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Shingles is a disease caused by reactivation of a previous infection with herpes zoster virus that results in a painful localized skin rash, usually with blisters on top of reddish skin.

It is easy to diagnose after but not before the skin rash appears. The patients usually have been experiencing extreme sensitivity or pain in a broad band on one side of the body for a few days to a few weeks; the sensation can be itching, tingling, burning, constant aching or a deep shooting, “lightning bolt” pain. The symptoms mimic the nerve root pain syndromes, so often misdiagnosed as nerve pain before the skin rash appears.

I came across at least two patients with shingles before their skin rash appears. Both were misdiagnosed in the first session. I also saw many such patients with the skin rash. Their common feature, before or after the skin rash appears, is their tongues. It seems most of these patients have very dark red tongue and yellow thick coat on top of it.  This sort of tongues is rarely found in patient with nerve root pain syndromes.

Shingles cannot be passed from one person to another. However, the virus can be spread from a person with active shingles to another who has never had chickenpox or received immunization. The risk of a person with shingles spreading the virus is low if the rashes is covered and it is not contagious when the rash has developed crusts.

Acupuncture is amazing at relieving the acute pain from shingles and reduce the risk of postherpetic neuralgia. The treatment should be started asap. The treatment plan has to be aggressive (quickly and frequently) and target the excess (shi) condition.

There are many risk factors that reactivate the virus. First is stress, which cause liver Qi stagnant, if the stagnant Qi lasts for a long time one day it turns to fire and then blazes out.  Other symptoms include bitter taste in the month, constipation, dark or scanty urine, dizziness, restlessness, red eyes and red facial complexion. The tongue is red with yellow thick and sticky coat. Pulse is wiry and rapid.

Second risk factors are weakened immune system due to old age, having certain diseases (cancer, HIV/AIDS etc) and taking certain medications (steroids). These factors usually affect the spleen Qi (digestive force) and produce damp heat inside out body. The symptoms include loose stools, bloating, fatigue and poor appetite. The tongues is puffy of flabby with greasy coating. The pulse can be soft or slippery, also can be rapid and wiry due to the pain.