Since it affects nerves, shingles can cause pain, burning, or tingling, as well as an itchy rash that blisters.

Shingles, also known as herpes zoster, results from the reactivation of the varicella-zoster virus.

After an infection of varicella, known as chickenpox, the virus remains dormant in the body’s nervous system. Years later, the virus can reactivate as herpes zoster, a viral infection in nerves leading to the skin’s surface.

In some people, shingles pain lasts after the rash has healed. This is called postherpetic neuralgia.

Let’s examine the type and locations of shingles pain, strategies for relief, and postherpetic pain.

Shingles pain can be mild or very intense. Before the onset of pain, you may feel burning, tingling, or itching in the area where the rash will appear. The rash usually appears in a strip on one side of the torso.

Some people feel pain from the slightest movement, such as a breeze or the touch of bedsheets, while others only feel itching. This can be in addition to systemic symptoms of a viral infection, including:

  • fever
  • headache
  • fatigue

Shingles pain most commonly occurs along the path of the rash. Inflamed nerves underneath the skin cause pain.

After the rash clears up, some people are left with pain along the rash’s track. This is called postherpetic neuralgia.

Pain can be felt wherever the rash is located. The two most common locations for a rash are:

Shingles pain in the back

Shingles pain on the back can range from mild to intense and it can be dull, burning, or sharp stabbing. It can also be constant or intermittent. Additionally, your skin may be tender.

Shingles and chest pain

According to a 2018 study, inflammation of nerve cells underneath the skin is the root cause of pain in shingles rashes. Shingles typically produces symptoms on one side of the chest, with a feeling of burning, itching, or tingling.

When the shingles rash has cleared up but the pain remains, this is a condition known as postherpetic neuralgia. Defined as pain existing 3 months after diagnosis of the condition, pain from postherpetic neuralgia can be mild or intense.

Trying to sleep can become difficult when you have shingles. There are several reasons for this. First, at night, there are fewer distractions from the pain. It becomes front and center in your mind just when you need to drift off to sleep.

Also, simple things like the weight of bed linens coming into contact with your rash can stimulate pain receptors in the skin.

When shingles pain peaks depends on the person.

Tingling, itching, and other systemic symptoms like fever can develop within 1 to 5 days of infection. The rash typically appears soon after and lasts 1 to 2 weeks.

Doctors recommend seeking treatment within the first 3 days of the rash to avoid prolonged pain and promote healing.

Several at-home and prescription treatments are available for shingles.

Home remedies

Many home remedies are worth looking into for treating shingles, including:

Does Apple cider vinegar treat shingles pain?

Apple cider vinegar can help treat a host of conditions, including shingles. However, no scientific studies support it as an effective treatment for shingles pain relief.

Over-the-counter (OTC) shingles pain relief

Speak with your doctor about what type of OTC pain and rash relief, such as oral or topical medication, is right for you.

They may recommend OTC pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) to help with pain.

What OTC creams work for shingles pain?

Creams for shingles include:

  • lidocaine cream and patches
  • capsaicin cream and patches
  • aluminum acetate (Burow’s solution), an astringent with a protective effect against inflamed and irritated skin
  • aloe vera, which has antiviral effects

Prescription shingles pain medication

Doctors typically prescribe an antiviral medication to fight shingles. Three popular choices are:

  • acyclovir
  • famciclovir
  • valacyclovir

Most cases of shingles last from 3 to 5 weeks. If the pain lasts longer than the rash, this may be postherpetic neuralgia.

Postherpetic neuralgia is pain lasting longer than 3 months after diagnosis of the rash. The pain can be mild or intense, and it can present as tingling, numbness, and coldness.

About 10% to 18% of people who develop shingles may have ongoing pain. However, postherpetic neuralgia may improve over time.

Reach out to your doctor if you have received a shingles diagnosis, are undergoing treatment, and experience any of the following:

  • if your rash is more painful than before
  • if the rash becomes infected
  • if you have a fever with the rash
  • if the rash spreads across your whole body

Shingles, or herpes zoster, is an infection that can develop after a person has chickenpox. The varicella-zoster virus, which causes chickenpox, can lie dormant in the nerve cells until years later when it reactivates and causes shingles, a painful, blistering rash that affects one side of the body.

Inflamed nerve endings cause pain from shingles under the skin. The rash typically spreads across the chest or back in a stripe, although it can also affect the face or head.

Shingles pain worsens with small things like breezes and the light touch of clothing. It typically subsides in a few weeks, although longer-lasting nerve pain called postherpetic neuralgia may result.