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What Are The First Symptoms Of Postherpetic Neuralgia & How Do You Test For It?

The shingles symptoms generally disappear for most individuals together with the associated rash that usually emerges on one side of the face or body. The shingles are caused by the same virus that triggers chicken pox. However, in some cases, the pain continues for long even after the skin rashes get cleared. It is known as postherpetic neuralgia or PHN, and it is a type of shingles complication. You may feel intense and persisting pain, with a burning, and tingling, sensation. This may last for more than 3 months and you may be susceptible to touch with difficulty in wearing any type of clothes. It is always advisable to consult your doctor if your shingles are continuing to pain for weeks1,2.

What Are The First Symptoms Of Postherpetic Neuralgia?

What Are The First Symptoms Of Postherpetic Neuralgia?

Postherpetic neuralgia is a common complication associated with shingles. The disease impacts your skin and nerve fibers, resulting in a long-lasting burning sensation once the shingle blisters and rash are gone. The chance of postherpetic neuralgia rises with age, mainly involving individuals over 60 years old. There is no remedy, but medications can alleviate symptoms3.

The symptoms of postherpetic neuralgia are usually restricted to the region of the skin where the onset of shingles first took place. Usually, it appears as a band around one side of the trunk3.

Other related symptoms are:

  • Having a persistent pain for over 3 months, even after complete healing of the shingles rash and blisters (aching, burning sensation, sharp and jabbing pain)
  • Highly sensitive to touch is a common sign (it is even difficult to wear clothes)
  • Numbness and itching feeling may be present in some individuals
  • Individuals suffer increased pain with a change in temperature
  • Headaches
  • Although rare, it may even result in weakness of muscles with signs of paralysis
  • Fatigue and difficulty in sleeping are common problems
  • Patients find it difficult to carry out daily chores of life
  • Wearing clothes and bathing become painful

If you are suffering from most of the above symptoms for weeks after healing of shingles then consult your doctor immediately. The Early start of treatment can help minimize the pain and extent of the disease.

How Do You Test For Postherpetic Neuralgia?

The virus stays inactive in your nervous system even after recovery from chicken pox. The virus may get reactivated in later stages of life, resulting in shingles. It is a nerve and neighboring skin infection where the abdomen and chest nerves are usually get affected. The usual functioning of nerve tissues is disrupted due to the damage of nerves induced by shingles. The defective nerves then get confused, sending chaotic and random signals of pain to your brain resulting in burning and throbbing pain3.

According to scientists, the shingles create pressure or strain to the nerves by developing scar tissues around it. This leads the nerve cells to transmit incorrect signals to the brain, many of which are pain signals. It is not clear why postherpetic neuralgia develops in some patients4.

Seeing Your Doctor And Early Diagnosis

Visit your doctor once you get the initial symptoms of shingles. Sometimes the pain begins before the emergence of the rash. If you start an antiviral therapy inside 72 hours of shingles rash development, your chance of having postherpetic neuralgia is reduced considerably.

Since postherpetic neuralgia is a type of shingle complication, it is usually simple to diagnose. You may have postherpetic neuralgia if the symptoms emerge after clearing of shingles or simply following the shingles. Physical examination and your case history of shingles and chickenpox are usually enough for a proper diagnosis. No further test or examination is required3,4.


Postherpetic neuralgia is pain that continues after rash healing following an acute event of as shingles. The pain was defined as a continuous feeling of stabbing or burning. Some people experience high sensitivity to touch. Symptoms may continue for a long time and even months or years and may have a profound impact on the life quality of the patient. Usually, a physical examination is sufficient to diagnose the disease in patients with a history of shingles (herpes zoster virus infection).


  1. Johnson RW. Herpes zoster and postherpetic neuralgia. Expert review of vaccines. 2010;9(sup3):21-26.
  2. Johnson RW, Rice AS. Postherpetic neuralgia. New England Journal of Medicine. 2014;371(16):1526-1533.
  3. Nalamachu S, Morley-Forster P. Diagnosing and managing postherpetic neuralgia. Drugs & aging. 2012;29(11):863-869.
  4. Jeon YH. Herpes zoster and postherpetic neuralgia: practical consideration for prevention and treatment. The Korean journal of pain. 2015;28(3):177.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 9, 2019

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