Shingles & Post-herpetic neuralgia

Shingles can be one of the most painful illnesses.   It begins somewhat innocuously with a general malaise of fever, headache and fatigue but is soon followed by intense stinging and burning pains arising on the skin.  This is usually accompanied by local itching, skin hypersensitivity or tingling.  The outbreak is localized to a specific belt-like strip of skin on one side of the body.  It can be on the torso, chest and or back, on the head or face even extending into the eyes, or else in the arms or legs.

Sometime between a few days to a few weeks later, along with the continuing pains a rash appears.  Three are small fluid filled blisters that over time will dry up, crust over and fall off.

Formally known as ‘herpes zoster’ (‘zoster’ meaning a belt or girdle), this affliction is caused by the varicella zoster virus VZV), which is the same virus that causes chickenpox.  Although in the same family, it is distinct from the herpes simplex virus that causes oral and genital herpes.

Chicken pox is actually the result of the initial infection of VZV.  After this phase has resolved, the virus doesn’t leave the body but goes dormant, residing in nerve cells along the spine.  When reactivated, it appears as shingles traveling down the axon of the nerve into the area of the body (or ‘dermatone’) that the nerve covers.  This accounts for the belt-like appearance as well as the one sidedness.  The virus can also spread from one nerve to others, causing corresponding symptoms in other dermatones.

While shingles is quite painful it is usually a self-limiting illness, typically running its course in about a month.  But, for some people, estimates run at about 15% of those who develop shingles, the symptoms do not fully resolve after the initial rash disappears, instead evolving into a chronic syndrome of pain known as ‘post herpetic neuralgia’ that can last for months or years afterward.

While the cause for the reactivation of the VZV into shingles is not fully known, the single most important correlation is advancing age.  About 1 to 3 persons per 1000 develop shingles yearly, but this figure rises to somewhere between 4 to 11 per 1000 for those over the age of 65.  It is thought that deteriorating immunity against the virus is the chief reason that it reappears later in life as zoster.  Exposure to toxins and mechanical injury, along with significant stress – all of which also affect the immune system, can be a factor.  Shingles cannot be ‘caught’ by being exposed to someone suffering from it (although one can catch chickenpox from contact with shingles eruptions).

Interestingly, since the late 1990’s there has been a 90% increase in the occurrence of shingles in adults.  Not coincidentally, since 1995 a massive chicken pox vaccination campaign was initiated nationwide.  It is logical to surmise that the resulting suppression of active chicken pox in children has deprived the adult population with the exposure to the virus that kept the immunity against it strong.  (This is similar to the idea that widespread overuse of antibacterial soaps and handwipes deprives children from developing strong immunity against various bacteria.)

Since that point in time, there has also been an increase in children developing shingles – a phenomenon that almost unknown previously.  Of course, the pharmaceutical industry is copasetic with these developments because it allows them to role out yet another salable product – the shingles vaccine.   It is also worthwhile to mention that the chickenpox vaccination itself does not proffer immunity against shingles.

Conventional treatment of shingles is quite limited and certainly not curative, especially when it comes to post-herpetic neuralgia.  In the acute phase, anti-viral drugs such as acyclovir are prescribed with the goal of reducing the length of the illness.  They generally have little effect in terms of either preventing or treating the chronic neuralgia.  Once the illness has entered that phase, various topical medications, pain medications including narcotics, anti-depressants and even nerve-block surgery are the standard, but not very successful treatment.

Fortunately, homeopathic medicines provide a consistently effective approach in the treatment of shingles.  There are nearly 100 remedies that have been successfully prescribed for both the acute phase and post-herpetic neuralgia – and those are just the ones found in the standard literature.

The selection of a particular medicine is based on what are called the ‘characteristic’ or individuating symptoms experienced by the patient.   For instance, on what side of the body the rash appears, what time of the day are the pains better or worse, or whether heat or cold in the form of a shower or room temperature increases or decreases the pain.   The appearance of the rash itself as well as the emotional state also provides important information for choosing the remedy.

As an example, Ranunculus bulbosa – the bulbous Buttercup so common to our woods, is one of the most commonly prescribed remedies for acute and chronic neuralgia.  Ranunculus has a strong affinity for the nerves.  It is indicated when the zoster appears on the torso or chest, especially when it is preceded or followed by pain between the ribs.  The Ranunculus rash is characterized by blister-like vesicles with a dark bluish appearance.  There is with great itching and burning.  These patients tend to be chilly and feel better with warm applications and rest.  They also can be quite irritable, easily to start a quarrel but yet they generally do not like to be alone.

Each case of shingles, when carefully diagnosed, will yield similar specific details that allows for the successful selection of a remedy individualized to the symptoms – and more importantly, to the person.