Treatment of Postherpetic Neuralgia / Shingles Using LLLT/PBMT

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), uses red and near-infrared light applied over targeted areas. In our clinic it is used as part of a GP-led treatment approach for selected postherpetic neuralgia presentations.

PBMT/LLLT is non-invasive and generally well tolerated. Suitability and response vary, and treatment recommendations depend on the diagnosis, severity, duration of symptoms and individual clinical factors. PBMT/LLLT has been studied for a range of pain and injury conditions, including some nerve-related presentations. See our references page for supporting literature.

Gentle. Drug-Free. Evidence-Informed

Key Points

Postherpetic neuralgia (PHN) is a complication of shingles, a viral infection caused by reactivation of the chickenpox virus, resulting in persistent nerve pain after the shingles rash has resolved.
Common causes include a prior episode of shingles, where the varicella-zoster virus damages nerve fibres and causes inflammation.
Symptoms of PHN include burning, stabbing or itching pain in the areas previously affected by shingles, often persisting for months or even years.
Standard treatments may include antiviral medication during acute shingles, pain medication, topical therapies or nerve blocks. These may offer symptom relief for some people but are not suitable or effective for everyone.
Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected PHN presentations where nerve sensitivity, pain and local inflammatory processes are contributing to symptoms.
Treatment at Laser Pain Therapy is GP-led by Dr Shikha Parmar, with a structured six-week program and individualised advice.
LLLT/PBMT may be considered where symptoms persist despite standard treatment options, after appropriate medical assessment.

What is Shingles?

Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. After an initial chickenpox infection, the virus lies dormant in the body’s nerve tissues. It can reactivate later in life typically when the immune system is weakened due to stress, aging, or other factors.

Shingles manifests as a painful rash, often appearing as a band or cluster of blisters on one side of the body, usually on the torso, although it can affect other areas, including the face. The rash is usually accompanied by itching, burning, or tingling sensations.

In some cases, the pain persists even after the rash has healed, leading to a condition known as postherpetic neuralgia (PHN).

What Is Postherpetic Neuralgia?

Postherpetic neuralgia (PHN) is a chronic pain condition that develops after an outbreak of shingles. It occurs due to nerve damage caused by the herpes zoster virus during the shingles outbreak leads to persistent pain, even after the rash has healed.

The pain associated with PHN can last for months or even years and is described as burning, sharp, or stabbing. It occurs in the area where the shingles rash was previously located, often affecting the skin and underlying nerves.

PHN is more common in older adults or those with weakened immune systems, and its severity can vary, making early treatment for shingles important in reducing the risk of developing PHN.

Causes of Postherpetic Neuralgia

The primary cause of PHN is a prior episode of shingles. The varicella-zoster virus damages the nerve fibres during the shingles outbreak, causing inflammation and affecting the way the nerves transmit pain signals.

Some risk factors for developing PHN include:

Advanced age (individuals over 60 are at greater risk)
Severe shingles rash or pain during the acute phase
Delayed or inadequate treatment during the shingles outbreak

Common Symptoms

PHN presents with:

Persistent burning, stabbing or itching pain in the area where the shingles rash appeared
Sensitivity to touch or wind (allodynia)
Pain that worsens with activity or temperature changes
Pain that can last for months or years after the shingles rash has healed

How is Postherpetic Neuralgia Diagnosed?

Diagnosis is made through clinical evaluation by your usual family doctor. Dr Shikha Parmar will confirm the diagnosis by assessing your history of shingles and the duration and nature of your pain. During the physical examination, she may check for areas of heightened sensitivity or allodynia.

Occasionally additional imaging or tests may be conducted to rule out other conditions or confirm nerve damage associated with PHN.

Postherpetic Neuralgia – Treatment Overview

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is considered as part of a structured treatment approach for selected postherpetic neuralgia presentations. It may help modulate local inflammatory processes, oxidative stress and nerve sensitivity following shingles without applying mechanical stress to sensitive nerve tissue.

Why Consider Low Level Laser Therapy (LLLT)?

Many patients present after limited relief from pain medications, antidepressants, anticonvulsants, topical creams or invasive interventions such as nerve blocks or cortisone injections. These standard approaches may temporarily ease symptoms but are not suitable or effective for everyone, and they may not address ongoing nerve sensitivity or local inflammatory processes. LLLT/PBMT can be considered where nerve injury and inflammation persist and where gentle, non-invasive treatment is required.

Topical treatments, including lignocaine or capsaicin creams, can offer some symptom relief but are limited in scope and effectiveness for some patients. Similarly, invasive treatments such as nerve blocks or corticosteroid injections can provide short-term relief, but they may not provide lasting benefit for everyone.

Why ice, anti-inflammatories and cortisone may not support long-term recovery. Read more here.

How LLLT Supports Healing

LLLT uses red and near-infrared light and may support:

Helping modulate inflammation and oxidative stress
Local circulation and oxygen delivery
Lymphatic drainage
Cellular energy production (ATP)
Nerve recovery processes where irritation is present
Assisting pain reduction without loading or stressing the affected nerve

Non-Invasive and Supported by Research

PBMT/LLLT is non-invasive and generally well tolerated. It has been studied in a range of musculoskeletal pain and injury conditions. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery. Read more here.

See how LLLT may support the cellular environment involved in tissue recovery here.

Our Treatment Program

All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:

Up to 12 LLLT sessions
Early progress review after the first 6 treatments
Individualised advice and activity modification
Guided rehabilitation to support longer-term function

Progress is reviewed during the program. Many patients notice appreciable improvement after the first 6 treatments. If there has not been sufficient improvement by this review point, further treatment may not be recommended.

View the full treatment protocol and expected outcomes here.

Ready to Discuss Your Postherpetic Neuralgia Treatment Options?

If you are struggling with postherpetic neuralgia or shingles neuralgia, we invite you to contact our team at Laser Pain Therapy to discuss the suitability of LLLT for your presentation. Treatment suitability and outcomes vary, and assessment is required before recommendations can be made.