Trigeminal Neuralgia and Postherpetic Neuralgia — August 2023

In August 2023 we published a clear, practical piece about trigeminal neuralgia and postherpetic neuralgia. Both cause real, often severe nerve pain, yet they start differently and need different actions. If you or someone you know has facial pain or lingering pain after shingles, the post gives straightforward steps you can use right away.

What connects them and how they differ

Both conditions come from nerve damage that makes the nerve send wrong pain signals. Trigeminal neuralgia usually affects the trigeminal nerve on one side of the face and causes sudden, electric-shock-like attacks. Simple things like chewing, talking, or a light touch can trigger it. Postherpetic neuralgia (PHN) happens after shingles. After the rash clears, the damaged skin nerves can keep sending burning, aching, or hypersensitive pain in the same area.

The connection is nerve injury: shingles is caused by the varicella zoster virus and often leaves lasting nerve damage. Trigeminal neuralgia may be from nerve compression, aging changes, or after nerve irritation from infections. In practice that means symptoms guide the first steps: PHN usually has a history of shingles in the same spot; trigeminal neuralgia often has sudden short shocks without a rash.

Diagnosis often involves a brief history and exam. Doctors may order an MRI when trigeminal neuralgia is suspected to rule out structural causes. For PHN, diagnosis is usually clinical—did you have shingles and now have persistent local pain or sensitive skin?

Practical takeaways from the article

First: don’t wait. Early treatment can reduce pain and improve recovery. If you had shingles, ask about antiviral treatment fast and talk to your doctor if pain continues beyond the rash. For trigeminal neuralgia, quick review by a clinician helps start proper meds and avoid unnecessary tests.

Second: medication options overlap but must match the cause. Common choices include carbamazepine or oxcarbazepine for trigeminal neuralgia and gabapentin or pregabalin for both conditions. Topical options like lidocaine patches or high‑dose capsaicin can help PHN at the skin site. Expect dose changes and side-effect checks—the post explains what to watch for and what tests your doctor may order.

Third: non-drug approaches matter. Nerve blocks, pulsed radiofrequency, physical therapy, and neuromodulation help many people. Simple home tips—cool compresses, loose clothing over sensitive skin, avoiding known triggers, tracking pain in a diary—make clinic visits more useful.

Finally, prevention: shingles vaccination (Shingrix) significantly cuts the risk of shingles and PHN. If you’re eligible, ask your provider about it. The August article walks you through practical questions to bring to your next appointment and action steps that can bring real relief.