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Treatment PlansAnkle & Lower LegShingles

Massage therapy · Kitchener–WaterlooShingles

Ankle & Lower Leg

What It Is

Shingles (sometimes known as herpes zoster) is an infection that causes a painful rash on one side of the body. The rash appears as blotches that become itchy blisters that ooze fluid, and a few days later the blisters dry out and scab (NHS, 2023a).

You cannot catch shingles from someone with shingles or chickenpox. But people who have not had chickenpox (or the chickenpox vaccine) can catch chickenpox from someone with shingles while the rash is oozing fluid. Once the rash has dried out and crusted over, it can no longer spread (NHS, 2023a).

Only people who have had chickenpox can get shingles. It is caused by the same virus, the varicella zoster virus. After chickenpox has cleared up, the virus stays in the nerves, and it can be reactivated later if the immune system is weakened, for example by stress, certain conditions, or treatments like chemotherapy (NHS, 2023a; UK Health Security Agency, 2025). The risk of shingles rises with age, which is why older people are more likely to get it (UK Health Security Agency, 2025).

It can take up to 4 weeks for the shingles rash to heal, and the skin can stay painful for weeks after the rash has gone (NHS, 2023a). In some cases shingles can cause post-herpetic neuralgia (nerve pain that lasts for several months where the rash was) (NHS, 2023a). The rash usually forms along the area of skin supplied by one nerve, known as a dermatome (UK Health Security Agency, 2025).

There is a vaccine available on the NHS that helps reduce your chances of getting shingles and of getting serious problems if you do get it. Since September 2023 it has been offered as 2 doses to people turning 65, people aged 70 to 79, and people aged 18 and over with a severely weakened immune system (NHS, 2023b). The vaccine now used gives much stronger and longer-lasting protection than the older vaccine (UK Health Security Agency, 2025). You can get shingles more than once, so it's important to get vaccinated even if you've had shingles before (NHS, 2023b). Ask your family doctor or nurse practitioner if you can get the vaccine.

If you suspect shingles, see a pharmacist or your family doctor or nurse practitioner as soon as possible. Antiviral medicine can help speed up recovery and avoid longer-lasting problems, and it works best if it is started within 3 days of the rash appearing (NHS, 2023a).

To ease the symptoms yourself, the NHS suggests taking paracetamol to ease the pain (NHS, 2023a). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) The NHS also suggests keeping the rash clean and dry, wearing loose-fitting clothing, using a cool compress (such as a bag of ice cubes or frozen vegetables wrapped in a towel, or a wet cloth) a few times a day, and not letting dressings or plasters stick to the rash (NHS, 2023a).

How Do I Know If I Have Shingles?

In the very early stages, you may get a tingling or painful feeling in an area of skin, a headache, or feel generally unwell (NHS, 2023a); some people also have a fever (UK Health Security Agency, 2025). A rash usually appears a few days later. It usually appears on the chest and tummy, but it can appear anywhere on the body, including the face, eyes and genitals (NHS, 2023a). The rash is on one side of the body only; a rash on both sides is unlikely to be shingles (NHS, 2023a). The blotches become itchy blisters that ooze fluid, and a few days later the blisters dry out and scab. Feeling tired, achy or unwell can continue during this time. Most people recover without problems, but scarring or changes in skin colour can occur after the rash has healed (NHS, 2023a).

Is Shingles Associated With Back Pain?

Yes it can be. Shingles can cause pain across the back. If a rash develops, suspect shingles. The pain can be severe, with sharp nerve pains too, and in rare cases shingles can cause pain without a rash (NHS, 2023a). However, this is not mechanical back pain, and unlikely to respond to manual therapy. The pain usually disappears when the shingles has gone, although in some cases nerve pain can persist for several months (NHS, 2023a).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

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