Most of the patients who come to me with shingles have already been treated in other hospitals or departments and have had poor results. The main reason for this is that most patients treat shingles as a skin disease. In fact, herpes zoster is a neurological disease, which is a typical neuropathic pain. The cause is the sudden activation of the herpes zoster virus, which is latent in the patient’s ganglia and takes advantage of the patient’s reduced resistance to replicate, rapidly destroying the corresponding ganglia, nerve roots and nerve endings, causing nerve trauma that is difficult to heal. Therefore, the first symptom that most patients with shingles experience is pain, and only in the following days are blisters found in the location of the pain. This also means that once the blisters appear on the surface of the skin, then the entire nerve is actually severely damaged. At this point it is unlikely that treating the skin blisters alone will be truly effective. Some patients have better resistance and strong body healing ability and can slowly heal, while others cannot heal and end up with neuralgia left behind and lifelong pain. Treatment sequence: 1. For patients with early acute herpes zoster, the best treatment method is x-ray image guided targeted nerve pulse radiofrequency combined with block therapy. It can immediately modulate the damaged nerves, enhance the healing ability of the nervous system itself and reduce the neuroinflammatory response. No patient with herpes zoster who was able to come to our department for treatment in the early stage of the disease has evolved into severe postherpetic neuralgia so far. 2. For patients with early acute but extensive lesions and severe pain, and for patients with subacute (>3 weeks)/chronic (>3 months) postherpetic neuralgia, direct spinal cord electrical stimulation therapy is recommended. The pain is controlled by the discharge of multi-contact electrodes placed on the back of the spinal cord, which control the transmission of pain signals along the nerves to the brain, and by the stimulation of the electrical current, which also promotes the repair of the nerves themselves. The electrodes can be left in place for 10-14 days, thus allowing the patient to receive a much longer treatment session than with radiofrequency nerve pulses alone, thus producing better results. Finally, in cases where electrical stimulation is effective, but the patient’s pain remains uncontrolled once it is stopped, a permanent implantation of spinal cord electrical stimulation is required, much like the implantation of a pacemaker, where we implant a neuromodulated pacemaker into the patient to ultimately obtain long-term and effective pain control. We have had patients whose pain disappeared after a minimum of 3 months of implantation and the neurostimulator was removed, and the longest time since implantation has been 6 years and pain control is still satisfactory.