Should I Have a Nerve Block For Shingles Pain?
Most people experience chickenpox as children. When this infection dissipates, the virus causing it (the varicella-zoster virus) remains inactive in your body. Years later, the virus can reactivate, causing shingles.
If the pain produced by shingles persists months after the blisters have dried, you may be experiencing shingles pain, also known as postherpetic neuralgia (PHN). This happens when shingles damage the nerves, producing intense, persistent pain. Some people turn to nerve blocks for shingles pain.
Anyone who’s had chickenpox can develop shingles, but PHN is not common. About 20% of people with shingles develop PHN.
The virus can “wake up” if your immune system weakens. This can happen as you age. That’s the reason most patients with PHN are over 50.
Facts About Shingles Pain
After shingles go away, the blisters can remain for several weeks. In most cases, the pain lasts for about a month. We consider you have PHN if the pain lasts for over 2 months.
PHN is caused by residual stimulation of the nerves. Without treatment, shingles pain can last for weeks, months, and even years.
Options include nerve blocks—injecting a local anesthetic–, and thoracic epidural injections–an anti-inflammatory medicine.
Treating Shingles Pain With Nerve Blocks
Depending on your case, one of our pain specialists may recommend using nerve blocks for shingles pain. This is a non-invasive procedure consisting of injecting a local anesthetic to reduce acute pain around a nerve or group of nerves, shortening the duration of PHN. Most patients find this procedure very effective.
Other treatment options for postherpetic neuralgia include radiofrequency ablation and the use of medication.
Important Facts About Nerve Blocks
Also used to diagnose what is causing pain, by analyzing your reaction to nerve blocks.
Non-surgical nerve blocks take only a few minutes. You don’t require any preparation.
FAQ About Nerve Blocks
How do nerve blocks work?
Nerve blocks, or neural blockades, are injections we use to deliver pain medication directly into the affected nerves, stopping pain signals from getting to the nervous system. They are used to both diagnose and treat pain.
There are several types of nerve blocks depending on the area that’s being treated. We can use this procedure to treat pain in different parts of the body. They are useful in managing both chronic pain conditions and short-term pain, allowing people to improve their quality of life.
What types of nerve blocks can alleviate shingles pain?
Intercostal nerve blocks for shingles pain: Intercostal nerves are located below the ribs, going from the back (in the spinal cord) to the chest (in the sternum). In our pain clinic, we often treat pain conditions affecting this area, like PHN, with intercostal nerve blocks. These nerve blocks help alleviate the pain, stimulate circulation, and reduce inflammation in the area.
Sympathetic nerve blocks: Different types of sympathetic blockades can be applied depending on the affected area: lumbar sympathetic block (legs and feet), stellate ganglion block, and sphenopalatine block (head and neck).
Trigeminal nerve blocks: The trigeminal nerve is located in the face. Although not common, sometimes shingles affect the face. When this happens, we can use trigeminal nerve blocks to help alleviate shingles pain in the area.
How can nerve blocks alleviate shingles pain?
Non-surgical nerve blocks act by stopping the nerves from sending pain signals to the brain. They don’t treat the underlying causes of shingles (the varicella-zoster virus) but they do help ease the pain and even prevent PHN before it occurs, by numbing the affected area.
Nerve blocks are a safe shingles pain treatment option. It allows patients to go back to their normal life and to the activities that they enjoy.
Am I a good candidate for nerve blocks?
People who’ve had pain for several months and haven’t responded to traditional therapies (like over-the-counter and prescription medications) are usually good candidates for nerve blocks.
Nevertheless, you should inform your doctor if you are allergic to any medication; if you are pregnant, have an active infection, have diabetes or heart disease, or if you are taking blood-thinning medication.
Can I use nerve blocks to prevent shingles pain?
The early use of nerve blocks may prevent PHN and avoid nerve damage in the affected areas. To prevent shingles pain, a specialist must perform several nerve blocks during the shingles phase. This, however, should be discussed with a shingles pain doctor.
How effective are nerve blocks in treating shingles pain?
Nerve block therapy is one of the safest and most effective strategies to treat shingles pain. The effects vary from patient to patient and depend on the type of nerve block.
Nevertheless, remember your doctor must analyze your case before deciding which is the best treatment for you. At our pain center, one of our specialists will create a comprehensive pain management plan for you depending on your personal needs.
Do nerve block injections require any preparation?
Your doctor will give you instructions before the nerve block procedure, which you must follow.
These may include:
- Stop taking blood-thinning drugs, like Aspirin, at least 10 days before the injection. Remember, you should always inform your doctor if you are taking this type of medication.
- Avoid taking anti-inflammatory medicines, such as ibuprofen, 24 hours before the nerve block.
- Ask someone to take you home after the procedure.
- On the day of the Injection, you must be free of infections, such as the flu. Let your doctor know if you have any symptoms (like fever or rashes) so you can reschedule the procedure.
Remember to stick to this and other recommendations your doctor gives you. This is very important for the success of the treatment and to avoid potential complications.
What will I experience during the procedure?
The pain specialist will administer a local anesthetic before injecting the nerve block.
This procedure involves inserting a thin needle directly into the area where the nerves are located. The doctor may also use imaging aids so they can administer the nerve block as efficiently and quickly as possible.
You will feel a “pinch” and a minor discomfort when the needle enters your skin. However, normally the fear of the procedure is worse than the procedure itself. The level of discomfort depends on how deep the needle is inserted.
What to expect after a nerve block procedure?
It takes about 30 minutes to recover from this procedure, then you will return home. You may experience soreness after the injection, so the doctor may prescribe you some over-the-counter medication. You can also apply ice to the area to treat this.
You’ll need to ask someone to drive you home since you won’t be able to. The doctor may ask you to rest for some hours, but you will be able to return to your normal activities the next day.
How long do nerve blocks last?
We typically perform the nerve block procedure on an outpatient basis, which and takes about half an hour.
Usually, the nerve blocks last from a few days to several weeks, depending on the type of nerve block. Some patients may need several nerve blocks in different sessions.
Which are the risks and side effect of nerve blocks?
Nerve blocks are very safe but they do involve some side effects, which are usually mild. You may experience some discomfort and bruise at the site of the injection.
Potential complications of nerve blocks include:
- Infection in the injected area
- Allergic reactions to the injected medication
- Nerve damage
- Blocking the wrong nerve
- Spread of the medication to other nerves
Medication is unintentionally injected into the bloodstream
You can reduce the risk of developing complications by getting this procedure administered by a certified pain specialist. If you are considering having this or any other pain procedure, we can help you at Premier Pain Clinics.
What treatment options are there for shingles pain?
In severe cases, PHN can be hard to treat using only medication. That’s why the most effective treatments are comprehensive. You may need a mix of traditional therapies, such as medication, with interventional procedures.
Besides nerve blocks, some of the interventional therapies for postherpetic neuralgia that we perform at Premier Pain Clinics are:
Radiofrequency ablation (RFA). This therapy consists of using radio waves to heat specific groups of nerves. This stops them from sending pain signals to the brain.
Spinal cord stimulation (SCS). Involves a small device that we implant under the skin during a minimally invasive procedure. This device “masks” pain signals using mild electrical currents. You can control this system using a remote control.
Medication for shingles pain management typically involves narcotic pain-control and nonsteroidal anti-inflammatory medications, antidepressants, anticonvulsants, and/or topical corticosteroids, among others.
At Premier, one of our pain specialists can guide you so you can find the best treatment plan for you and recover your quality of life.