When shingles heals, but the nerve pain stays.
Postherpetic neuralgia, or PHN, is chronic nerve pain that can remain long after a shingles rash is gone. If medications, injections, or time have not brought lasting relief, Dr. Demetrio Aguila evaluates whether the painful peripheral nerves themselves may be part of the problem.
PHN is not just a rash problem. It is nerve pain.
Many patients say the rash was only the beginning. The skin may look healed, but the affected area still burns, shocks, stings, or aches.
For some, even clothing, bedsheets, a light touch, or normal movement can trigger severe pain.
What if the painful area can still be mapped?
PHN is often treated as a medication-management problem. Dr. Aguila looks at it through a peripheral nerve surgery lens.
During evaluation, the team looks for whether specific damaged or irritated peripheral nerves may be sending ongoing pain signals. When the painful pathway can be identified, there may be more options than simply living with the pain.
The goal is not to guess. The goal is to identify the pain source.
Not every patient with PHN is a surgical candidate. A careful consultation helps determine whether the pain pattern, history, and exam findings suggest a treatable peripheral nerve problem.
History and pain pattern
The team reviews when shingles occurred, where the pain remains, what the pain feels like, and what treatments have already been tried.
Peripheral nerve mapping
Dr. Aguila evaluates whether the painful area follows a pattern that may correspond to specific peripheral nerves.
Diagnostic confirmation
In some cases, diagnostic nerve blocks or other steps may help clarify whether the suspected nerve source is truly driving the pain.
Treatment planning
If the evaluation suggests a surgically treatable pain source, the team discusses the treatment plan, expectations, risks, and next steps.
PHN treatment should be specific to where the pain is coming from.
Many PHN patients have already tried medication, topical creams, injections, or other pain management treatments. Those may help some patients, but they do not always provide lasting relief.
Dr. Aguila’s approach focuses on identifying whether damaged or irritated peripheral nerves can be treated directly. This may involve targeted nerve procedures or surgery depending on the patient’s condition.
Scalp and face
PHN may affect the head, scalp, forehead, eye region, or face after shingles.
Chest and ribs
Some patients feel band-like burning or electric pain around the chest or flank.
Abdomen and back
Pain can remain along the abdomen, trunk, lower back, or side of the body.
Arms and legs
PHN can also affect the shoulder, arm, hand, hip, leg, ankle, or foot.
You may be ready for a deeper evaluation if the pain has not gone away.
This page is for patients who still have pain after shingles and feel like they have run out of answers.
The rash healed, but pain remains
The visible skin changes are gone, but the pain is still affecting sleep, clothing, movement, work, or daily life.
Standard treatments have not been enough
You have tried medication, creams, injections, or other treatments without lasting relief.
The pain follows a specific area
Your pain may follow a clear line, patch, band, or nerve-like pathway on one side of the body.
Frequently asked questions about PHN and shingles pain.
Postherpetic neuralgia, often shortened to PHN, is chronic nerve pain that continues after a shingles outbreak. The rash may be gone, but the affected nerves can continue producing pain.
No. PHN can affect many areas, including the scalp, face, chest, abdomen, back, arm, hand, hip, leg, ankle, or foot. The location depends on which nerves were affected by shingles.
No. Surgery is not automatically recommended. The purpose of consultation is to determine whether your pain pattern and exam findings suggest a surgically treatable peripheral nerve source.
Many patients who seek a PHN consultation have already tried several treatments. Prior treatment history helps the team understand what has and has not worked.
Yes. Total Pain Solutions reports that patients have traveled from all 50 states and 32 countries for care with Dr. Aguila.
If shingles pain is still controlling your life, start with a conversation.
You do not need to decide on treatment before you talk with the team. The first step is to share your story, your pain location, and what you have already tried.
Total Pain Solutions can help you determine whether a PHN consultation with Dr. Aguila may be appropriate.
Contact Dr. Aguila’s team
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2122 North 117th Avenue, Omaha, NE, 68164
402-370-9515
info@totalpainsolutions.net
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