Shingles, also known as herpes zoster, is an infection that causes a painful rash and can lead to further complications. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in the body. Years later, the virus can reactivate as shingles. So if you’ve had chickenpox in the past, you’re at risk for developing shingles.
What are the symptoms of shingles?
The main symptom of shingles is a painful rash that develops into itchy, fluid-filled blisters. The rash usually occurs in a single stripe on either the left or right side of the body. Less commonly, it can occur on both sides. The rash generally clears up within 2 to 4 weeks.
Before the rash develops, people often have early warning signs and symptoms including:
- Pain, burning, tingling or numbness of the skin in the affected area
- Headache
- Fever
- Chills
- Upset stomach
So in answer to the question – yes, shingles can sometimes cause both fever and body aches. Let’s explore this further.
Fever with shingles
It’s estimated that about 1 in 3 people with shingles will develop a fever at some point during their illness. The fever is generally mild, with a temperature of 100°F (37.8°C) or slightly above.
Fever can occur:
- In the days or weeks before the shingles rash appears, as one of the early warning symptoms
- At the same time as the shingles rash
- After the shingles rash has formed blisters and begun crusting over
In most cases, the fever is temporary and subsides once the shingles rash starts to clear up. But in rare cases, it persists and requires treatment.
Why fever happens with shingles
The fever associated with shingles is thought to be caused by cytokines – substances released by immune cells in response to the shingles virus. Cytokines help coordinate the overall immune response. But they can also enter the bloodstream and cause bodywide symptoms like fever.
Body aches with shingles
Body aches are also common during a shingles outbreak. About 70-80% of people with shingles experience some type of body pain or discomfort.
Areas of pain can include:
- Joint pain
- Muscle pain
- General body aches
- Headache
The pain often precedes the shingles rash by several days or up to a week. Some people describe it as a deep ache or sensation of burning along the nerve pathways. The head, neck and eye area are sometimes affected.
Why body aches happen with shingles
Like fever, body aches are believed to be related to the release of cytokines and the immune system’s inflammatory response. The varicella-zoster virus causes inflammation of sensory nerves, which can radiate outward and cause referred pain in other parts of the body.
Body aches from shingles often improve once the blisters form and start to dry. But in some cases, certain pains can linger even after the rash resolves.
How long do fever and body aches last with shingles?
For most people, the fever and body aches caused by shingles are temporary and subside within a few weeks. But in some cases, they can persist or recur, becoming chronic issues.
Postherpetic neuralgia (PHN) is a common complication of shingles where severe pain persists for months or years after the initial rash has healed. It’s caused by nerve damage from the shingles virus. PHN can involve chronic headaches, muscle aches, joint pain, and burning sensations.
Fever and body aches can also return if the initial shingles outbreak doesn’t fully resolve and the virus reactivates. Some other factors that can contribute to ongoing symptoms include:
- Older age
- Weakened immune system
- Very painful or extensive initial outbreak
- Rash located on the face, eyes, neck, or genitals
Around 10-15% of people who get shingles will experience long-term fever and body pain. Seeking prompt treatment for an acute shingles outbreak may help reduce the likelihood of complications.
When to see a doctor
Call your doctor promptly if you notice a painful rash with fluid-filled blisters, especially if it’s accompanied by fever, chills, body aches, and nausea. Starting an antiviral medication like valacyclovir within 72 hours of rash onset can help shorten the duration of shingles and reduce the risk of complications.
You should also let your doctor know if any shingles symptoms last more than a few weeks or keep recurring after the initial rash has cleared. Postherpetic neuralgia can be difficult to treat but medications, injected steroids, nerve blocks, antidepressants, and painkillers may help provide relief.
Diagnosing shingles
To confirm a shingles diagnosis, your doctor will typically:
- Ask about your medical history and symptoms
- Examine your rash and assess any areas of pain
- Order lab tests on a sample from the rash to detect the varicella-zoster virus
In straightforward cases, simply describing your symptoms and showing your doctor the distinctive shingles rash is often enough for them to make a diagnosis. Testing usually isn’t required unless the presentation is unusual.
Differential diagnosis
There are some other conditions that can mimic early signs of shingles like fever and body aches. These include:
- Herpes simplex virus (cold sores or genital herpes)
- Allergic reactions
- Skin infections like impetigo
- Contact dermatitis
However, once the blistering shingles rash develops, it’s quite distinct. Other conditions that can occasionally look similar such as contact dermatitis and atopic eczema tend to have more generalized widespread rashes rather than a single stripe on one side.
Treating shingles
While there is no cure for shingles, prompt treatment can help ease symptoms and potentially prevent complications. Treatment usually involves:
- Antiviral medication – Drugs like valacyclovir (Valtrex), acyclovir (Zovirax), or famciclovir (Famvir) can help reduce the severity and duration of shingles if started within 72 hours of rash onset.
- Pain medication – Over-the-counter options like acetaminophen, ibuprofen, or local numbing creams can help manage pain. Prescription meds or special nerve blocks may be needed for severe cases.
- Anti-itch treatment – Topical calamine lotion, colloidal oatmeal baths, and oral antihistamines like diphenhydramine (Benadryl) can help relieve itching.
- Wet dressings – Applying a wet compress over the rash can aid healing and decrease crusting.
- Antidepressants – Tricyclic antidepressants are sometimes used to treat nerve pain associated with shingles.
Getting adequate rest, staying hydrated, and eating a balanced diet can also promote healing. Severe cases may require hospitalization.
