Caused by a virus? Stress? Other ...
(Keywords: Chiropractic Shingles, shingles chiropractic, meningitis, heart attack )
The diagnosis of Chiropractic Shingles usually comes about quite by accident. A patient with nerve pain of unknown origin, mostly starging in the midback and then spreading around the trunk, consults a chiropractor with back or chest pain, or on the face or scalp perhaps, and very occasionally down the leg, before the characteristic shingles rash becomes evident.
It appears to come in two forms. One where there is mid back pain on inspiration, and the other just a pain in the back.
There are few places where the medical "virus or bacteria" model confrfonts the chiropractic "irritated or frankly pinched nerve" more head on and with more difficulty. The patient often presents with deep breathing pain: signs of a rib head subluxation.
There are three facets on the vertebrae for the attachment of the rib, each capable of provoking very sharp pain when subluxated. There is nothing unusual so far; these are symptoms seen almost daily at the Chiropractic Coalface.
Normally speaking, an attack of "medical shingles" has no inspiration pain. "Chiropractic shingles" presents first with the typical signs of a rib head subluxation, followed by the rash. Was this a chiropractic misdiagnosis?
I believe not. A rib head subluxation, like all subluxations, makes the vulnerable patient open to viral and bacterial attack. Under stress? The rib subluxation patient gets shingles.
Chiropractic subluxations are usually found by the chiropractor in that part of the spine enervating the painful patch of skin, and the patient is duly treated for a chiropractic subluxation. Then the shingles rash appears, much to the chiropractor's (and patient's) consternation: an incorrect diagnosis has seemingly been made.
My only defence is that medicine often doesn't diagnose the disease correctly either until the rash appears. I recently had a patient referred to me by a doctor for a pinched nerve - all three of us, the patient, her doctor and myself - were quite caught by surprise three days later.
Shingles is an infection of a nerve and the area of skin that is supplied by it, usually causing face pain or chest pain, although it may occasionally cause a sciatic pain in the buttock and leg. It is caused by the herpes varicella-zoster virus which also causes chickenpox.
Most people have chickenpox as a child, but after the illness has gone, the virus remains dormant (inactive) in the nervous system. The immune system keeps the virus in check, but later in life it can become reactivated, and cause chiropractic shingles, and most likely chest pain.
About 1 in 5 people get shingles at some point in their life. Although it can occur at any age, it is most common in people aged over 50. Shingles usually affects the nerve supply on one side of the body. The main symptoms are chest pain, or face pain and a rash.
You can catch chickenpox from someone with shingles if you've never had the infection.
The skin blisters that form in shingles are full of the chickenpox virus, which means a person with shingles and chest pain is infectious. You can't catch shingles from someone with shingles (or someone with chickenpox), but you can catch chickenpox from someone with shingles if you've never had the infection and therefore aren't immune.
Most adults - about 95 per cent - have been exposed to chickenpox and are immune, even though many aren't aware of it (they may have had only a mild dose of chickenpox when they were young). However, a small number of adults aren't immune and will be at risk. Also, when the immune system is suppressed (for example, when someone is being treated for cancer, or is HIV positive), a person can catch chickenpox for a second time.
Around one in four or five people will develop shingles in their lifetime, with men and women affected equally. It's most common in older people, although it can also occur in younger people and those with a weakened immune system, or those excessively stressed. Perhaps too by subluxations, which may be why this condition may respond well to chiropractic shingles.
What are the symptoms?
The first sign of chiropractic shingles is usually midback pain followed by excessively
sensitive, tingling or burning skin where the shingles rash subsequently
Sometimes, there may be fever, headache and enlarged lymph nodes.
After a few days, the characteristic shingles rash appears as a band or patch of red spots on the side of the trunk or face, and occasionally on the buttock and down the leg. In or around the eye it can be serious.
It usually appears on one side only. The rash develops into fluid-filled blisters that then collapse, forming small ulcers. These dry out and form crusts.
If you enjoy reading then you will love chiropractor Bernard Preston's yarns from his own Coalface and his life. For more information about Preston's books, click here. Bernard Preston home page...
