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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Herpes Zoster causing Nerve Damage? My doctor had been trying to diagnose the cause of pain which began in the front, lower, left rib cage. In the last 2 years, it has reached from to back. left & right, as well as the sides where the ribs come together (intercostal?). After several tests, he ran a blood test and told be it showed I had 'had a severe herpes zoster infection', and that this virus was not causing 'neuritis & neuralgia' or just plain nerve damage. The only recommendation was to go to a pain clinic and have multiple injections of steriods (most probably prednisone). I am terrified of needles (as any phlebotomist who has had to stick me), and prednisone makes me 'crazy & violent'. The only time I was given prednisone, I was required to be babysat for 3 days to be sure I did no harm to myself. That was embarrassing for a 35 year old! So, as you can see, this option does not work for me. The pain continues to grow and expand, and interferes with breathing. The one time I went to the hospital about it, they said my ECG was 'suspicious', then later said it was 'just now normal for me', which I find ludicrous. Have you heard of Herpes Zoster causing this kind of problem? What can I do? Could it be damaging my heart? Herpes (Varicella) zoster can certainly infect nerve roots and when it does typically causes shingles. To produce such chronic, slowly evolving pain over years would be unusual. If one is actively, symptomatically infected with herpes zoster, treatment with an antiviral agent is usually instituted (such as acyclovir/Valtrex). Note that this is different than a blood test showing that you had previously at some point in your life had the infection, which is what I believe you are describing. The most likely neurological cause of pain of the type you describe would be from damage to the thoraccic spinal nerve roots, most frequently caused by diabetes. There is another syndrome that affects young women known as Tietze's syndrome, a form of extremely painful costochondritis (inflammation of the area where the rib bone joins the rib cartilage), and can definitely be severe enough to interfere with deep breathing. Antiiflammatory drugs and especially a drug called indomethacin can alleviate this otherwise bothersome condition. Steroid injections can alleviate inflammation to nerve roots, and if properly administered, the amount of corticosteroid absorbed into the circulation should be minimal--- much less than with pills. But if I had experienced what you did last time you tried them, I would avoiding them like the plague too. If you have not had an EMG to see of there is ongoing, active damage to your thoraccic spinal nerve roots, this may be a helpful diagnostic test, as would a thorough evaluation by a neurologist, to see if there is any other evidence of nervous system disease or damage. If you are interested in being evaluated by a Cleveland Clinic staff neurologist, our number is 1-800-223-2273/extension 45559. Any of our neurologists could provide you with a thorough evaluation of such a problem. Please remember that information provided on the forum is intended for general medical informational purposes only, and that the actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information helpful.
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