Burning Pain
A constant burning or searing sensation in the area where the shingles rash appeared. This is the most commonly reported symptom and can range from mild to severe.
- Constant or near-constant
- Follows the rash area
- Can worsen at night
Postherpetic Neuralgia Specialist
Nerve pain after shingleshelp
Postherpetic neuralgia is nerve pain that lingers after shingles. It can feel like burning, stabbing, or deep aching that does not let up. Our pain specialists work out the right approach to reduce your pain and help you get back to daily life.
- Postherpetic Neuralgia Specialist
- Personalised exercise plan
- Ongoing support
Overview
Around 10 to 18% of people who get shingles develop postherpetic neuralgia. The risk is higher over 60. Early specialist treatment can make a significant difference to outcomes.
Source: British Journal of Anaesthesia
You're not alone
Help is available, and you do not have to manage this on your own.
Symptoms
What Is Postherpetic Neuralgia?
Postherpetic neuralgia happens when the varicella-zoster virus (the virus that causes chickenpox and shingles) damages nerve fibres during a shingles outbreak. Even after the rash clears, the damaged nerves keep sending pain signals to the brain.
Stabbing and Shooting Pain
Sharp, sudden bursts of pain that can feel like electric shocks. These can happen without warning and are often very distressing.
- Sudden onset
- Electric shock feeling
- Unpredictable timing
Allodynia
Extreme sensitivity where even light touch, clothing, a breeze or bedsheets causes pain. This happens because the damaged nerves overreact to normal sensations.
- Pain from light touch
- Clothing sensitivity
- Temperature sensitivity
Itching and Numbness
Intense itching or a deep numbness in the affected area. Some people experience both at different times, along with a crawling or tingling sensation under the skin.
- Deep itch
- Numbness or tingling
- Crawling sensation
Sleep Disruption
The pain often worsens at night, making it hard to fall asleep or stay asleep. Poor sleep makes the pain feel worse the next day, creating a difficult cycle.
- Worse at night
- Difficulty sleeping
- Fatigue and low mood
Common Locations
PHN most often affects the torso (chest and abdomen), but can also occur on the face, neck or limbs, wherever the original shingles rash appeared.
- Chest and rib area
- Face and forehead
- Neck and shoulders
Causes
When to See a Specialist
If your pain has lasted beyond the shingles rash or is not improving, it is worth getting specialist advice.
Burning pain that persists after the shingles rash has healed
Skin so sensitive that even clothing causes pain
Shooting or stabbing pain that comes in sudden bursts
Pain that is disrupting your sleep or daily routine
Over-the-counter painkillers are not making a difference
Pain lasting more than three months after shingles
Treatments
Treatment Options
Postherpetic neuralgia often needs a combination of approaches, tailored to how your pain presents.
Explore Treatments
Nerve Block Injections
Targeted injections to reduce inflammation around the affected nerves and interrupt pain signals. Can provide meaningful relief when medication alone is not enough.
- Intercostal nerve blocks
- Paravertebral blocks
- Targeted nerve root injections
Neuropathic Pain Medication
We review and optimise medication that specifically targets nerve pain, including certain antidepressants and anticonvulsants. Getting the right combination and dose is key.
- Gabapentinoids
- Tricyclic antidepressants
- Topical treatments (capsaicin, lidocaine)
Rehabilitation and Self-Management
Structured programmes to improve sleep, build coping strategies, and gradually restore function. Understanding and managing the condition is a key part of long-term recovery.
- Sleep and pacing support
- Desensitisation techniques
- Graded return to activity
How it works
What to Expect
Getting started is straightforward.
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1
Request
If you know the type of pain you're experiencing, you can request an appointment online or give us a call - it only takes a couple of minutes. If you're unsure where to start, please give us a call. Our team will be happy to listen, answer your questions, and help guide you toward the most appropriate next step.
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2
Consultation
Your consultation will usually last 30–45 minutes with one of our experienced pain specialists. This gives your doctor time to understand your symptoms, review your medical history, discuss any previous treatments, and consider the most appropriate next steps for you. The consultation fee is €350, payable on the day of your appointment.
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3
Your Treatment Plan
We'll create an individual, tailored pain management plan based on your needs. This may include a combination of treatments, procedures, or infusions, with review appointments to monitor your progress and ongoing care from our experienced pain specialists.
Common questions
FAQs
What is postherpetic neuralgia?
Postherpetic neuralgia (PHN) is nerve pain that continues after a shingles rash has healed. The virus damages the nerve fibres during shingles, and this damage causes ongoing pain, sometimes lasting months or years. It is the most common complication of shingles and is more likely in people over 60.
Do I need a GP referral?
A GP referral is required for insurance cover of any treatments or procedures. If you are self-paying, a GP referral may not be required. Please bring any relevant medical information, reports, scans, or medication details to your appointment. Our current waiting time is typically 1–2 weeks.
How common is postherpetic neuralgia?
Around 10 to 18% of people who get shingles go on to develop PHN. The risk increases significantly with age. Roughly 1 in 3 shingles patients over 60 will experience it. In Ireland, shingles affects thousands of people each year, so PHN is more common than many people realise.
Can postherpetic neuralgia be cured?
There is no guaranteed cure, but effective treatment can significantly reduce pain and improve quality of life. Many patients experience substantial relief with the right combination of medication, nerve blocks, and rehabilitation. For some, the pain gradually resolves over time.
Is it covered by insurance?
We accept all the major insurers. We recommend checking with your insurer to confirm what is covered under your specific policy.
What happens at my first appointment?
Your first visit lasts about 30 to 45 minutes. The specialist will go through your medical history, examine the affected area, and discuss your symptoms and how they are impacting your life. From there, we create a tailored pain management plan designed around your case.
Conditions we treat