Shingles is caused by the varicella zoster virus, which is also responsible for chickenpox. It occurs because of a reactivation of the chickenpox virus, which remains in the nerve cells of the body after an attack of chickenpox. Anyone who has had chickenpox can develop shingles. However, people who have never had chickenpox can catch the virus from another person with shingles.

Shingles is a skin rash characterised by pain and blistering. The affected region of skin is often very painful and may even be too sore to have your clothes touching the skin. This is known as allodynia, where normally non-painful sensations become painful due to the sensitisation of the nerve by the virus. The skin turns red and breaks out in tiny fluid-filled blisters.

People who contract chickenpox are at risk of developing shingles later in life, since the virus lies dormant in the body. Shingles can also affect any part of the body, including the face. The rash will sit in the region of skin innervated by the affected spinal nerve. The chest and stomach are most commonly affected areas. The rash can last for a few days or weeks. During that time, a scaly crust might appear. Once the attack is over, the skin usually returns to normal.

Sometimes, the pain doesn’t go away once the shingles rash has cleared. This complication is called post-herpetic neuralgia and is more common when the shingles rash appeared on the face rather than the body. This type of shingles rash tends to affect the skin around the eye and occasionally, the eye itself.

Shingles is not a musculoskeletal condition and is therefore not treatable with physiotherapy. However, we will often see patients presenting with pain which is in fact being caused by the shingles virus. Your physiotherapist will send you directly to your GP for the appropriate medication. Anti-viral medications can help ease the pain and shorten an attack of shingles. The medication works best if administered within three days, and ideally within 24 hours, of the onset of a rash. Fortunately, it is rare to have more than one attack of shingles.