Postherpetic Neuralgia

Postherpetic Neuralgia: Long-Lasting Nerve Pain After Shingles

Postherpetic neuralgia (PHN) is a chronic nerve pain condition that can develop after a shingles outbreak. While shingles typically resolves within weeks, PHN may cause persistent, burning pain that lingers for months—or even years—after the skin rash has healed.

If you’re experiencing ongoing discomfort following shingles, you’re not alone. PHN affects up to 20% of shingles patients, especially older adults. The good news? Advanced treatments are available to help manage this condition and restore quality of life.

What Causes Postherpetic Neuralgia?

PHN occurs when the varicella-zoster virus damages nerves during a shingles outbreak. Even after the visible rash disappears, irritated nerves can continue to misfire, sending pain signals to the brain without any external cause.

This nerve damage leads to the hallmark symptoms of PHN—chronic pain, heightened sensitivity, and discomfort that can interfere with daily activities.

Risk Factors for Developing PHN

Age over 50 (risk increases significantly with age)
Severe or widespread shingles rash
Delayed antiviral treatment during shingles
Shingles involving the face or eyes
Weakened immune system

Common Symptoms of Postherpetic Neuralgia

Symptoms typically appear in the same area where the shingles rash occurred. These may include:

Burning, stabbing, or electric shock-like pain
Extreme sensitivity to touch (even clothing can cause discomfort)
Persistent itching or numbness
Sleep disturbances due to pain
Mood changes, including anxiety or depression linked to chronic pain

Treatment Options for Postherpetic Neuralgia

While PHN can be stubborn, effective treatments are available—especially when managed by an interventional pain specialist. At SpinePain Solutions, we tailor care plans based on your specific symptoms and pain severity.

Our treatment approaches include:

Medications: Anticonvulsants (like gabapentin), antidepressants, topical lidocaine or capsaicin patches, and nerve pain modulators.
Interventional Procedures:
- Nerve blocks to calm hyperactive nerves
- Pulsed radiofrequency (PRF) for non-destructive nerve modulation
- In select cases, spinal cord stimulation for refractory PHN
Regenerative Medicine: Emerging therapies such as PRP or exosome injections aim to promote nerve healing. Learn more at Bloom Infusions & Wellness.

Early intervention can significantly reduce the duration and intensity of PHN symptoms, so don’t delay seeking care.

Living with Postherpetic Neuralgia: Coping Strategies

PHN can impact daily life, but a combination of medical treatment and lifestyle adjustments can make a difference:

Use loose-fitting clothing to minimize skin irritation.
Apply cool compresses for temporary relief.
Engage in gentle activities like walking or stretching to improve circulation.
Consider relaxation techniques such as meditation or breathing exercises to manage pain perception.

For many patients, a multidisciplinary approach—combining medical, physical, and emotional support—offers the best outcomes.

What’s New in PHN Research?

Researchers continue to explore innovative treatments for postherpetic neuralgia, including:

Advanced neuromodulation devices
Targeted biologic therapies
Gene-based interventions for nerve repair

While these options are still under investigation, they offer hope for future breakthroughs in managing chronic nerve pain.

When to See a Specialist

If your nerve pain persists beyond four weeks after a shingles rash, especially if it disrupts sleep or daily activities, consult a pain management expert.