Shingles or Herpes Zoster is reactivation of the dormant varicella virus (chicken pox) that remains in the dorsal root ganglion after the initial viral infection. The reactivation usually occurs in individuals with a depressed immune system and occurs along any dermatome or pathway of a nerve root. It most commonly affects the thoracic region at approximately 50% and next most common nerve distribution is the trigeminal nerve affecting the face. The pain usually will occur first before the rash and blisters appear. In a small percentage of those affected with shingles there may be sustained inflammatory changes in the nervous system that are the result of the pain associated with Post Herpetic Neuralgia (PHN). Along with pain, there may be other associated symptoms such as increased sensitivity, weakness and itching. The prevalence of the continued pain associated with PHN increases with age and may go on the last months or years after the initial outbreak. The best outcomes are with early treatment. Because PHN can be very painful treatment can be aggressive treatment may be necessary, depending on the stage and region of the pain Salem Pain & Spine Specialists has many different options available. A vaccine is now available to prevent shingles and is recommended for those over 60 years old. According to the CDC, (Centers for Disease Control and Prevention) the vaccine does not completely eliminate the risk of obtaining shingles or post herpetic neuralgia but does reduce the risk of shingles itself by about half (51%) and the risk of post-herpetic neuralgia by 67%.