Pain Management Procedures
Localized Cutaneous Injections for Shingles-Related Pain
Localized Cutaneous Injections for Shingles-Related Pain
What is this treatment?
Shingles can injure small sensory nerves in the skin and leave burning, stabbing, itching, or extreme touch sensitivity after the rash resolves. In selected cases, a clinician may place small injections in the skin or tissue just beneath it around the painful area. Medication may include local anesthetic and, depending on the protocol, another agent.
When may it be recommended?
The term “subcutaneous dermal injection” is not one standardized procedure. It may refer to local anesthetic field blocks, tender-point injections, or another technique for localized postherpetic neuralgia. Before publication, APG should specify the exact medication, method, and intended diagnosis. These injections are generally considered when pain is localized and persists despite appropriate medication or topical treatment.
What happens?
The painful skin area is mapped carefully. After sterile preparation, a fine needle places small amounts of medication at selected points in or under the skin. Several injections may be needed to cover the painful patch.
What should I expect?
Temporary numbness, small raised areas, bruising, or a short burning sensation can occur. Relief may be brief or may outlast the numbing effect, but results are variable. Avoid heat or injury to numb skin.
Important risks
Risks include bleeding, infection, medication reaction, skin injury, and local-anesthetic toxicity if too much medication enters the bloodstream. Active shingles lesions or another skin infection may change whether and where an injection can be performed. This copy should remain unpublished until APG confirms the exact service.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.