Ann Arvin, professor emerita at Stanford Medical School, and Robert Johnson, a physician and researcher at the University of Bristol, delve into the perplexing link between chickenpox and shingles. They recount a riveting detective story from the 1950s that clarified this connection. Arvin emphasizes the importance of vaccination in preventing severe outcomes, while Johnson shares his insights on treating long-term pain caused by shingles. Together, they explore the complexities of shingles, its symptoms, and the biopsychosocial approach to pain management.
Edgar Hope Simpson's investigation in the 1960s revealed the crucial link between shingles and chickenpox, securing scientific understanding of their connection.
Current approaches to shingles treatment emphasize the significance of addressing both physical pain and psychosocial factors for comprehensive patient care.
Deep dives
The Historic Unraveling of Shingles
Shingles has historically puzzled scientists due to its elusive connection to chickenpox. In the 1960s, Edgar Hope Simpson, a dedicated family doctor, investigated the relationship between the two diseases, particularly how someone with shingles might transmit chickenpox. His groundbreaking work began when he read about an outbreak of chickenpox linked to a schoolteacher with shingles on a remote Shetland Island. Simpson's hands-on approach, including contact tracing and meticulous record-keeping, helped establish that shingles could indeed lead to chickenpox, thereby confirming the connection between the diseases.
Chronic Pain and Shingles
One of the most significant challenges associated with shingles is the pain that can persist long after the initial rash has healed, resulting in a condition known as post-herpetic neuralgia. Patients often experience varying pain symptoms, from burning sensations to severe shooting pains, which can last for months or even years. The unpredictability of pain severity adds to the complexity of treating shingles, as not all patients will experience the lingering effects. Understanding the biopsychosocial model of pain highlights the importance of addressing not just the physical but also the emotional and social aspects of care for those suffering from shingles-related pain.
Research Advances and Treatment Options
Recent research has focused on both preventive measures and treatment options for shingles, particularly for those who develop post-herpetic neuralgia. Vaccination against chickenpox and shingles is crucial for reducing the incidence of these diseases, especially given that about 30% of individuals will experience shingles in their lifetime. Antiviral drugs are recommended to treat shingles in its acute phase, while low-dose amitriptyline has shown promise in managing pain for patients with lasting effects. Ongoing studies aim to further uncover effective treatments and improve overall patient care, emphasizing the importance of personalized approaches based on an individual's needs and circumstances.
For a long time, people could tell that there was some connection between chickenpox and shingles. But exactly how they were related was a mystery. Then, in the 1950s, a family doctor shipped out to a remote Scottish island to investigate an outbreak, and made a discovery that shaped our understanding of shingles. On today's show, Ann Arvin, professor emerita at Stanford Medical School, tells us that detective story. Then Robert Johnson of the University of Bristol explains what he's learned about treating pain in his decades working with shingles patients.