Postherpetic Neuralgia – Symptoms and Causes
What Is Postherpetic Neuralgia?
Postherpetic neuralgia is a nerve pain condition that develops after a shingles infection. This painful condition persists long after the visible signs of shingles—the rash and blisters—have healed.
The condition primarily affects older adults. People over 60 face the highest risk. Though there is no cure for postherpetic neuralgia, several treatment options can help manage the symptoms.
Most patients experience improvement over time. The pain typically feels like burning or stabbing in the area where the shingles rash occurred. For some people, even light touch to the affected skin can trigger intense pain.
Pain Symptoms After Shingles
Postherpetic neuralgia creates pain that stays in the skin area where shingles first appeared. This typically forms a band around the body’s trunk, usually affecting just one side.
Common symptoms include:
- Lasting pain that continues for more than three months after the shingles rash heals
- Pain may feel burning, sharp, jabbing, deep, or aching
- Sensitivity to touch where even clothing touching the skin becomes painful
- Itching or numbness in the affected area (less common)
When to Get Medical Help
Contact your healthcare provider as soon as you notice possible shingles symptoms. The pain often begins before you see any rash.
Taking antiviral medications within 72 hours after the rash appears can greatly reduce your risk of developing long-term nerve pain.
Don’t wait to see if symptoms improve on their own, as early treatment is key to preventing complications.
Causes
Shingles come from the same virus that causes chickenpox. After someone has chickenpox, the virus doesn’t leave the body. It stays dormant (inactive) in nerve tissues for many years.
The virus can reactivate later in life, causing shingles. This reactivation becomes more likely as people get older. Certain factors that weaken the immune system can trigger an outbreak, such as:
- Aging (people over 50 are at higher risk)
- Cancer treatments
- Medications that suppress the immune system
- Stress
- Other illnesses
Postherpetic neuralgia, a painful condition that can follow shingles, happens when the virus damages nerve fibers. These damaged nerves send confused signals to the brain.
Instead of normal sensations, the person feels ongoing pain that can last for months or even years after the shingles rash disappears.
Risk Factors
Certain factors increase your chance of developing postherpetic neuralgia after having shingles:
- Age over 60 – older adults face a higher risk.
- Severe shingles outbreak – intense rash and pain that interfere with daily activities.
- Chronic health conditions – having ongoing illnesses like diabetes.
- Location of shingles – rashes on the face or trunk area.
- Delayed treatment – not starting antiviral medications within 3 days after the rash appears.
- Vaccination status – not having received the shingles vaccine.
Complications
Long-term nerve pain from postherpetic neuralgia may lead to several other health issues. These problems often depend on how severe the pain is and how long it lasts.
People might experience:
- Depression
- Sleep problems
- Fatigue
- Loss of appetite
These complications can make daily life more difficult. When pain persists, it affects both physical health and emotional well-being.
Prevention
Vaccination is the most effective way to prevent shingles and its painful complication, postherpetic neuralgia. The Shingrix vaccine is recommended for adults 50 years and older in the United States.
This highly effective vaccine is also recommended for adults 19 and older who have weakened immune systems due to certain medical conditions or treatments.
Shingrix requires two doses, given 2 to 6 months apart. The vaccine offers strong protection. When both doses are received, it has over 90% effectiveness in preventing both shingles and postherpetic neuralgia.
Important points about shingles vaccination:
- You should get Shingrix even if you’ve already had shingles
- Previous vaccination with older vaccines doesn’t eliminate the need for Shingrix
- Discuss timing with your healthcare provider
Other countries may offer different shingles vaccines. Your healthcare provider can help determine the best prevention strategy based on your age, health status, and vaccine availability in your region.