Home care
Along with professional treatment, the following self-care tips can help you recover more comfortably at home:
- Take over-the-counter pain relievers like acetaminophen or ibuprofen.
- Apply cool compresses to soothe itchy, blistering skin.
- Take colloidal oatmeal baths to ease irritation.
- Try calamine lotion and oral antihistamines for itch relief.
- Wear loose-fitting clothing to avoid irritating the rash.
- Distract yourself with relaxation techniques, reading, or music.
- Avoid skin-to-skin contact to prevent spread.
Make sure to get plenty of rest and stay hydrated. Good nutrition can also provide strength to help fight the virus.
Can lifestyle and natural remedies help?
While there’s no definitive clinical evidence that lifestyle measures and natural remedies can treat shingles, some complementary approaches may aid the healing process. Options to discuss with your healthcare provider include:
- Stress reduction – Chronic stress may weaken immunity and reactivate the shingles virus. Relaxation techniques like meditation and yoga may help.
- Exercise – Light physical activity can potentially improve immune function and pain tolerance.
- Good sleep habits – Getting enough high-quality sleep supports the immune system and healing.
- Balanced nutrition – Eating a diet rich in fruits, vegetables, whole grains, and lean proteins provides essential nutrients for combating infections.
- Zinc – This mineral supports immune health. Food sources include oysters, meat, nuts, and legumes.
- Lysine – This amino acid may help inhibit viral replication. Lysine supplements are sometimes used for shingles.
- Vitamin C – Vitamin C has antimicrobial properties and enhances immunity. Good dietary sources include citrus fruits, broccoli, and bell peppers.
Keep in mind that these complementary approaches lack strong clinical evidence. But they may be beneficial when combined with standard medical treatments under the supervision of your healthcare provider.
Risk factors
Anyone who has had chickenpox is at risk for shingles, but these factors can increase susceptibility:
- Older age – Shingles risk rises as immunity naturally declines with age. About half of cases occur in adults 60 years or older.
- Immune deficiency – Diseases like HIV/AIDS and leukemia, or immunosuppressive medications like steroids or chemotherapy can impair immunity and reactivation of the virus.
- Cancer – People with malignancies seem to be at higher risk.
- Physical trauma – Injury to certain dermatomes or nerve pathways may trigger shingles.
- Emotional stress – High stress burdens the immune system and may contribute to shingles risk.
Is shingles contagious?
Direct contact with the fluid from shingles blisters can spread the varicella-zoster virus and cause chickenpox in someone who hasn’t had it or the chickenpox vaccine. But this risk is low unless there is substantial contact. Shingles itself doesn’t spread from person to person.
You can’t transmit shingles to another person to give them shingles. However, someone with shingles can spread the varicella-zoster virus, which could then result in someone developing chickenpox.
You are contagious to others with shingles until all your blisters have scabbed over. To prevent spread, keep the rash covered and avoid skin-to-skin contact.
People with active shingles should also avoid contact with:
- Newborns
- Pregnant women
- Those with weakened immune systems
- Anyone who hasn’t had chickenpox or the varicella vaccine
The biggest risk is to newborns and pregnant women as chickenpox infection during pregnancy can harm the fetus.
Complications
While shingles itself usually isn’t life-threatening, it can lead to potentially serious complications including:
- Postherpetic neuralgia – Persistent nerve pain after the rash has cleared.
- Vision loss – If shingles affects the eye region (herpes zoster ophthalmicus).
- Neurological problems – Facial paralysis, inflammation of the brain or meninges, stroke.
- Hearing loss – If shingles affects the ear region (Ramsay Hunt syndrome).
- Skin infections – Bacterial skin infections may develop if blisters aren’t kept clean.
Prompt treatment can reduce the risks of lasting complications. Keep a lookout for any concerning persistent symptoms and follow up with your healthcare provider if needed.
Prevention
Two vaccines offer protection against shingles:
- Varicella vaccine for chickenpox – Getting vaccinated in childhood provides immunity to varicella-zoster and prevents about 95% of chickenpox and shingles cases.
- Shingles vaccine (Shingrix) – This vaccine is recommended for healthy adults 50 years and older, with 2-3 doses providing over 90% protection that lasts for years.
The Centers for Disease Control and Prevention (CDC) recommends that all healthy adults 50 years and older get two doses of Shingrix, separated by 2 to 6 months, even if they already had shingles or received the previous Zostavax shingles vaccine.
Studies show the Shingrix vaccine maintains high efficacy for at least 8 years. Some other ways to help prevent shingles include:
- Keeping up to date with recommended vaccines like the annual flu shot
- Managing stress
- Eating a balanced, nutritious diet
- Getting adequate sleep and regular exercise
- Treating underlying medical conditions that compromise immunity
While shingles can’t always be prevented, vaccination and healthy lifestyle habits are key protective factors.
Conclusion
Shingles frequently causes fever and body aches, often preceding the painful blistering rash by several days or up to a week. It’s believed cytokines released by the immune system in response to the virus trigger widespread symptoms like fever, chills, headache, and muscle pain.
In most cases, the fever and body aches clear up along with the rash within a few weeks. But sometimes, they can persist long-term or reoccur. Prompt antiviral treatment, pain management, and good self-care can help promote recovery and reduce the risk of complications like postherpetic neuralgia.
While shingles isn’t fully preventable, vaccination with Shingrix offers the best protection and is recommended for adults over 50. Along with vaccination, stress management, a healthy lifestyle, and prompt treatment if shingles does occur can help mitigate the potential impacts of this common viral infection that can cause fever, body aches, and other uncomfortable symptoms.