Coping with Shingles Pain

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Pain Relievers

The visible symptoms of shingles, including its telltale rash, usually fade in a few weeks. But all too often, the pain of this infection lingers for months or years—a problem called Post-Herpetic Neuralgia (PHN). Whether you're feeling the first twinges of shingles or living with the sting of ongoing nerve damage in its aftermath, here's how to find relief.

Seek Treatment Fast

Tingling, burning, itching, or severe pain on one side of the body are often the first signs of a shingles outbreak. At this stage, over-the-counter pain relievers may ease the ache. Try acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

Other symptoms of shingles include upset stomach, fever, headache, and chills. Soon, you'll develop a red rash at the site where you felt the first discomfort.

See your doctor as soon as possible if you suspect shingles. While there's no cure, taking antiviral medication within 72 hours after the rash starts can help shorten the outbreak and decrease the potential for pain. In people older than 50,  receiving the shingles vaccine has been shown to lessen the intensity and duration of the shingles attack and lower the chances of getting PHN. 

Calming the Burn

In a few days, the red bumps of your rash will turn into fluid-filled blisters, often around your stomach or on your face. For some people, this rash causes only a mild pain. For others, radiating pain occurs at the slightest touch or even with a breeze, making regular activities difficult.

As with any other infection, rest and fluids can help you feel better. To soothe both itching and pain, apply anti-itch lotions, such as Benadryl and Caladryl. You can also try cool compresses soaked in a mixture of water and white vinegar, or baths containing colloidal oatmeal.  

If your pain is severe and persists even after trying these remedies, talk with your doctor. He or she may prescribe a more potent painkiller or corticosteroids to ease swelling and throbbing.

When Hurting Doesn't Stop

Shingles pain usually decreases within one or two months. But for about one in 10 people, the agony associated with shingles lasts for months or years. This painful condition is called postherpetic neuralgia (PHN), in which sensory nerve fibers are damaged, sending persistent pain signals to the brain.

The consequences of this pain are real and can include depression, insomnia, anxiety, and unwanted weight loss. PHN can keep you from doing your daily activities and enjoying your life. The older you are when you develop shingles, the greater your risk of PHN.

Though you may feel isolated, don't suffer in silence. Talk about your pain with your family, your friends, and, most importantly, your doctor. There are about a dozen medications that have been shown to be effective against PHN pain. These include steroids, antidepressants and anticonvulsants. You may benefit from a prescription for strong painkillers called opioids, or your doctor may recommend a cream, spray, or patch containing lidocaine or capsaicin, which you apply directly to your skin in the area that's painful.

In most cases, pain from PHN will eventually subside. In the meantime, make sure you're taking care of yourself. Rest, avoid stressful situations if you can, and eat nutritious foods. Ask your doctor if stretching or other simple exercises could help. And do things you enjoy—whether it's listening to music, watching a comedy, or reading—to help keep your mind off the pain.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Apr 14

  1. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. J. Fashner et al. American Family Physician. June 15, 2011, vol. 83, no. 12, pp. 1432-7.

  2. JAMA Patient Page: Shingles. J.M. Torpy. JAMA. January 12, 2011, vol. 305, no. 2, p. 212.

  3. Shingles. American Academy of Family Physicians.

  4. About Shingles. , NIH SeniorHealth.

  5. Shingles (Herpes Zoster): Prevention & Treatment. Centers for Disease Control and Prevention.

  6. Clinical Overview. Centers for Disease Control and Prevention.

  7. Shingles. National Institute on Aging.

  8. Shingles: Hope Through Research. National Institute of Neurological Disorders and Stroke.

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