Shingles is a very painful and distressing viral condition which particularly effects the elderly and those with lowered immune systems. Having had to treat this recently prompted me to discuss how acupuncture can help. The herpes zoster virus is reactivated (the original infection is from chicken pox) and attacks a nerve often from root to tip. It usually causes itchy and painful blisters along the course of the nerve leading to excruciating pain and burning. After the herpes rash has disappeared it can leave nerve damage which continues to produce pain and sensory disturbances for a long time. After 3 months since the last blisters disappear if this pain is still continuing then it is called postherpetic neuralgia and is a very distressing complication of shingles. Unfortunately the rate of herpes zoster complications increases with age. If diagnosis is early enough then anti-viral medication can be given, which gives the best prognosis, otherwise drugs are given to manage the pain such as tricyclic antidepressants, certain opioids, and gabapentinoids. These often sedate the person, causing them to sleep most of the time, so impacting significantly on their quality of life.
Acupuncture treatment mirrors the conventional approach of early intervention. The sooner treatment is started, a few days after the blisters are beginning to appear, brings the most positive outcome in terms of lessening the duration and severity of the pain.
The treatment of post herpetic pain has been heavily researched in China with some positive results. The trials are not of great quality though and as usual more research is required (which sadly is unlikely to be any drug company’s priority!). In China acupuncture has been found to hasten the lifecycle of the virus to crust formation (and so resolution) and reduce pain. A shorter lifecycle might mean less long term nerve damage.
Acupuncture is given daily in the acute phase (before 14 days since the appearance of the rash). Needles are placed superficially surrounding the blisters along the course of the nerve (see photo above). Other points will be placed on the body too according to a Chinese Medical diagnosis. Treatment is given daily until pain is reduced or gone and no new blisters are being formed. Usually up to 10 sessions. Then treatment is stopped or frequency reduced depending how the person has responded. The key to success with acupuncture is early treatment. If postherpetic pain has developed, then Gua sha can also be used. This is a press-stroking technique which is applied on the skin along the course of the nerve or pathway of pain. It stimulates the body’s own pain relieving chemicals.
The message here is if you have been ill, had an operation or in some way feel your immune system might be low and you develop a rash – go immediately to your Doctor and get a diagnosis; even press for an emergency appointment if your surgery can only offer you an appointment in a few days time or later. Don’t worry if you think that it may only be an insect bite, chronic nerve pain can be unbearable and not worth the risk.