The pain is described as excruciating, burning and stabbing and has been compared to the pain of childbirth or kidney stones.
On the surface, shingles is a blistering rash. But beneath the skin, in the body’s nerve pathways, the pain is pulsing to the surface.
And it’s all caused by the varicella zoster virus, the virus that causes chickenpox.
“The virus that causes shingles never leaves your body,” said Dr. Mark Kleinman, a family practice physician at Kaiser Permanente’s Orchards clinic. “Everybody that’s had chickenpox carries around the virus that causes chickenpox and has the potential to get shingles.”
After a person gets chickenpox, the virus lies dormant in nerve roots. Shingles, also called herpes zoster, occurs after the virus becomes active again in the nerves many years later, according to the National Institutes of Health.
The reason the virus becomes active again isn’t clear. But the people most likely to get the infection are older than 60, had chickenpox before the age of 1 and have an immune system weakened by medications or disease, according to the NIH.
The virus isn’t predictable; doctors have no way of knowing who will get shingles and who won’t, Kleinman said.
According to the Centers for Disease Control and Prevention, nearly one in three Americans get the infection in their lifetime. Each year, about 1 million people in the U.S. get shingles, according to the Centers for Disease Control and Prevention.
For those who do get shingles, the experience is painful.
“The main symptom is pain, which can be pretty severe,” Kleinman said.
The pain and rash occur on one side of the face or body, with the outbreak occurring in the nerve area where the virus is stored. The outbreak typically lasts two to four weeks, Kleinman said.
For about one in five people who get shingles, however, the pain can last longer. The most common complication from the infection is called postherpetic neuralgia, which is persistent pain caused by damaged nerve tissue, he said. Rarely, shingles can cause pneumonia, vision problems or blindness.
Shingles does not have a cure. Physicians can prescribe pain medication and antiviral drugs but those only lessen the symptoms, Kleinman said.
“If you have a shingles outbreak, you’re going to have it,” he said. “We can’t make it go away.”
To help prevent shingles, physicians recommend a shingles vaccine for people 60 and older. Clinical trials found the vaccine reduced the risk of shingles by 50 percent and also reduced pain in people who get shingles after being vaccinated, according to the CDC.
While shingles is most common in people older than 50, the CDC does not have a vaccination recommendation for people younger than 60. The Food and Drug Administration has, however, approved a vaccine for that age group.
Nationwide, shingles vaccination rates are substantially lower than other adult immunization rates, according to a Feb. 1 CDC report.
In 2011, fewer than 16 percent of adults older than 60 received a shingles vaccine. In the same year, about 62 percent of people older than 65 received a pneumococcal vaccine and about 54 percent were up-to-date on their tetanus shots, according to the CDC.
Unlike chickenpox, shingles cannot be passed from one person to another.
However, a person can pass the virus on to a person who is not immune to chickenpox.
In that case, the infected person would develop chickenpox, not shingles.