What Do Shingles Pains and Symptoms Feel Like?

Early treatment can shorten the course of shingles

Patient explaining chest pain to nurse with clipboard
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The pain from shingles can be unlike anything you've experienced. If you get treatment with antiviral medications as soon as you recognize the symptoms, it may reduce the duration of your bout of shingles. Learn what to look for so you can see your doctor early in its course.

Who Is at Risk for Shingles?

If you've ever had chickenpox, you are at risk for getting shingles. The varicella-zoster virus that causes chickenpox remains inactive in your nerve cells.

It can reactivate at any time in life and produce pain and rash along the path of that nerve.

You are more at risk if you over age 50, have a weakened immune system, or have an episode of illness, stress, or trauma. A vaccine is available for those age 60 and older. It can reduce your risk by over half. Most people have shingles only once, but it is possible to get it more than once.

The Early Signs of Shingles Before the Rash

When the virus reactivates, the first symptom is usually pain, appearing two or more days before the rash. The pain is a neurogenic pain. It is described as burning, numbness, tingling, itching, stabbing, or shooting. It is usually sensitive to the touch and the skin in the area may be reddened. You may also have a fever, chills, headache, or an upset stomach.

Early Shingle Pain

The early pain of shingles can range from mild to intense. You may wonder whether you've injured a muscle or whether you're having trouble deeper in your body, such as your heart or kidneys.

The location of the pain is where the rash will later appear. This is typically in a band on one side of the torso, but it can be around one eye or on one side of the face or neck. Shingles around the eye is especially a concern as it can lead to blindness.

One patient describes her early symptoms in this way, "It began with what felt like muscle pain in my right shoulder blade.

It ached, yet I had done nothing to hurt myself. The pain didn't change as I moved my arm around, or twisted my body, so I knew it couldn't be muscle-related. Initially, it didn't hurt enough to bother with a doctor's appointment. However, over the next few days, the pain intensified. It hurt constantly, no matter whether I was standing, walking, sitting or lying down. About five days after my shoulder blade began to ache, the burning began on my back. It felt like a sunburn. The burning didn't replace the ache—it was an addition to the achy pain I felt."

Shingle Rash and Pain

While some people have only the pain, most get a shingles rash that begins a few days after the pain. It usually starts as a reddened band or patch of dots on one side of the body or around the waistline. It develops into a raised, red, itchy rash with fluid-filled blisters. The blisters break open and crust over. When the rash appears, people are more likely to realize it is the shingles and to see their doctor.

The pain continues with the rash. One patient described it, "My back and shoulder blade pain continued to be constant, but the burning and nerve pain could sometimes make the back pain seem trivial. The nerve pain was like an electric fence strapped to my right side that would pulse painful electrical shocks sometimes four to five times a minute."

You are contagious for chickenpox when you have the shingles rash. If anyone around you has not had chickenpox or is not immunized, they can contract it by contact with you. The blisters will usually dry out in a few days but could take weeks.

Treatment for Shingles

Your doctor will usually diagnose shingles based on the rash, or may send a swab to the lab. You may be given antiviral drugs, which are most effective if given within the first three days of symptoms. These can help you heal faster. You can use over-the-counter pain medication such acetaminophen or ibuprofen for the pain. You may also be given drugs to help with severe pain, including capsaicin cream, anticonvulsants such as gabapentin, numbing agents, narcotics, or injections of corticosteroids or anesthetics.

Healing From Shingles

Your pain and rash may last from two to six weeks. However, some people have longer-term pain, a condition called post-herpetic neuralgia. Post-herpetic neuralgia can last from weeks to months, but may last for years. It is rare in people under the age of 40. But it happens a third of the time in untreated people who are over the age of 60.

A Word From Verywell

Early treatment can help shorten the course of shingles, so make an appointment as soon as you can. If you are over age 60 and don't yet have shingles, ask your doctor about the vaccine for shingles so you can reduce your risk.

Sources:

About Shingles (Herpes Zoster). CDC. https://www.cdc.gov/shingles/about/index.html.

Shingles. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/shingles.

Shingles. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/shingles/basics/symptoms/con-20019574.

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