"It's neuralgic pain," says Oxman, who is also professor of medicine and pathology at the University of California, San Diego. "So it's not like a broken leg or a burn, which you can relieve with painkillers. This is pain that's actually generated in the nervous system, and it doesn't respond very well to any methods of controlling pain. It's a major cause of suicide."'
There are many options to relieve or inhibit pain in shingles sufferers, but none of them are routinely effective. They include antiviral drugs, which are often effective at lessening the duration of shingles if taken soon after an outbreak. "Antiviral drugs only stop further virus multiplication. They don't make a dead nerve cell come to life. So the earlier you get diagnosed and treated, the more likely it is to have some impact," Oxman tells WebMD.
Although no agreement has been reached on the appropriate management of shingles, steroids have been tried, as have antidepressants, anticonvulsants, and topical agents such as the anesthetic lidocaine, which has recently become available in patch form. For some, the lidocaine is effective at helping with the chronic pain, but as Oxman points out, it's hard to put it over your eye. About 15% of shingles sufferers are affected in that area, sometimes to the point of blindness. Perkin, whose mother had shingles, said she described the feeling as "having an icepick through your eye."
Other methods such as electrical stimulation and acupuncture are used, and in severe cases surgery is an option. But once the shingles awaken and come down to the skin, "the horse is out of the barn," Oxman says. Prevention is the key. Unfortunately, none of these approaches has been proven to prevent shingles.
The VA study "is an attempt to see if we can prevent shingles with a vaccine, and it's based on very compelling circumstantial evidence," Oxman tells WebMD. He and his colleagues are trying to enroll 37,000 people at 21 VA sites nationwide. So far, they've enrolled just over 6,000 people but are actively seeking more to reach their goal.