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Identifying the cause of your pain using a combination of clinical examination and imaging technologies. Once the cause of pain is identified, we target our therapies using precision-based and minimally invasive injections on a daycare basis. Attention to detail and having all aspects of pain covered is our motto in providing pain control and long-term favorable patient outcomes.


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Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.

The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There's no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.


The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on one side of your body.

Signs and symptoms might include:

  • Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.

  • Sensitivity to light touch. People with the condition often can't bear even the touch of clothing on the affected skin (allodynia).

  • Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

When to see a doctor

See a doctor at the first sign of shingles. Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is lessened if you begin taking antiviral medications within 72 hours of developing the shingles rash.

In case you continue to have pain after months of the rash you need to see a pain medicine consultant ot explore various options to manage the pain.

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Once you've had chickenpox, the virus remains in your body for the rest of your life. As you age or if your immune system is suppressed, such as from medications or chemotherapy, the virus can reactivate, causing shingles.

Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers can't send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that can last months — or even years.

Risk factors

When you have shingles, you might be at greater risk of developing postherpetic neuralgia as a result of:

  • Age. You're older than 50.

  • Severity of shingles. You had a severe rash and severe pain.

  • Other illness. You have a chronic disease, such as diabetes.

  • Shingles location. You had shingles on your face or torso.

  • Your shingles antiviral treatment was delayed for more than 72 hours after your rash appeared.


The options for managing post herpetic neuralgia are many and one or more than one of the below options can be used depending on the severity of the pain and how the pain is affecting the person’s daily life.

  • Nerve pain medications- these are special group of medications which help in decreasing nerve damage related pain. Under supervision of your pain medicine consultant these can be safely taken in the long term to control the pain

  • Locally applied plasters are available to control pain.

  • Minimally invasive interventional pain management options like pulsed radiofrequency appliacation to dorsal root ganglion. In this procedure a specialized thin needle is inserted under X-ray guidance to the nerve that is affected and strong radio current is applied to the nerve. This helps to relieve pain in the long term.

  • Dorsal Root ganglion stimulator is also an option in people who have no benefit from any of the above.



The only way one can prevent post herpetic neuralgia is if one does not get shingles. This is possible if vaccinations are offered to eligible persons (eg: age above 50, in people with low immunity). 

Also, good pain control by your pain medicine consultant during the acute phase of shingles will help prevent chronic post herpetic neuralgic pain. 

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