Adam Sewell MD


Post herpetic neuralgia is a side effect of shingles.  It presents as a painful nerve and skin condition caused by the virus herpes zoster. The same virus is responsible for chickenpox in youth and inexplicably causes shingles in some adults. Post herpetic neuralgia is the persistent, often quality of life altering pain associated with a shingles outbreak.

The most common symptom is a burning pain as nerves are damaged during a shingles outbreak. The nerves no longer communicate properly with the brain. The result is sharp, annoying pain that can intensify with even a light touch. Post herpetic neuralgia pain is typically located at the same site as the shingles outbreak.  Usually it’s located on one side of the back, chest or stomach.

Other common symptoms include:

  • Itching or numbness
  • Muscle weakness or paralysis

There is no specific test for post herpetic neuralgia, nor is there a specific cure.  A variety of pain medications and options may be prescribed until the patient and physician find the right combination. These may include: antidepressants, anticonvulsants, pain relieving skin patches, opioids, and topical pain creams.  It’s important to note, that shingles patients who are able to see a pain physician within the first 72 hours of the signature rash appearing and can start a course of antivirals are half as likely to develop post herpetic neuralgia.  Additionally, shingles and related post herpetic neuralgia are entirely preventable via vaccine.


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