How can shingles be treated?

Question

Hello doctor,

My mom has a pretty severe case of shingles. Starting on the left side mid back and goes around to the belly. She has been prescribed Pregabalin and it is not helping, they tried Gabapentin and she has bad side effects from it. We have tried compounded pain ointments, ice, cool water, etc. Nothing is helping. She is 74 with late stage COPD, diabetic and has osteoporosis severely as well. Is there anything else we can do to try to ease her pain. She is bellowing out in pain every 5 minutes.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Shingles or Herpes Zoster, occurs due to the reactivation of the chickenpox virus (Varicella-Zoster Virus, VZV), which remains dormant in the spinal nerve ganglia after childhood infection. Reactivation can occur in cases of immunosuppression or old age, leading to a rash that follows a nerve pathway in a girdle-like fashion.

It typically begins with fluid-filled lesions (vesicles) that heal within up to 2 weeks, but nerve damage (neuropathy) may cause severe pain (postherpetic neuralgia, PHN) that can persist for an extended period.

I hope there are no active fluid-filled lesions (vesicles). If present, kindly send a photo and renal function test (RFT) report.

Treatment

Pregabalin SR (Sustained Release) 25 mg + Methylcobalamin 1500 mcg tablet twice daily.
Capsaicin or Lidocaine patch for local pain relief.
Tramadol (opioid analgesic) tablet if pain is severe (SOS – si opus sit, meaning "if needed"), maximum once daily.
Calamine lotion applied three times daily.

Review after 4 weeks. Shingles pain can sometimes be resistant to treatment, and if necessary, other options like intraspinal steroid injection or botulinum toxin (Botox) injection may be considered.

I hope this helps.

Revert with the answer to assist further.

Thank you and take care.