What is Post Herpetic Neuralgia

Post-herpetic neuralgia (PHN) is a type of severe pain that can develop in someone who has previously suffered from shingles (herpes zoster). The varicella-zoster virus is the cause of shingles, and it also causes chickenpox. After a person recovers from shingles, the virus can remain dormant in the nervous system. The virus may reactivate in rare circumstances, causing Post Herpetic Neuralgia to appear.

Types of Post Herpetic Neuralgia

Post Herpetic Neuralgia can be categorized into two types based on the duration of pain

  • Classic Post Herpetic Neuralgia: Pain persists for more than 3 months after the shingles rash has healed.

  • Persistent Post Herpetic Neuralgia: Pain lasts for over 1 year after the onset of shingles.

Common Conditions under Post Herpetic Neuralgia

Post Herpetic Neuralgia can result in various symptoms and complications, including

  • Persistent, burning, or stabbing pain in the affected area.
  • Increased sensitivity to touch or temperature changes.
  • Itching or tingling sensations.
  • Sleep disturbances and fatigue.
  • Emotional distress or depression due to chronic pain.
  • Impaired daily activities and reduced quality of life.

Causes of Post Herpetic Neuralgia

Post Herpetic Neuralgia is caused by damage to the nerves during a shingles outbreak. After the varicella-zoster virus reactivates from its dormant state, it travels along the nerve fibers, causing inflammation and damage. The resulting nerve damage can lead to chronic pain that persists even after the shingles rash has healed.

Symptoms of Post Herpetic Neuralgia

The primary symptom of Post Herpetic Neuralgia is chronic pain in the affected area, which may be accompanied by

  • Burning, throbbing, or shooting pain.
  • Hypersensitivity or increased sensitivity to touch.
  • Itching in the affected area.
  • Skin disorders, such as redness.
  • Fatigue, improper sleep, and mood changes.

Diagnosis of Post Herpetic Neuralgia

An extensive review of the patient's medical history, a physical exam, and an evaluation of the defining symptoms are often required to diagnose post-herpetic neuralgia. To check out the potential causes of the symptoms, the healthcare professional may also request further testing, such as blood tests, imaging examinations, or nerve conduction tests.

What triggers Post Herpetic Neuralgia

Post Herpetic Neuralgia can be triggered by various factors, including

  • Aging:The risk of developing PHN increases with age.

  • Severity of shingles: The more severe the shingles outbreak, the higher the likelihood of developing PHN.

  • Location of shingles: Shingles that occur in areas with a higher density of nerve endings, such as the face or trunk, may increase the risk of PHN.

  • Immune system weakness: People with immune systems already compromised, such as those who have HIV/AIDS or are receiving immunosuppressive therapy, are more likely to acquire PHN.

Treatment of Post Herpetic Neuralgia

  • Medications: To aid with pain relief, anticonvulsants, tricyclic antidepressants, topical lidocaine, opioids, or topical capsaicin may be used.

  • Nerve blocks: Local anesthetics or steroids may be injected into the affected nerves to provide temporary pain relief.

  • Transcutaneous electrical nerve stimulation (TENS): This method uses low-level electrical currents to stimulate the nerves and lessens pain.

  • Physical treatment: Stretching routines, massages, and other physical therapy methods may help people move more freely and have less discomfort.

  • Psychological assistance: Patients who need help coping with chronic pain's emotional and psychological effects may benefit from counselling, support groups, or other psychological therapies.

Interventional Pain Management of Post Herpetic Neuralgia

  • Epidural steroid injections: Steroids are injected into the epidural space surrounding the spinal cord. This can help reduce inflammation and alleviate pain associated with Post Herpetic Neuralgia.

  • Nerve blocks: Nerve blocks involve the injection of local anesthetics or steroids near the affected nerves to block pain signals and provide relief. Common nerve blocks used for Post Herpetic Neuralgia include thoracic or lumbar sympathetic blocks, intercostal nerve blocks, or trigeminal nerve blocks, depending on the location of the pain.

  • Spinal cord stimulation: Spinal cord stimulation entails the implantation of a tiny device that sends gentle electrical impulses close to the spinal cord. These impulses help to modify or mask pain signals, providing relief for chronic pain, including Post Herpetic Neuralgia.

  • Radiofrequency ablation: Radiofrequency ablation uses heat generated by radio waves to disrupt pain signals from specific nerves. Some people with Post Herpetic Neuralgia may find long-term pain alleviation from this minimally invasive therapy.

  • Trigger point injections: Trigger point injections involve the injection of medication, such as local anesthetics or corticosteroids, into specific trigger points in the muscles. This can help alleviate muscle pain and reduce pain associated with Post Herpetic Neuralgia.


Kerur Pain Care is dedicated to providing thorough care for those with Post Herpetic Neuralgia since we recognize this illness's difficulties. Our skilled medical specialists offer personalized treatment plans based on your unique needs and specialize in diagnosing and managing Post Herpetic Neuralgia. We work to reduce pain, increase function, and improve your general well-being using a combination of medication management, interventional pain methods, and supportive care. Contact us today to schedule a consultation and take the first step towards finding relief from Post Herpetic Neuralgia.