129: Shingles & Post Herpetic Neuralgia (PHN)

Airing Pain

Determining what Shingles really is and why vaccine uptake is so low?

This edition of Airing Pain has been funded by a grant from The RS Macdonald Charitable Trust and The Stafford Trust

What exactly is Shingles? We often hear it thrown into conversation alongside a virus many of us have already had: Chickenpox. So how are the two linked? Why is one more associated with young people and the other with older people? The answer is they are both infections caused by the varicella-zoster virus. The vast majority of us had the Chickenpox virus when we were children, with many parents even intentionally exposing their children to the virus. Shingles, on the other hand, occurs after someone has already had Chickenpox when the virus (which remains in the body) is reactivated.

One of the main worries people have about having Shingles is the potential to develop Post Herpetic Neuralgia (PHN). This is defined as persistent pain 3 months after the initial rash developed. Unfortunately PHN is a chronic condition which causes burning neuropathic pain. This condition is caused by the damage the virus inflicted during its reactivation.

Paul Evans speaks to health professionals and somebody with lived experience of Shingles & PHN in order to illuminate the intricacies of the varicella-zoster virus, how it works and how it affects us throughout our lives.

Time Stamps

1:55 - Dr Michael Serpell speaks: What is Shingles and how does it affect us?
6:15 - Dr Robert Johnson speaks: What is Post Herpetic Neuralgia (PHN)?
11:35 - Jan Fisher, who has lived with PHN for 8 years, speaks about her experience.
14:55 - Marian Nicholson from the Shingles Support Society speaks: Shingles awareness, treatment & what to do if you think you have Shingles?
16:55 - Dr Robert Johnson speaks about treatment for Shingles & PHN.
20:05 - Jan Fisher elaborates on her own experience of medication for PHN.
21:25 - Dr Michael Serpell on what you can expect from PHN treatment & pain management techniques.
26:10 - Dr Robert Johnson discusses the Shingles vaccination.
26: 45- Marian Nicholson speaks about the rollout of the Shingles vaccination and who is eligible.
27:45 - Dr Robert speaks about the low uptake of the vaccine and why it's important to get it.
33:11 - Dr Robert Johnson on amitriptyline and studies on preventing PHN.
35:15 - Final words from Jan Fisher on why you should get the Shingles vaccine.

Issues covered in this programme include: Shingles, Chickenpox, varicella-zoster virus, neuropathic pain, Post Herpetic Neuralgia, pain management, virus reactivation, insomnia, vaccination, vaccine uptake, side effects, amitriptyline, Gabapentinoids, depression.

Contributors:

• Dr Michael Serpell, Consultant in Anaesthesia & Pain Medicine at Stobhill Hospital Glasgow.
• Marian Nicholson, Director of the Herpes Viruses Association & Shingles Support Society.
• Dr Robert Johnson, Honorary Senior Research Fellow, Bristol Medical School, University of Bristol.
• Jan Fisher, had the Shingles virus & lives with Post Herpetic Neuralgia.

More information:

• Shingles Support Society
• Airing Pain 46: Post-Herpetic Neuralgia and Migraine
• Airing Pain 115: Neuropathic Pain 1
• Airing Pain 116: Neuropathic Pain 2
• Pain Concern’s leaflet on Neuropathic Pain
• Herpes Viruses Association
• NHS Guidance for Shingles
• British Pain Society
• IASP Global Year Against Neuropathic Pain 2014-15