In the second article in this series on acupuncture we will be looking at shingles, a very painful and debilitating condition for many people, and I will explain how acupuncture is a key treatment in healing an outbreak. Last time, I gave a brief overview of acupuncture, its history and how it works.
Most of us know someone who has experienced a shingles outbreak – the sudden feeling of fatigue or flu-like symptoms followed by a painful, itchy rash with small fluid filled blisters. Shingles is caused by the Varicella Zoster virus, a herpes virus that also causes chicken pox.
Shingles can develop only from a reactivation of the varicella zoster virus in someone who has previously had chicken pox. In other words, shingles itself is not transmitted from one person to another; in order to get shingles you must first have a chicken pox infection. Once it enters the body, the varicella virus can live dormant in nerve cells for years and, given the right trigger, can be reactivated leading to a painful outbreak of shingles.
Shingles is most often diagnosed by sight because of its distinctive rash of small, fluid-filled blisters that occur in a stripe (called a dermatome) anywhere on the body, usually only on one side. It is a condition I often treat with acupuncture.
What Causes Shingles?
Stress and a weakened immune system are the perfect triggers for a shingles outbreak. Most people get their first outbreak either after a prolonged period of stress which suppresses the immune system or after a major illness which makes it work very hard. In both cases, the end result is the same for those who carry the varicella virus – the virus, that has been dormant for many years, suddenly has an opportunity to become active and cause a shingles outbreak.
The first sign of an outbreak is painful or tingling skin a few days before the rash appears. Then, once the rash and blisters appear, it takes about 2-4 weeks for the rash, blisters, fatigue and pain to go away. In most cases, the rash and blisters will resolve and people may never have another outbreak. However for some, the nerve pain can continue for months or even years and can go on to cause what is known as ‘post-herpetic neuralgia’ – or nerve pain. Long after there is any sign of the virus, people may have chronic burning nerve pain along the same path the rash took.
Is Shingles Contagious?
Yes. Although you cannot catch shingles itself from someone who is infected, it can be contagious to a person who has never had chicken pox or who has not been vaccinated with the varicella virus. It is possible to catch chicken pox from someone with shingles but not shingles itself.
Unlike a chicken pox infection where the virus is present (and you are therefore contagious) before the rash even appears, in shingles the virus is only present once the rash shows up. This means that, if you keep the blisters covered and clean, and do not share clothing, towels, bedding or anything else that comes into direct contact with the rash, there is a low risk of passing it on to other people. Once the rash appears the virus is also present in saliva and could theoretically be transmitted that way too, so no kissing! Once the blisters dry up the virus is no longer present so, even if the pain persists, there is no longer any risk of transmission to anyone else.
How Acupuncture Works to Treat Shingles
A shingles outbreak can manifest in 3 different patterns, although the cause is always the same – the varicella zoster virus. In Chinese medicine, each of these three patterns has a poetic description and the acupuncture points your acupuncturist will needle will depend on the pattern of outbreak you have.
Pattern 1 – Blazing Fire in the Liver and Gallbladder
In this pattern, the skin lesions are red and hot and filled with fluid. There is a burning sensation and the pain resembles pin pricks. Generally, the person is hot and irritable with a dry mouth and keen thirst. They may have been under lots of stress and pushing themselves hard with work and life. This pattern will also come with over-indulgence of alcohol and sugar, and a poor diet in general.
Here, the treatment principle is to clear the liver and drain the heat. Each acupuncture point has its own function: there are points to move the liver qi and points to clear the heat. These, in addition to points to treat pain, inflammation, stress and a weak immune system will be needled.
Even though the outbreak may be on the left side of the stomach wrapping around the ribs to the back, acupuncture points will be needled all over the body.
Pattern 2 – Damp Heat
This pattern is characterized by large blisters filled with yellow fluid. These may be prone to infection since their walls are thin and easily broken. The person will have no appetite and poor digestion.
Just like the treatment for the previous pattern, treatment for this pattern also involves draining the heat from the affected part of the body. However, this pattern will have more dampness associated with it and therefore the points will also include points that drain dampness. Two of the most common points for draining damp are spleen 9 at the top of the tibia bone in the depression below the knee on the inside of the leg and San Jiao 5, 2 inches above the wrist on the top of the forearm between the radius and ulna.
