• Richard Suherlim Department of Neurology, Neurology Resident, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia.
  • I Putu Eka Widyadharma Department of Neurology, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia
  • I Made Oka Adnyana Department of Neurology, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia
  • Anak Agung Ayu Suryapraba Department of Neurology, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia




Laser, high intensity, pain, post-herpetic neuralgia


Post-herpetic neuralgia (PHN) is chronic neuropathic pain that is felt for at least 3 months or more at the site of the rash due to herpes zoster infection. Epidemiological studies get a prevalence of 0.49 cases of PHN per 1000 people per year. The clinical manifestation of PHN is chronic pain on the skin lesions due to herpes zoster infection. The therapy that is commonly used as the first line is the provision of pharmacotherapy such as gabapentin or pregabalin. An 83-year-old male patient with a diagnosis of PHN that had been felt for 5 years. He has been taking drugs for 5 years but the pain has not improved. The patient is given high-intensity laser therapy. After 5 treatments with an interval of 1-2 weeks, pain was significantly reduced from an 8/10 scale to 4/10. The frequency of occurrence of severe pain is also reduced from 5 times per day to only 1 time per day. The use of high-intensity laser therapy is not commonly used as a therapy for PHN. Based on its mechanism of action, the use of high-intensity laser therapy is worth considering because of its effectiveness in treating pain in a shorter time than low-intensity laser therapy.


Hadley GR, Gayle JA, Ripoll J, Jones MR, Argoff CE, Kaye RJ, et al. Post-herpetic neuralgia: A review. Curr Pain Headache Rep; 2016. 20(3):1–5.

DOI: 10.1007/s11916-016-0548-x

Perhimpunan Dokter Spesialis Saraf Indonesia. Panduan praktik klinis neurologi. Perdossi; 2016. 154–6.

Gharibo C and Kim C. Postherpetic neuralgia: An overview of the patophysiology, presentation, and management. Pain medicine news. Mcmahon Publishing; 2011:1-7. Available from: https://www.painmedicinenews.com/download/PostNeuralgiaPMN0411_WM.pdf

Angkasa F, Putra IB, Yosi A. Correlation between postherpetic neuralgia (PHN) patients’ stress level and the quality of life of their families in Universitas Sumatera Utara Hospital. Bali Med J; 2020. 9(3):749. DOI: 10.15562/bmj.v9i3.1738

Yang F, Yu S, Fan B, Liu Y, Chen YX, Kudel I, et al. The epidemiology of herpes zoster and postherpetic neuralgia in China: Results from a cross-sectional study. Pain Ther [Internet]; 2019. 8(2):249–59.

DOI: 10.1007/s40122-019-0127-z

Mallick-Searle T, Snodgrass B, Brant JM. Postherpetic neuralgia: Epidemiology, pathophysiology, and pain management pharmacology. J Multidiscip Healthc; 2016. 9:447–54. DOI: 10.2147/JMDH.S106340

Gupta R, Kaur S, Kaur J, Singh S. Post-herpetic neuralgia: A review of current management strategies. Indian J Pain; 2013. 27(1):12. DOI: 10.4103/0970-5333.114857

Herr H. Prognostic factors of postherpetic neuralgia. J Korean Med Sci; 2002. 17(5):655–9.

DOI: 10.3346/jkms.2002.17.5.655.

A Butt and G Sinha. A Case of Shingles with No History of Chicken Pox. Arch Dis Child; 2018. 119(10). DOI: 10.1136/archdischild-2018-rcpch.313

Moodley A, Swanson J, Grose C, Bonthius DJ. Severe Herpes Zoster Following Varicella Vaccination in Immunocompetent Young Children. J Child Neurol; 2019. 34(4):184–8.

DOI: 10.1177%2F0883073818821498

Friesen KJ, Falk J, Alessi-Severini S, Chateau D, Bugden S. Price of pain: Population-based cohort burden of disease analysis of medication cost of herpes zoster and postherpetic neuralgia. J Pain Res; 2016. 9:543–50. DOI: 10.2147/JPR.S107944

Ankit S, Zeng T, Chen Y, Gupta HN, Shah K, Wang X. The current treatment and prevention of post herpetic neuralgia. Yangtze Med; 2018. 02(01):28–38. DOI: 10.4236/ym.2018.21003

Weber G, Saad K, Awad M, Wong TH. Case report of cryoneurolysis for the treatment of refractory intercostobrachial neuralgia with postherpetic neuralgia. Local Reg Anesth; 2019. 12:103–7.

DOI: 10.2147/LRA.S223961

Bernstein LR. Successful treatment of refractory postherpetic neuralgia with topical gallium maltolate: Case report. Pain Med (United States); 2012. 13(7):915–8. DOI: 10.1111/j.1526-4637.2012.01404.x.

Mukhtar R, Fazal MU, Saleem M, Saleem S. Role of low-level laser therapy in post-herpetic neuralgia: a pilot study. Lasers Med Sci; 2020. 35(8):1759–64. DOI: 10.1007/s10103-020-02969-5

Overman D. Treating pain with low vs high-power lasers: What is the difference; 2019. Available from: https://rehabpub.com/pain-management/technology/treating-pain-low-vs-high-power-lasers-difference/. (Accessed on 20th June 2021)

BTL. High intensity laser; 2021. Available from: https://www.high-intensity-laser.com/subpage. (Accessed on 20th June 2021)

Ezzati K, Laakso EL, Salari A, Hasannejad A, Fekrazad R, Aris A. The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: A systematic review. J Lasers Med Sci [Internet]; 2020;11(1):81–90. DOI: 10.15171/jlms.2020.14

Abdelbasset WK, Nambi G, Alsubaie SF, Abodonya AM, Saleh AK, Ataalla NN, et al. A randomized comparative study between high-intensity and low-level laser therapy in the treatment of chronic nonspecific low back pain. Evidence-based Complement Altern Med; 2020. 2020.

DOI: 10.1155/2020/1350281.

Chatterjee P, Srivastava AK, Kumar DA, Chakrawarty A, Khan MA, Ambashtha AK, et al. Effect of deep tissue laser therapy treatment on peripheral neuropathic pain in older adults with type 2 diabetes: A pilot randomized clinical trial. BMC Geriatr; 2019. 19(1):1–10. DOI: 10.1186/s12877-019-1237-5

Tache-Codreanu D-L, Murgu AI, Marinescu LD. The possible side effects of high intensity laser. Iuliu Hatieganu University of Medicine and Pharmacy Publishing; 2015. 16(3):219–22. Available from: http://pm3.ro/pdf/61/RO/08%20-%20tache-codreanu%20%20%20%20219-222.pdf




How to Cite

Suherlim, R., Widyadharma, I. P. E., Adnyana, I. M. O., & Suryapraba, A. A. A. (2022). HIGH-INTENSITY LASER THERAPY TO TREAT NEUROPATHIC PAIN IN POST-HERPETIC NEURALGIA. MNJ (Malang Neurology Journal), 9(1), 65–69. https://doi.org/10.21776/ub.mnj.2023.009.01.14



Case Report