FROM THE COALFACE
Two years ago, this chiropractor was under a lot of stress. And I mean a lot: deep conflict with another chiropractor. Civil war is always the worst. Fortunately I was still having my regular chiropractic adjustment - about once every two months.
The other chiropractor developed the worst torticollis I have ever seen. And I got shingles. Fortunately both the torticollis and shingles responded well to good chiropractic care. Luckily my own shingles was one of the lightest I have ever seen - a few vesicles on the scalp following the course of the Ophthalmic nerve, but fortunately didn't infect the eye. What's more, my doctor also didn't diagnose it correctly - she thought it was sinusitis. It's the only time I've taken drugs, the wrong medicine, in the last five years.
The dumb things human beings get themselves into! That's real chiropractic shingles!
What's the treatment?
The shingles virus can be treated with antiviral medication. Painkillers can relieve the chest pain or facial pain, while calamine lotion should help to reduce the itching.
Shingles that affects the eye requires antiviral therapy and urgent referral to an ophthalmologist.
If someone with a weakened immune system is exposed to shingles they are usually referred to hospital for possible intravenous antiviral therapy, as they're at very high risk of complications from chickenpox. An injection of immunoglobulin or antiviral antibodies from someone recently infected may be effective in treating shingles.
This doesn't prevent the disease, but may reduce the length and severity of the infection, and the risk of complications. The sooner immunoglobulin is given, the more effective it is likely to be. It must be given within 96 hours to have a significant effect.
The treatment of post-herpetic neuralgia can involve painkillers, capsaicin cream and, if necessary, specific antidepressants.
As stated above, chiropractic and shingles treatment is usually applied quite by accident, spinal subluxations being located and presumed to be the cause of the pain. In the author's experience, patients with chest pain from shingles who are treated with chiropractic usually recover from the condition very quickly, and intractable post herpectic pain is rare. Concommitant medical treatment is advised, particularly if the face is involved.
To my knowledge, there is no research confirming (or denying) that chiropractic treatment is an effective treatment for the chest pain of shingles. This is simply anecdotal, and may or may not be valid. But chiropractic shingles is certainly worth a thought before it becomes chronic nasty pain.
A common complication of the chest pain or facial pain from shingles is pain in the area of the rash that persists after the rash has disappeared, called post-herpetic neuralgia. It may be severe and last for several years. Simply the touching of a shirt for example may cause excessive irritation and chest pain. People with intractable post-herpetic pain often become depressed. Post-herpetic neuralgia is more likely to occur the older you are. Don't allow shingles to become chronic. Or any other condition for that matter. Deal with it. Consider chiropractic shingles as one of your options.
An aside. When is the right time to consult your doctor or chiropractor? There is no easy answer. No doctor in his right mind would suggest you have to rush off and make an appointment for a cough or cold, or a little pain in the back. My rules for what it's worth are:
Best advice. Use your common sense. With chiropractic shingles
too. Like any other problem, if you think it's not getting better as
you would expect, then it's time to make a move.
The good news
This is an unresearched, perhaps unconvincing opinion but I've never had a patient with "chiropractic shingles" go on and develop months and months of post-herpetic neuralgia.
The patient comes to the chiropractor "by mistake". A "wrong" diagnosis is made; the patient develops a shingles rash. The chiropractor's name is mud. S/he has seriously deficient diagnostic skills. He is a quack. But the patient recovers in double quick time. Two years down the road s/he is not still suffering from a very irritating neuralgic pain. Simply the contact between shirt and skin is painful.
It's not an easy condition to diagnose prior to the emergence of the rash, and the answer to this conundrum is probably decades away.
Question: Does every patient with "medical shingles" have a subluxation at the nerve root or rib head? I wonder...
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Interesting challenges of the day
1. Mr D has very severe midback back. He bent and twisted, feeding his son, and then laughed. Every breath is a nightmare. A sprung rib is every chiropractor's delight. He or she has golden hands. 30 percent better after one treatment.
2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.
3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.
7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.
8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.
9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine.
10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.
11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
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You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
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