What is Shingles?
Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus—the same virus responsible for chickenpox. After you’ve had chickenpox, the virus stays dormant in your nervous system. Years later, it can reactivate, especially in people with weakened immune systems, leading to a painful outbreak known as shingles.
Shingles typically affects one side of your body or side of the face, producing a blistering rash and deep, burning pain. In some cases, even after the scab and rash heal, patients develop postherpetic neuralgia, a long-lasting form of chronic pain.1
What Causes Shingles-Related Pain?
The shingles rash damages the nerve fibers beneath the skin. When the virus inflames these nerves, they can continue sending pain signals long after the rash has cleared. The most common trigger is a reactivation of the chickenpox virus, and the risk of developing shingles increases with age, immune suppression, or significant stress.
Pain may occur in the:
- Thoracic spine (chest or back)
- Side of the face, scalp, or neck
- Lumbar spine or lower back
- Arms, legs, or affected area of the trunk
Symptoms of Shingles and Post-Herpetic Neuralgia
Shingles usually starts with a tingling or burning sensation, followed by a painful skin rash that turns into fluid-filled blisters. This shingles rash usually appears on one side of the body, but the pain can spread or linger.
Common symptoms of shingles and PHN include:
- Burning, stabbing, or aching nerve pain
- Sensitivity to touch, even from clothing
- Tingling or numbness in the affected area
- Persistent pain lasting longer than three months
- Discomfort along the side of your body or face
- Disrupted sleep, anxiety, or reduced quality of life2,3
If you still feel pain after your shingles infection has cleared, you may be dealing with postherpetic neuralgia, a condition that requires medical attention.
How is it Diagnosed?
Our experienced healthcare providers use your symptoms, history of shingles, and a physical exam to diagnose postherpetic neuralgia or related conditions. In some cases, we may order imaging to rule out other causes of chronic pain, such as degenerative disc disease, spinal stenosis, or facet joint irritation.
We’ll also ask about previous use of antiviral medications like valacyclovir or acyclovir, which can shorten the duration of shingles if taken early.
Conservative & Non-Surgical Treatments
We believe in starting with non-surgical treatment options tailored to your pain level, location, and lifestyle.
Medication Management
Neuropathic pain relievers, including tricyclic antidepressants and anti-seizure drugs, may reduce overactive nerve signals. Antiviral drugs like acyclovir or valacyclovir are most effective when taken early and may reduce the severity of PHN.
Targeted injections of anesthetic can block pain signals from the affected nerves, offering both relief and diagnostic clarity.
These reduce inflammation around the spinal nerves, especially when shingles has affected the thoracic or lumbar spine.
Uses radio waves to deactivate the nerves sending chronic pain signals—ideal for long-term shingles pain that hasn’t responded to other treatments.
This non-invasive therapy delivers mild stimulation to nerves near the skin surface, helping reset abnormal pain responses in the affected area.
Used for chronic pain conditions that involve changes in brain pain processing. Helpful for stubborn cases of PHN.
Physical Therapy & Pain Coaching
Some patients benefit from gentle movement, posture guidance, and strategies to avoid triggering nerve pain—especially when the pain disrupts sleep or mobility.
Advanced Treatment Options
For patients with severe or unresponsive postherpetic neuralgia, advanced therapies may offer longer-term relief:
This treatment places a small device near the spinal cord to block pain signals before they reach the brain. It’s highly effective for chronic shingles pain.
A cutting-edge approach for nerve pain that hasn’t responded to conventional therapies. Ketamine works by disrupting pain signaling in the nervous system and can be helpful for stubborn PHN.
FAQs About Shingles Pain
Can shingles pain become permanent?
In some cases, yes. When nerve damage persists, it can lead to postherpetic neuralgia—a chronic pain condition that needs targeted treatment.
What are the best ways to treat shingles pain?
Treatment options include medications, nerve blocks, and advanced therapies like spinal cord stimulation. Early treatment with antiviral medications may also reduce your risk of PHN.
Is the shingles vaccine helpful?
Yes. The shingles vaccine is the best way to reduce your risk of developing shingles and its complications. Talk to your primary care or dermatology provider about your eligibility.
Where can I find shingles pain treatment near me?
We care for new patients from across Dallas, Fort Worth, Arlington, and surrounding Texas communities. Our compassionate team will help you explore the right path forward.
Schedule a Consultation
If you’re still in pain after a shingles infection, don’t wait. At DFW Spine & Pain Institute, we provide expert care for postherpetic neuralgia and shingles-related nerve pain using the latest in pain management techniques. From Dallas to Fort Worth, Arlington, and beyond, our specialists are here to help you heal. Contact us today to schedule a consultation.
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