Introduction

Post-herpetic neuralgia is a persistent nerve pain that occurs at the site of a previous attack of shingles.

It's estimated up to one in every five people with Shingles will go on to develop post-herpetic neuralgia, and older people are particularly at risk.

The paincan improve after a few months and medication can help control it in the meantime, although some cases are more persistent and can even be permanent.

Why does it happen?

In post-herpetic neuralgia, the varicella zoster virus the virus that causes chickenpox and shinglesdamages nerves under the skin of the affected area.

It's not clear why some people with shingles develop post-herpetic neuralgia, but increasing age, pain in the early (prodromal) stage of a shingles attack, and severe pain throughout an episode of shingles are all associated with an increased risk of the condition.

Signs and symptoms

The main symptom of post-herpetic neuralgia is continuous nerve pain in an area previously affected by shingles. The pain has been described as burning, stabbing, shooting, aching or throbbing.

The affected area may also:

• feel intensely itchy
• be moresensitive to pain than usual (hyperalgesia)
• feel painful as a result of something that would not normally hurt (allodynia), such as a light touch ora cool breeze

Living with post-herpetic neuralgia can be very difficult as it can interfere with your ability to carry out certain daily activities, such as dressing and bathing, and can lead to further problems such as extreme tiredness (fatigue), sleeping difficultiesand depression .

Read about living with long-term pain for information and tips on how to cope.

Seeing your GP

Howpost-herpetic neuralgia is treated

Manypeople with post-herpetic neuralgia make a full recovery within a year of developing the condition. But occasionally the nerves do not heal completely and symptoms last for several years or permanently.

Medication can ease the symptoms of post-herpetic neuralgia, although they may not relieve the pain completely.

As post-herpetic neuralgia generally doesn't respond to standard painkillers such as paracetamol and ibuprofen , alternative medications will need to be prescribed.

These will often be medications originally intended to treat depression (antidepressants) or epilepsy (anticonvulsants), but have since been found to also be effective in relieving nerve pain.

However, antiviral medication will often be given early during an episode of shingles to help reduce the risk of complications such as post-herpetic neuralgia.

Alternatively, you can reduce your risk of post-herpetic neuralgia by having the shingles vaccination to try to prevent an attack of shingles occurring.

This vaccine is routinely offered to older people on the NHS. It is given as a single injection to anyone aged 70. There is also a catch-up programme for those aged 78 and 79. You will only need to have this vaccine once.

If you wish to have the shingles vaccine and you are not eligible for the NHS vaccination programme, you will usually need to visit a private clinic. Private vaccination is likely to cost 100 to 200.

Trigeminal neuralgia

This article focuses on post-herpetic neuralgia, a common type of nerve pain that occurs after a previous attack of shingles.

Despite having a similar name, trigeminal neuralgia is a much rarer type of facial nerve pain that occurs in sudden short attacks lasting from a few seconds to about two minutes.

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