also frequently stimulate points right next to the spine which control the nerve pathway along which the shingles pain is located. The image to the right shows the “dermatomes” which are the pathways controlled by each nerve root. We can incorporate this understanding of the body into our acupuncture treatments to approach the pain from multiple levels, understandings, and directions. Standard acupuncture and electro-acupuncture are often combined to achieve the best results.