### Understanding Postherpetic Neuralgia For most people, the symptoms of shingles usually fade away along with the rash that may have appeared along one side of their body or face. But for some people, pain persists long after their skin has cleared. This condition is called postherpetic neuralgia, a complication of shingles. You might feel intense sensations of tingling, burning, and shooting that don’t let up. This could last for 3 months or longer, and you could be sensitive to touch and have trouble wearing clothes. ### Causes Postherpetic neuralgia starts out with a very familiar illness: chickenpox. The virus that causes it is called varicella-zoster. Once chickenpox has run its course, the virus “hides out” in your nervous system. Doctors aren’t sure exactly why, but sometimes the virus reactivates decades later and travels along pathways to your skin, causing a painful, blistering rash known as shingles. In some cases, shingles can damage your nerves so that they can’t send messages from your skin to your brain as they usually do, triggering the ongoing pain of neuralgia. ### Symptoms You usually have pain on one side of your body, where you had the blisters. The feeling is described as shooting, sharp, or stabbing. Other signs you have neuralgia include sensitivity to touch and trouble wearing clothes. ### Treatment Options Medication can help with shingles pain. Your doctor has a host of ways to treat your pain after shingles, including a variety of medications such as anticonvulsants, tricyclic antidepressants, and prescription painkillers. Over-the-counter medicine may be enough for mild cases, but others might need more powerful opioid (narcotic) painkillers. You might also find relief with topical treatments like creams containing capsaicin or patches like Qutenza and Lidoderm. Other methods include TENS (transcutaneous electrical nerve stimulation), cold packs, and wearing comfortable clothes. ### Prevention The FDA has approved two shingles vaccines, Zostavax and Shingrix. A vaccine is now recommended for everyone 60 and older. People from 50 to 59 may want to talk to their doctor about it if they have ongoing pain or skin issues or have a weakened immune system. The vaccines cut the chance of shingles by at least 50%. Even if you still get shingles, the painful period is shortened and you reduce your risk of postherpetic neuralgia. Early treatment for shingles can also lower your chances of getting this complication. So if you think you have it, call your doctor right away. The main treatment is with antiviral drugs during the early stages of shingles, within 2 to 3 days of symptoms coming on.