Pattern 3 – Stagnation of Qi & Blood
This pattern refers to the post-herpetic pain described above and often affects elderly people who are fatigued and rundown. The pain is either sharp like pin-pricks or is characterized by soreness in the area of the rash that is worse with movement. There tends to be fatigue but restlessness, no appetite and poor sleep.
This is the chronic pain pattern and, in Chinese medicine, most pain is seen as a stagnation of qi (energy) & blood. When the energy of the body is stuck and not flowing smoothly then pain ensues therefore the treatment for this pattern will include building and moving the qi, as well as moving the blood.
Why Acupuncture Works
Acupuncture is effective in treating shingles because it allows individual to be treated specifically for the symptoms they are experiences and their unique constitution. The acupuncturist is able to determine which pattern of shingles the person has and use the precise acupuncture points to treat the underlying imbalance that allowed the virus to rear its ugly head in the first place. Acupuncture points can be needled to clear any heat and move the qi and thus reducing any pain and swelling there may be. In addition, the immune system can be strengthened which helps fight the virus and return it to its dormant state. Another benefit of acupuncture is that you can also use it to treat any other symptoms that may be associated with the outbreak, like a headache or nausea.
The virus can do damage to the nerve cells and lead to years of pain and using acupuncture helps to prevent this, partly by needling around the affected area while the rash is present or into the region once it has gone, and partially by treating the body as a whole to support it in healing the pain and inflammation.
Other Recommendations for Shingles Treatment
Being a naturopath as well as an acupuncturist I tend to combine multiple forms of medicine to treat a health condition. Here are my tips for treatments you can use alongside acupuncture for a shingles outbreak.
Avoid the following foods – they all create heat and dampness in the body which, from a Chinese medicine perspective, will make the symptoms worse.
Nuts which are high in arginine, an amino acid used for viral reproduction
There are many supportive treatment options for shingles in naturopathic medicine as well. However for the purpose of this article, I am only going to mention one key treatment.
L-Lysine (an amino acid that is an important anti-viral for the herpes family)
Recommended dose during an outbreak – 3000mg a day.
As a naturopathic physician, vaccines are always a topic of debate however, in my experience, the pain and suffering that can occur with a shingles outbreak makes this a vaccine to consider getting especially if you are under stress or have a weak immune system.
The shingles vaccine can prevent an outbreak as well as limit the amount of pain or nerve damage that can occur with an outbreak. It is usually recommended for people 60 years or older; however shingles is now more common among people in their 30s and 40s so I often recommend people getting the vaccine earlier than 60 years old. You can receive the vaccine at most local pharmacies.
Acycloir or Valtrex are the two most common anti-viral medications used to treat the Varicella Zoster virus. These are pharmaceutical medicines and, as such, can only be prescribed by a physician. I recommend this medicine as part of the treatment for most outbreaks due to the severity of the symptoms.
To manage the pain that comes with a shingles outbreak, I will always prescribe a topical cream that contains a combination of analgesic and pain medication that you can use instead of, or in addition to, oral pain medications. You can get this from a compounding pharmacist – a more traditional pharmacist who can combine (or compound) multiple medicines requested specifically for you by your doctor has into a single cream or capsule. This differs from a standard pharmacy that only carries pre-prepared brand pharmaceuticals.
Because acupuncture is so useful in treating shingles, I have treated many severe outbreaks over the years. I don’t take an outbreak lightly because I have seen the damaging effects the shingles virus can have on the nerves and the chronic pain it causes so, if I diagnose someone with shingles I get them started on an anti-viral, a topical compounded pain cream as well as acupuncture straight away. If you, or someone you know, have been diagnosed with shingles I recommend getting them in to see an acupuncturist immediately. Acupuncture, especially if started early can help resolve the outbreak faster, treat the pain, prevent nerve damage and chronic post-herpetic neuralgia (pain) as well as helping to build the immune system back up to prevent another outbreak.
I hope you enjoyed this article on just one of many valuable uses of acupuncture. Join me next time when I will discuss how acupuncture can treat your stress and insomnia.
If you would like to follow along you can subscribe by putting your email address into the subscription box to the right of the screen. To schedule an acupuncture appointment at my clinic in Issaquah or a naturopathic appointment in person or by phone you can use the book online tool above.