Pain is an important sign that the body is ill, prompting people to seek help from a specialist! Thoracic and upper abdominal organ lesions can cause chest and back pain. Due to the large number of organs involved in these areas, it is difficult for the patient or even the specialist to identify the lesion in a short period of time. The large number of examinations puts financial pressure on the patient, and the pain must be endured to the point of taking large amounts of analgesic medication, which also poses a challenge to the clinician. We often encounter such cases in outpatient clinics, where the patient’s expression is painful and depressed, and the family is at their wits’ end, having seen many doctors, spent a lot of money and done a lot of tests, but still failing to find the cause, the pain is as usual or even more intense, and ordinary analgesics are not effective. At this time, we are often alert to “snake-tan” and look for diagnostic bases from its characteristic manifestations, so that we can quickly and accurately make a judgment and give effective treatment. What is “snakebite”? There is a widespread folklore that there is a strange disease in ancient times – “snake dan”, which is the incarnation of a snake, constantly pestering humans, slowly crawling in the human skin, winding around one side, where the skin rash, blistering, breaking, oozing, painful; once wrapped around the whole body, it can kill people. With the development of modern health care, its pathophysiological mechanism has been fully elaborated, and it is the herpes zoster that we often encounter nowadays and suffer from. How to self-diagnose “snakebite”? 1. Specific groups: middle-aged and elderly people, people with poor immunity, overworked people, people with colds, intoxicated people, people who have applied hormones and immunosuppressants for years; 2. Effective thoracic spinal nerve root or intercostal nerve block; 3. Effective antiviral treatment; 4. Characteristic pain manifestations: acupuncture-like, knife-like, fire-like, anthrax-like, electric shock-like pain, aggravated at night; 5. Positive/negative, 6. Infrared thermographic features: the affected area shows inflammatory reaction and relatively high temperature skin changes. What is the core of the differential diagnosis of “snakebite”? The misdiagnosis of “snakebite” is mostly in the latent phase, when there is no obvious papule or herpes on the skin, and only characteristic pain is present. Pain site: the pain is basically accurately localized, mainly in the area of the innervation of the thoracic spinal nerve root or intercostal nerve involved on the body surface, mostly unilateral; pain nature: mostly needle-like, knife-like, fire-like, ant-crawl-like, electric shock-like pain; pain duration: spontaneous paroxysmal attacks, non-continuous, ranging from a few seconds to a few hours, no pain during the interval, obvious at night; pain aggravation or relief factors: not related to body position, activity or rest. The pain was not associated with posture, activity or rest, pain concomitant symptoms: no functional impairment of limbs and body. Nerve block and antiviral therapy are effective.