Skin Health Fungal, Bacterial & Viral Infections Shingles How to Manage Shingles Pain By Sherry Christiansen Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Updated on November 15, 2022 Medically reviewed by Cristian Zanartu, MD Medically reviewed by Cristian Zanartu, MD Twitter Cristian Zanartu, MD, is a licensed board-certified internist who has worked for over five years in pain and palliative medicine. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Pain During Shingles Pain After Shingles Treatment Prevention Coping Early treatment for shingles (herpes zoster) includes antiviral medications that can shorten the duration and lessen the severity of symptoms. It’s important to seek medical attention at the first sign of symptoms to help with shingles pain. This article addresses how to manage shingles. franciscodiazpagador / Getty Images Pain During Shingles Shingles pain may be experienced in the area where the blisters will soon surface (before any visible rash is present). A person often experiences a pins and needles sensation, or a painful, itchy feeling at this stage of the disease called the prodromal phase. The prodromal phase may last several days. As the condition progresses, a painful red rash with blisters appears and new vesicles will continue forming for three to five days. The blisters will gradually burst, eventually crusting over, sometimes causing severe itchiness. The herpes zoster virus begins to spread from the nerve root to the peripheral (outside of the central nervous system) nerve endings. This causes the nerves to send messages to the brain that are interpreted as severe pain, burning, or itching. The skin—located in the rash area—becomes much more sensitive than it normally is. The type of pain that is common for people with shingles includes: Stabbing or burning painPain that feels like an electric shockPins and needles sensationBurning or throbbing pain in the eye, blurred vision, extreme sensitivity to light Shingles and Your Eyes If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye. Shingles pain—and other symptoms from an outbreak of herpes zoster—usually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, it’s called postherpetic neuralgia (PHN). Pain After Shingles Approximately 10% to 18% of those who get shingles will experience PHN. The risk of PHN increases with age. PHN involves pain and discomfort in the area where the shingles occurred. It’s not possible to predict who will develop the long-term symptoms of PHN, but age, race, and general health are thought to play a role in its development. The pain from PHN is defined as mild to severe pain that continues months after the initial rash breaks out. Symptoms of discomfort from PHN may include: Pain that is intermittent or constant Pain that is easily stimulated by simply touching the skin (a condition called allodynia) Tingling Coldness Loss of feeling Scientists are unclear about the exact cause of the ongoing pain that occurs when a person has PHN. Some experts hypothesize that there is residual inflammation from damage to the nerve after the initial outbreak of shingles resolves. Treatment Treatment of Pain During Shingles Pain management for shingles discomfort may include: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn)Tylenol (acetaminophen)Antiviral medicationsCorticosteroidsNarcotic pain relievers How Shingles Is Treated Treatment of Pain After Shingles Treatment for people with PHN may include: Nerve blocks: Local anesthetic or alcohol injected directly into the nerve affectedThoracic epidural injections: Local injection in the space around the spinal cordAntidepressant medications: Such as amitriptylineMembrane stabilizers: Such as gabapentinCapsaicin application: Topical (on the skin) cream applied to the affected area Prevention For some people, pain after shingles can become resistant to treatment; this is why very early intervention is vital. Ideally, treatment should begin when a person initially feels the tingling or burning sensation, even before the rash breaks out. Shingles Vaccine A shingles vaccine is the only way to protect against shingles; it also guards against PHN. The Centers for Disease Control and Prevention (CDC) recommends that any person aged 50 or older should have two doses of the Shingrix vaccine (each dosage is separated by two to six months). Shingrix is said to initially provide 90% effectiveness against shingles and PHN. Protection remains at more than 85% for four years after a person is vaccinated. Shingles Vaccine Side Effects Coping With Shingles Pain If you have shingles, you may be wondering how to cope with the pain: Be sure to get plenty of sleep and eat a healthy diet to help boost your immune system.Wear comfortable, loose clothing with natural fiber (such as cotton).Establish or maintain a regular exercise routine.Utilize home remedies to help soothe pain from blisters.Engage in activities that help take your mind off of the pain.Establish a routine to help manage stress.Seek out support when needed from family and friends as well as professional supportive services. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Shingles (herpes zoster). MedlinePlus. Postherpetic neuralgia. National Institute of Neurological Disorders and Stroke. Shingles: hope through research. MedlinePlus. Shingle-aftercare. Cleveland Clinic. Burning, lingering pain after shingles? 5 options may help you. Cleveland Clinic. Shingles. National Institute on Aging. Shingles. By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit