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Shingles can cause tingling or pain in one patch of skin on one side of the body
A tingling or painful feeling in one patch of skin can be the first sign of shingles, an infection that causes a painful rash [1]. The rash usually appears a few days later [1].
Key points
- Shingles often starts with tingling or pain in one area of skin, and a rash usually follows a few days later [1].
- The rash appears on one side of the body only, and a rash on both sides is unlikely to be shingles [1].
- Medicine for shingles works best when started within 3 days of the rash appearing [1].
- Shingles near the eye can affect sight, and eye problems from shingles can lead to sight loss [1].
- Nerve block injections for chronic pain are supported mostly by case reports and retrospective studies [2][3].
Shingles can start as tingling or pain before any rash shows
Shingles is an infection that causes a painful rash. It often begins with a tingling or painful feeling in an area of skin, and the rash usually appears a few days later [1]. In rare cases, shingles causes pain without any rash [1].
- The rash shows up as blotches on one side of your body only [1].
- The blotches become itchy blisters that ooze fluid, then dry out and scab a few days later [1].
- It usually appears on the chest and belly, but it can show up anywhere, including the face, eyes and genitals [1].
- The rash can look red, but redness is harder to see on brown and black skin [1].
- A rash on both the left and right sides of your body is unlikely to be shingles [1].
Shingles comes from the chickenpox virus. After chickenpox, the virus stays in the body and can reactivate later if your immune system is weakened [1]. Stress, certain conditions and treatments such as chemotherapy can be the reason [1].
When to get care
Shingles in some people calls for prompt medical attention
If you think you have shingles, get advice as soon as possible [1]. Treatment started early can reduce the risk of complications [1].
- If you have a severely weakened immune system, for example from chemotherapy, shingles needs prompt medical attention [1].
- If you are breastfeeding and the rash is on your breasts, shingles needs prompt medical attention [1].
- If you are pregnant, shingles is mostly mild with usually no risk to you or your baby, but a doctor should arrange for a specialist to advise on treatment [1].
A rash in and around the eye can make it sore and red, and it can affect your sight or hearing [1]. It can also make it hard to move one side of your face [1]. Eye problems from shingles can lead to sight loss [1].
If you think you may have a medical emergency in the United States, call 911 or go to the nearest emergency room.
Antiviral medicine for shingles works best within 3 days of the rash
If you are 18 or older with shingles symptoms, try to see a pharmacist within 3 days of the rash appearing. Medicine can speed up recovery and help avoid longer-lasting problems [1]. A pharmacist can give antiviral medicines and direct you to other medical help if needed [1].
Not everyone needs medicine. A mild rash may need no treatment [1]. Antiviral tablets may be offered if your pain or rash is moderate or severe, or if the rash affects areas other than your chest, belly and back [1]. Treatment can also include painkillers, steroid tablets or medicines for nerve pain [1].
| Complication | What it means |
|---|---|
| Long-lasting nerve pain | Pain continues for several months after the rash has gone [1] |
| Skin infection | The rash becomes infected and may need antibiotics [1] |
| Scarring | Scars or skin color changes can remain after healing [1] |
| Eye problems | These can lead to sight loss [1] |
| Ramsay Hunt syndrome | A rare condition where shingles affects the facial nerve, causing weakness on one side of the face and sometimes hearing problems [1] |
Most people recover without problems [1]. Getting treatment as soon as possible after symptoms start can reduce the risk of complications [1].
Home care can ease shingles symptoms while the rash heals
- Keep the rash clean and dry to reduce the risk of infection [1].
- Use a cool compress a few times a day, such as a wet cloth or frozen vegetables wrapped in a towel [1].
- Do not let dressings stick to the rash [1].
- Avoid clothes with rough fibers that can irritate your skin [1].
The rash can take up to 4 weeks to heal. Your skin can stay painful for weeks after the rash has gone, but it usually gets better over time [1].
Protecting others
You cannot give someone shingles, but a person who has not had chickenpox or the chickenpox vaccine could catch chickenpox from you [1]. You can only pass it on while the rash oozes fluid, so cover it with loose clothing or a non-sticky dressing [1]. Stay away from anyone pregnant who has not had chickenpox and from people with a weakened immune system [1].
The shingles vaccine helps reduce your risk, and symptoms can be much milder if you get shingles after vaccination [1]. You can get shingles more than once, so vaccination still matters after an episode [1].
Nerve blocks and needle therapies for nerve pain have limited evidence
Nerve blocks are part of the management of chronic pain [2]. The erector spinae plane block was first described in 2016 for thoracic nerve pain [3]. A review found some support for it, usually with steroids, as part of care for long-lasting chest wall and abdominal pain [2].
The evidence is thin. It comes mostly from case reports and retrospective studies, with few randomized trials [4][2][3]. In one pooled review of 242 reported cases, one adverse event was reported [3].
| Approach | Evidence |
|---|---|
| Erector spinae plane block | Mostly case reports, few randomized trials, unclear spread of the medicine [4][3] |
| Fire needle therapy for shingles pain | A pooled analysis of 25 studies found lower pain scores and fewer cases of long-lasting nerve pain [5] |
In the fire needle analysis, adverse events were not mentioned in all of the included studies [5]. The analysis also notes that publication bias has not been taken seriously [5].
Trigeminal neuralgia shows how a compressed nerve can cause sharp facial pain
Trigeminal neuralgia causes sudden, severe pain like an electric shock in the jaw, teeth or gums, usually on one side of the face [6]. Attacks last from a few seconds to about 2 minutes [6].
It is usually caused by a blood vessel pressing on the trigeminal nerve inside the skull [6]. Light touch, such as washing or brushing teeth, can trigger attacks [6]. Carbamazepine is usually the first treatment recommended [6].
Sources
- Shingles nhs.uk
- Utilization of Truncal Fascial Plane Nerve Blocks for Chronic Pain Management: A Narrative Review Current pain and headache reports
- The erector spinae plane (ESP) block: A pooled review of 242 cases Journal of clinical anesthesia
- Erector Spinae Plane Block for Pain Management in Pediatric Urologic Surgeries: A Narrative Review Current pain and headache reports
- [Systematic review and sequential analysis on treatment of herpes zoster pain mainly by fire needle therapy] Zhen ci yan jiu = Acupuncture research
- Trigeminal neuralgia nhs.uk
Not medical advice. This page is general education written from the sources above. It cannot diagnose a condition or replace a licensed clinician who knows your history. If you may be having an emergency, call your local emergency number or go to the nearest emergency department.