• 23 Oct, 2026
• UnityPain
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Postherpetic Neuralgia from Shingles | Unity Pain

When Shingles Pain Stays Long After the Rash Is Gone

If you have had shingles, you know how painful it can be. The burning, itching rash is hard enough to deal with. But for some people, the pain does not stop when the rash heals. This lasting pain is called postherpetic neuralgia, or PHN. It can stick around for months or even years. If this is happening to you, please know that you are not alone — and that your pain is real, even when others cannot see it.

Living with nerve pain every day is exhausting. It can make it hard to sleep, work, or enjoy time with the people you love. You may feel frustrated that something that seemed like a skin problem is still causing so much suffering. This article will help you understand why PHN happens, what it feels like, and what kinds of care may be available to help you.

What Is Postherpetic Neuralgia?

Postherpetic neuralgia is a type of nerve pain that happens after a shingles infection. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you recover from chickenpox, the virus stays dormant, or sleeping, in your nerve cells. Years later, it can wake up and cause shingles.

When shingles happens, the virus travels along nerve pathways and damages the nerves themselves. Even after the rash clears, those damaged nerves can keep sending pain signals to your brain. PHN is defined as pain that lasts for 90 days or more after the shingles rash first appears. It is the most common complication of shingles.

Not everyone who gets shingles will develop PHN. But your chances are higher if you are older, had very severe shingles pain, or had a serious rash. People over age 60 are especially at risk. Understanding why it happens can help you feel less confused and more prepared to seek the right kind of help.

What Does PHN Feel Like?

PHN pain can feel different from person to person. Many people describe a burning or stabbing sensation. Some feel a deep aching pain. Others say even a light touch — like clothing brushing against their skin — causes terrible discomfort. This extreme sensitivity to touch is called allodynia, and it is one of the most difficult parts of living with PHN.

The pain usually stays in the area where the shingles rash was. This is often one side of the chest, back, or face. Some people also feel itching, numbness, or tingling in that area. The pain can come and go, or it can be there all the time. It often gets worse with stress, temperature changes, or fatigue.

Because the pain is nerve-based, it does not always respond well to regular pain medicines like ibuprofen or acetaminophen. This is why many people with PHN need specialized care from a pain management provider who understands nerve pain.

How Is PHN Diagnosed?

There is no single test that diagnoses PHN. A doctor will ask about your health history, including whether you have had shingles, when your rash appeared, and how long you have had pain. They will also ask you to describe the pain in detail. A physical exam helps the doctor check for skin changes and areas of sensitivity.

It is important to tell your doctor everything — even small details can help. For example, mention if the pain is worse at certain times of day, if anything makes it better or worse, and how it is affecting your daily life. The more your care team knows, the better they can help you.

Getting an accurate diagnosis is the first step toward getting the right treatment. If you have been dealing with ongoing pain after shingles and have not yet seen a pain specialist, it may be time to seek a professional evaluation to explore your options.

Treatment Options for PHN

There is no one-size-fits-all treatment for postherpetic neuralgia. A combination of approaches often works best. Some commonly used treatments include certain prescription medications that work specifically on nerve pain. These may include anticonvulsants, antidepressants used for pain relief, or topical treatments like lidocaine patches or capsaicin creams. Your doctor will consider your overall health before recommending any medication.

In some cases, procedures like nerve blocks or other types of injections may be recommended to help reduce pain signals. Physical activity and gentle movement can also play a role in managing discomfort and improving quality of life over time. Some patients find that a combination of medication and physical therapy gives them better relief than either one alone.

At Unity Pain Management in Modesto, CA, our team understands how deeply nerve pain can affect your daily life. We offer personalized care plans that may include medication management, injection therapy, physical therapy referrals, and telehealth visits — all with an insurance-friendly approach. If you are struggling with PHN, we encourage you to reach out for a professional evaluation to discuss what options may be right for you.

Can Shingles Be Prevented?

Yes — and prevention is one of the most powerful tools we have against PHN. The shingles vaccine is recommended for adults 50 years and older. The current vaccine, called Shingrix, is given in two doses. It is highly effective at reducing the risk of getting shingles in the first place, and it also lowers the chance of developing PHN if shingles does occur.

If you have already had shingles and now have PHN, vaccination will not treat your current pain. But if you have not had shingles — or even if you have — talk to your primary care provider about whether the vaccine is right for you. Protecting yourself and your loved ones from shingles is a meaningful step toward avoiding this painful complication.

Finding Hope and Moving Forward

Living with postherpetic neuralgia is genuinely hard. The pain is invisible to others, but it is very real to you. It can wear on your mood, your sleep, and your sense of hope. Please know that it is okay to ask for help — from your doctors, your family, and your support network.

Many people with PHN do find meaningful relief with the right care plan. Pain levels often improve over time, especially with proper treatment and support. The goal of pain management is not always to eliminate pain completely, but to help you live a fuller, more comfortable life. You deserve care that takes your pain seriously.

If you are in the Modesto area and looking for compassionate, specialized support, Unity Pain Management is here to help. Contact us today to schedule an evaluation and take the next step toward feeling better.

References

• Dworkin, Robert H. et al. “Recommendations for the Management of Herpes Zoster.” Clinical Infectious Diseases. 2007.
• Johnson, Robert W. and Anne A. Rice. “Postherpetic Neuralgia.” New England Journal of Medicine. 2014.
• Centers for Disease Control and Prevention. “Shingles (Herpes Zoster): Clinical Overview.” CDC.gov. 2023.
• National Institute of Neurological Disorders and Stroke. “Postherpetic Neuralgia Information Page.” National Institutes of Health. 2023.
• Mayo Clinic Staff. “Postherpetic Neuralgia — Symptoms and Causes.” MayoClinic.org. 2023.