Shingles pain can start before the rash appears

Nerve pain, not a rash, is often the first sign of shingles, according to local medical experts.

Gerontologist Sam Cradduck said the condition starts with intense burning in the body. She described the sensation as comparable to a severe toothache traveling along a nerve pathway. Cradduck experienced shingles twice, and both episodes were linked to an autoimmune condition.

The pain follows a specific path known as a dermatome. Dr. Rhea Rogers, a board-certified physician, explained that the discomfort does not appear in random spots. Instead, it maps out the route of a single nerve. Patients can trace the pain to identify the affected area.

The rash itself is distinctive. Cradduck described her rash as very red, almost fiery, and close to the skin. Her second outbreak followed the same nerve pathway as the first but caused less pain. The shingles virus is the same virus that causes chickenpox. It remains dormant in the body and can reactivate later.

Amy O'Rourke, an aging expert, advocates for the shingles vaccine. The vaccine consists of two shots. O'Rourke noted that some patients forget to receive the second dose. Rogers said the vaccine does not eliminate the virus, but it can make symptoms much milder if the virus reactivates.

Age and overall health influence the risk of shingles. Rogers stated that the immune system becomes less effective as people get older. Stress and autoimmune diseases can also compromise the immune system, making it harder for the body to fight off reactivation.

Shingles can cause long-term damage. O'Rourke cited a friend who suffered from shingles and ended up with persistent eye nerve pain. The friend now takes medication to manage the nerve pain. O'Rourke described the condition as potentially long-term and damaging.

Cradduck uses an analogy to explain how shingles works. She compares the dormant virus to a bad houseguest living in an attic. The virus occasionally comes out to cause havoc in a single hallway, which represents a nerve path. It then returns to the attic. The virus can choose a different nerve path during future outbreaks.

A strong immune system suppresses the virus. Rogers said a healthy immune system prevents the virus from coming out. She recommended minimizing inflammation to keep the immune system strong. She pointed to basic health habits such as sleep and proper nutrition as key factors in maintaining immune health.