Acupuncture and Chinese medicine have been shown in clinical research to help manage the pain and discomfort of shingles, including the nerve pain that can persist after the rash clears, known as postherpetic neuralgia (PHN).¹ ² Shingles, also called herpes zoster, is a painful viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox. It typically produces a blistering rash that wraps around one side of the torso or face.
Throughout my years of clinical experience, I have helped many patients with herpes zoster and post herpetic neuralgia with acupuncture and chinese medicine to reduce pain, discomfort, and inflammation with the goal of bringing about long term improvements.
In this article, I will tell you how Chinese medicine works to treat herpes zoster and post-herpetic neuralgia as well as share clinical research about these challenging conditions.
This article is for educational purposes only and does not serve as medical advice. Please consult a Chinese Medicine Practitioner before taking Chinese herbal medicine.
Table of Contents
Symptoms of Shingles
The main symptom of shingles is a painful, blistering rash that usually appears on one side of the body, often in a band-like pattern. This is accompanied by pain, itching, and sometimes flu-like symptoms. The pain results from inflammation of the nerves under the skin where the rash occurs.
Postherpetic Neuralgia
Postherpetic Neuralgia (PHN) is a chronic pain condition that can remain after the skin rash of shingles has healed. The pain of PHN can be intense, deeply aching, burning, or stabbing, and it can persist for months or even years after the initial outbreak.
PHN occurs when the shingles infection damages the sensory nerves, leading to changes in nerve function at the sites of the rash and along the nerve pathway.
Shingles and Postherpetic Neuralgia from a TCM Perspective
In Chinese Medicine illness is a manifestation of an underlying imbalance within the body. Shingles is often caused by an attack of heat and dampness. Heat is associated with inflammation, redness, and pain. And dampness is a way of describing the blisters that form along the nerve pathway resulting in the painful and blistering rash characteristic of shingles. Heat and dampness are common causes associated with viral and bacterial infections.
The condition often emerges along the liver and gall bladder acupuncture meridians which run along the sides of the body over the chest, ribs, and back.
Other signs of damp heat may also be present such as a fever, a feeling of heaviness, irritability, or digestive issues. We may see a red tongue with a thick yellow coat.
Post herpetic neuralgia occurs after the inflammation has damaged the nerves of the body leading to blood stagnation and qi deficiency.
Acupuncture
Acupuncture treatment for shingles and post herpetic neuralgia focus on clearing damp heat, restoring the flow of Qi and blood, boosting immune function, and balancing emotional well-being.
The selection of acupuncture points for shingles is tailored to the individual’s symptoms and the specific TCM diagnosis. We make also include acupuncture needles close to where the pain is located, what is called Ashi or ouch points.
Mechanisms of Acupuncture for Pain Relief
Modulation of Pain Signals: Acupuncture is thought to modulate pain by stimulating nerves in muscles and other tissues, triggering the release of endorphins and other neurochemicals such as serotonin and norepinephrine. By influencing the nervous system, acupuncture can change pain-processing pathways in the brain and spinal cord, reducing sensitivity to the pain associated with shingles and PHN. A large randomized clinical trial published in JAMA Neurology found that electroacupuncture significantly reduced pain severity in patients with postherpetic neuralgia, with nearly double the response rate compared to sham treatment, benefits that persisted a month after treatment ended.¹
Reduction of Inflammation: Acupuncture may help reduce inflammation by promoting the release of the body’s own immunomodulatory factors, helping to ease both the acute and chronic pain of shingles and PHN.⁴
Improvement of Circulation: Acupuncture is known to improve circulation, helping clear inflammatory chemicals and pain-inducing substances from affected areas, and potentially supporting the healing of nerve tissue damaged by the virus.
Promote Relaxation: Acupuncture is often a calming experience, reducing the anxiety and stress that can worsen pain perception, making it easier for patients to manage their symptoms.
Chinese Herbal Medicine for Shingles
Herbal medicine also targets the underlying imbalance. Herbs that clear damp heat from the liver and gallbladder are often used, chosen for their antiviral and anti-inflammatory properties.
Long Dan Xie Gan Tang (Gentiana Drain Liver Decoction) is one of the most commonly used formulas for shingles. It’s designed to clear damp heat from the liver and gallbladder, containing herbs such as Gentiana (Long Dan Cao), Radix Rehmannia (Sheng Di Huang), Alisma (Ze Xie), and others that work together to cool the liver, eliminate dampness, and reduce pain and inflammation. A systematic review of 26 clinical studies and nearly 3,000 participants found that Gentiana-based formulas resolved pain faster than pharmacotherapy alone, and significantly reduced the incidence of postherpetic neuralgia when combined with topical Chinese herbal medicine, effects attributed to the anti-inflammatory action of the formula’s key herbs.²
Other formulas or individual herb modifications are often added. For example, Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxin) addresses heat toxicity and inflammation and is particularly helpful when lesions appear on the head and upper body.
For treating postherpetic neuralgia, key objectives include augmenting Qi, moving Blood, and dispelling residual pathogenic factors. This may include herbs that reduce blood stagnation, such as Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), and Chuan Xiong (Ligusticum Wallichii). Huang Qi (Astragalus Root), which boosts Qi and strengthens the body’s defenses, is often added as well; laboratory research on astragaloside IV, one of its active compounds, has shown it can promote the regeneration of injured nerves, supporting its traditional use for nourishing nerve healing in this context.³
Chinese Medicine Nutritional Therapy
In Chinese medicine, dietary therapy is used to nourish the body and aid in the healing process. The goal is to avoid flaring up the dampness heat while also cooling the body.
Avoid Heat-Producing Foods: Spicy, fried, and greasy foods can exacerbate damp heat. Patients are advised to avoid these types of foods to help clear the condition. We call these activating foods.
Increase Intake of Cooling Foods: Foods with a cooling nature, such as leafy greens, cucumbers, and watermelon, can help balance internal heat.
Limit Damp-Forming Foods: Dairy products, sweet foods, and overly rich meals can increase dampness in the body and should be consumed in moderation.
Feel Better, Get Acupuncture!
Traditional Chinese Medicine and acupuncture target the underlying imbalances to reduce inflammation and pain associated with shingles. This approach not only aims to alleviate the symptoms but also seeks to stimulate the body to heal naturally and bring long-term balance.
Please call us at 212.319.5757 or you can make your appointment online.
References:
- Chen L, Liu Q, Pei L, et al. Effect of Electroacupuncture on Postherpetic Neuralgia: A Randomized Clinical Trial. JAMA Neurol. 2026;83(7):667-676.
- Wang K, Coyle ME, Mansu S, Zhang AL, Xue CC. Gentiana scabra Bunge. Formula for Herpes Zoster: Biological Actions of Key Herbs and Systematic Review of Efficacy and Safety. Phytother Res. 2017;31(3):375-386.
- Zhang X, Chen J. The mechanism of astragaloside IV promoting sciatic nerve regeneration. Neural Regen Res. 2013;8(24):2256-2265.
- Zeng JC, Liao YZ, Li JJ, et al. Clinical efficacy of fire needling combined with cupping therapy on herpes zoster of acute stage and the effect on Th17/Treg cellular immune balance. Zhongguo Zhen Jiu. 2023;43(10):1128-1133.
