Shingles, also known as herpes zoster, is a painful skin rash caused by the reactivation of the varicella-zoster virus—the same virus that causes chickenpox. After a person recovers from chickenpox, the virus lies dormant in nerve tissue and can reactivate years later, especially with aging or immune system decline.
Shingles typically appears as a strip of painful blisters on one side of the body, most often on the chest, back, face, or neck. It can cause burning, itching, or shooting pain, and may be followed by long-term nerve pain known as postherpetic neuralgia (PHN).
What Causes Shingles?
The main cause of shingles is reactivation of the varicella-zoster virus. This can happen when the immune system is weakened due to:
Aging (especially over age 50)
Chronic illness or autoimmune disease
Stress or trauma
Cancer or chemotherapy
Immunosuppressive medications
HIV/AIDS or other conditions affecting immunity
Symptoms of Shingles
Burning, tingling, or itching sensation in a localized area
A painful, blistering rash that follows a nerve distribution (dermatome)
Rash is typically unilateral and may wrap around the torso or appear on the face
Fever, fatigue, and sensitivity to touch
In facial shingles: eye involvement can threaten vision and requires urgent care
After the rash resolves, postherpetic neuralgia (PHN) can persist for months or longer
How Is Shingles Treated?
Antiviral Medications
Starting treatment early—within 72 hours of rash onset—can reduce the severity and duration of shingles:
Acyclovir, Valacyclovir, or Famciclovir to inhibit viral replication
Helps prevent complications like PHN
Pain Management
NSAIDs or acetaminophen for mild discomfort
Neuropathic agents (gabapentin, pregabalin) for nerve-related pain
Topical lidocaine or cool compresses for localized relief
Corticosteroids may be used in select cases to reduce inflammation
Preventive Measures
Shingrix Vaccine:
Recommended for adults age 50+
90% effective in preventing shingles and postherpetic neuralgia
Interventional Pain Management Options
If shingles pain becomes severe or progresses to postherpetic neuralgia, targeted interventions can significantly improve comfort and quality of life:
Peripheral Nerve Blocks
Local anesthetic and steroid injections can reduce acute inflammation and pain
Especially useful when shingles affects the thoracic nerves or trigeminal distribution (face)
Stellate Ganglion Block
Helpful for facial or upper body shingles, particularly when the eye or forehead is involved
Can reduce pain and prevent chronic nerve sensitization
Epidural Steroid Injections
Ideal for thoracic or lumbar shingles pain
May decrease inflammation around affected spinal nerves
Radiofrequency Ablation (RFA)
For select patients with persistent pain, RFA may interrupt nerve transmission
Used as a long-term option for refractory cases
Spinal Cord Stimulation (SCS)
An advanced option for patients who develop postherpetic neuralgia
Provides long-term pain control by modulating pain signals at the spinal cord level
When to See a Specialist
You should seek prompt medical attention if you experience:
Localized tingling or pain before a rash develops
Blistering rash on the face or near the eyes
Severe nerve pain that persists after the rash heals
Early diagnosis and management not only shorten the course of shingles, but also help prevent long-term nerve damage and complications.
Get Expert Help for Shingles and Nerve Pain
At Parkview Spine & Pain, we provide comprehensive care for patients experiencing shingles and nerve-related pain. With expertise in both early management and interventional pain techniques, we help you heal faster—and stay pain-free.
👉 Schedule your consultation today to explore the best treatment options for shingles and postherpetic neuralgia.