Post-herpetic neuralgia (PHN) is a long-lasting nerve pain that occurs after an episode of shingles (herpes zoster). It happens when the varicella-zoster virus — the same virus that causes chickenpox — reactivates later in life and damages the sensory nerves. Even after the rash has healed, nerve irritation and inflammation can leave behind persistent, often severe pain in the affected area.
Typical symptoms include:
Post-herpetic neuralgia most commonly affects the chest, abdomen, face, or eye area, but it can occur anywhere shingles develops. The risk increases with age, immune compromise, or severe initial shingles outbreaks. Because the pain can persist for months or even years, early specialist management is key to improving quality of life.
At Wessex Pain Clinic, diagnosis is based on a clear history of shingles followed by persistent pain in the same nerve distribution. Our consultants perform a detailed neurological examination to assess sensation, skin sensitivity, and any residual rash or scarring.
We may use pain mapping to identify affected nerves and confirm whether the pain is confined to one dermatome (a band-like area of skin supplied by a single nerve). In some cases, ultrasound or MRI may be used to exclude other causes of nerve pain.
No invasive tests are usually needed, and diagnosis is primarily clinical.
Our physiotherapists and rehabilitation specialists help patients maintain gentle mobility and posture, preventing stiffness and weakness that can result from guarding the painful area. Hydrotherapy offers a soothing, low-impact way to move without worsening pain.
Our pain psychology team provides emotional and cognitive support, teaching techniques such as pacing, relaxation, and mindfulness to help manage chronic pain, anxiety, and sleep difficulties.
We take a holistic, consultant-led approach, ensuring that both the physical and psychological effects of shingles pain are addressed.
At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
We may prescribe a combination of:
Our consultants carefully tailor medication regimens, balancing effectiveness with safety, especially in older adults.
Botox is a recognised treatment for post hepatic neuralgia (shingles pain). It works at a nerve level to subdue overactive peripheral nerves. This is done in clinic with a very small needle, minimising discomfort. We also offer Qutenza Patches. These are high strength capsaicin patches that are only licensed for specialist use. They are applied to the area and can cause nerve die-back, reducing the areas sensitivity. They are an NHS approved and recognised treatment option for peripheral nerve pain. Wessex Pain clinic are one of very few clinics in the UK offering this privately.
In severe or treatment-resistant cases, we may consider nerve blocks, intravenous lidocaine infusions, or neuromodulation (spinal cord stimulation) to reduce abnormal nerve signalling and improve pain control.
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
