Herpes zoster, commonly referred to as “shingles” and “tangles”, is actually a disease caused by varicella-zoster virus infection. Although the clinical manifestations of chickenpox disappear quickly, the herpes virus is latent in the nerve cells of the body. When the immune function of the patient decreases or when there is a stress reaction (exertion, mental stimulation, etc.), the virus recurs, replicates and spreads along the sensory nerves, resulting in pain and herpes in the area of the affected nerve. “In fact, the herpes virus can invade any nerve in the body, for example, if it invades the trigeminal nerve, it can cause herpes and pain in the face or eyes. Most patients seek treatment for severe pain before the onset of the typical rash, and they are usually thought to have myocardial ischemia, cholecystitis, appendicitis, hernia, etc. Some asymptomatic patients with shingles have never had a rash and the pain persists. Abnormal nociceptive sensations in patients include spontaneous, persistent burning or persistent deep pain, throbbing pain, spontaneous knife-like pain or paroxysmal burning pain, abnormal pain and nociceptive hypersensitivity, and intolerable tumor itch. The above nociceptive sensations are accompanied by autonomic instability and can be exacerbated by physical and mental tension, and conversely can be relieved by relaxation. Herpes zoster neuralgia can be classified as acute pain within 1 month, subacute pain between 1-3 months and postherpetic neuralgia beyond 3 months. Postherpetic neuralgia can last for years or even a lifetime in some patients, severely affecting normal work and life, reducing quality of life, creating depression or anxiety, and even progressing to suicide. Since none of the current treatments for postherpetic neuralgia are ideal, prevention is especially important, namely early and comprehensive treatment of herpes zoster. (1) For acute herpes zoster, the main treatment measures are early application of antiviral drugs and regular and quantitative application of mild analgesics, such as acetaminophen and NSAID, which are beneficial for some patients. Tricyclic antidepressants not only reduce pain and promote sleep, but their early application can reduce the likelihood of postherpetic neuralgia. The use of nerve blocks to reduce pain is widely used, and some scholars believe that early high-dose blocks can reduce the incidence of long-term pain. (2) For postherpetic neuralgia, medications are the primary treatment, aiming not only to relieve pain but also to help patients overcome insomnia. Medications usually used include: tricyclic antidepressants, and anxiolytics. Antivirals and oral hormonal agents are ineffective in the treatment of postherpetic neuralgia. Transcutaneous electrical nerve stimulation (TENS) can reduce the patient’s symptoms. It produces analgesia by electrically stimulating the A-beta fibers with epidermal electrodes, and also causes the release of endogenous opioid peptides or 5-hydroxytryptamine in the body, preventing injurious stimuli from being transmitted to the thalamus. Nerve block therapy has been proven to block neuropathic pain transmission loops and reduce pain after years of practice. However, the frequency of treatment is not standardized internationally. Botulinum toxin has received widespread attention for the treatment of neuropathic pain. It acts on the presynaptic membrane of the motor end plate to produce relaxation paralysis in skeletal muscle by inhibiting the release of acetvlcholine. bTX I A inhibits the efferent of muscle and muscle vascular nociceptive receptor nerves and the overactivity of the muscle spindle. It affects the central nervous system through inverse uptake in the central nervous system. It inhibits the release of substance P from the suture nucleus in the brain and inhibits other nerve conduction, such as the conduction of trigeminal nerve endings. Its advantage is that it is simple to administer and its efficacy is long-lasting, and a single injection can last for 3-6 months. After years of research and clinical practice, our center has concluded a set of mature treatment methods for herpes zoster neuralgia. These include oral medication, physical therapy, local blockade, psychological guidance and botulinum toxin injection. Botulinum toxin has been used clinically for twenty years and is widely used to treat various pains, such as headache, low back pain, myofascial pain syndrome and neuropathic pain (herpes zoster neuralgia, trigeminal neuralgia, diabetic peripheral neuropathy, etc.). Our center assesses the pain level according to the patient’s condition and adopts comprehensive treatment. After several years of clinical observation, the total effective rate can reach more than 85%, and the vast majority of patients can resume normal work and life.