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This is caused by the varicella-zoster virus which is the same virus that causes chickenpox. Acute pain can be burning, shooting and severe. Acute shingles pain must be treated aggressively and immediately. Chronic shingles pain can be difficult to treat. Besides medications and physical therapy, interventional pain specialists can perform epidural steroid injections , and intercostal nerve blocks or radiofrequency ablation of the nerve to help minimize the pain.