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Are sore throat and neck associated with shingles on the scalp and neck?

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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Posted on Fri, 25 May 2018 in Brain and Spine
Question: Hello
50 year old woman in relatively good health. Not currently on any medications beyond general supplements.

I have recently been diagnosed with shingles—to scalp and neck- and wondered if you could help me understand what I’m experiencing and how long this may take to resolve.
Background—week of Dec 18 started to experience neck aching and then terrible headaches. I have occasional migraines, brought on by hormone changes, weather—and have found prescribed meds helpful. Nothing was touching them. Stabbing pain that would move around and then ear pain. Quite severe- I’ve never experienced anything like this and was just in tears. I have a breast cancer history, so really began to worry. I was ready to go to the ER when I noticed a patch of red small blisters at the base of my neck and then realized they ran all the way to the top of my scalp, on the right side only. Shingles.

I was able to get into a doctor same day who confirmed the diagnosis. She put me on an antiviral right away (Vancocyclin), but offered little help to manage the pain. I had leftover Vicodin from a recent foot surgery, about 8 pills left. She offered me 10 more and advised ibuprofen and a prescription of lidocaine patches… which I found a little ridiculous as the rash literally runs up under my hair….

Now, about 8 days later, the headaches are not as severe, but still bothersome. The progression of the rash stopped, blisters have resolved and the whole mess seems scabbed over. I continue to be bothered by and am confused by—a sore throat, just on the right side and a very stiff, sore neck as well. Ear pain comes and goes. The rash is not as painful, though I do experience a weird “crawling” sensation at times.

Could you advise as to whether the sore throat and neck are associated with this? I am familiar with Post herpetic nerve damage and really hope this does not occur. I’m really not sure, however, how long it might take to recover.
Pain relief—there is so much sensitivity right now about opioid addiction. I don’t like to take strong meds and am not a seeker or abuser—but honest to goodness, these headaches are brutal and it’s the only thing that helped at all. I want to ask my doctor to offer me some more for a period of time, or, is there another option I might ask about?

Finally- what might have brought this on? I am near menopause and had not had a period for 8 months—until, ironically, the same day I recognized the rash. Could this have affected my immune system in some way? I admit to a certain amount of stress, work full time, teenagers, add the holiday etc—but nothing unusual. Is this a red flag for something else. As noted, have gone through bc treatment, (2 primaries, no nodes, no mets) but not since 2008 and am following carefully.

Thank you for any advice you might offer.
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Answered by Dr. Neeraj Kumar 1 hour later
Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
Shingles usually occurs in immunocompromised status.
You should get blood counts and blood sugar tested.
You can continue opioid pain killers for 2-3 weeks.
Drugs like pregabalin,gabapentin,amitriptyline or carbamazepine can be added.
The improvement may take 1- 3 months.
The neck pain and throat pain can be linked as herpetic lesions may involve oral cavity too.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
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