In December 2020, a study was published looking at the increased risk in Herpes zoster (shingles) in people who have had sciatica. Why is this and what things should you consider. 

Sciatica is often a very painful condition. It involves inflammation and irritation of the sciatic nerve, causing pain down one or both legs. It is associated with conditions such as disc herniation or vascular/chemical changes irritating the nerves.

Shingles is caused by the same virus that causes chickenpox. The virus can remain dormant in a part of the nervous system called the dorsal root ganglion.  Pain, itching and tingling may often precede a rash that follows a nerve.                                                                                                                                                       

Compromised Immune System – Stress

Shingles more often occurs in people over 50 and in those with compromised immune systems. Stress can weaken the immune system. 

How is sciatica involved?

We don’t know for sure.  Sciatica is a common condition involved in chronic pain. Chronic pain often leads to depression. Pain and depression are both significant stressors to the body and my compromise the immune system. This could explain the increased risk ok shingles. The study found that patients who had had sciatica were 1.19 times more likely to develop shingles. 

Recommendations:

The authors recommended that when doctors encounter patients over 50 who have a history of sciatica, shingles vaccination should be considered.  

Reference:

Ke, DS., Hsu, CY., Lin, CL. et al. Herpes zoster in patients with sciatica. BMC Musculoskelet Disord 21, 813 (2020). https://doi.org/10.1186/s12891-020-03847-5