Pain Management: Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is a painful, chronic condition that can occur following shingles, a viral infection that causes a mildly itchy to intensely painful rash.

PHN occurs most often in elderly people and in people whose immune systems have been compromised.

The pain of PHN, which occurs in the same area as the pain and rash of shingles, results from damage to nerve fibers during the shingles infection. Shingles is caused by a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Anyone who has had chickenpox can get shingles, but the disorder is most common in people over the age of 50.

What Are the Symptoms of Postherpetic Neuralgia?

In PHN, pain is intense and may be described as burning, stabbing, or gnawing. Affected areas of the body may be hypersensitive or may have decreased sensation. In addition, areas previously affected by shingles may show evidence of scarring.

How Is Postherpetic Neuralgia Diagnosed?

PHN usually is diagnosed when pain lasts four months or more after acute attack of shingles or when pain persists more than 90 days or appears after the skin lesions of shingles have healed.

How Is Postherpetic Neuralgia Treated?

PHN is treated with medications including prescription pain relievers, anticonvulsants, and antidepressants. For some people, PHN may improve over time without treatment.

Reviewed by the doctors at The Cleveland Clinic Pain Management Department.