I don't care what some docs say I do believe Herpes can cause an array of neuropathic pain symptoms. I recently got diagnosed & have had chronic flareup of nerve pain in the distribution of the sacral dermatome (as the docs say), but also involving the entire spine into hands/arms, face/scalp ears. Perhaps there was an underlying neural excitability (i've suffered nerve pain from other diagnoses & multiple car accidents with neck/back sprains and a concussion). Anyway the type of nerve pain from Herpes is a stabbing needle-like pain in buttock, stabbing/tingling/burning in SI joint area, burning in bottom of feet,icy cold needle pains randomly in ankles, calves,top of foot, knees. Thighs numb, waist down to glutes numb, occasionally entire back numb feeling with sensitivity to cold/touch of clothes. Lips,ears, scalp occasionally tingly & numb. Severe headaches before & during the "outbreak" I haven't gotten any new lesions. Just the same symptoms as when I got the primary outbreak & all of these weird new nerve issues, so it has to be the herpes. My theory is if it sits in the nerve it must be aggravating it somehow, which explains the lower extremity issues, but I'm guessing that it must also aggravate the spine & even nerves in the upper regions, which may be causing the upper extremity issues. That's my theory after 5 mths of chronic multiple outbreaks. Sitting can make it worse-almost as if the sacral area is hypersensitized & a burning/tingling goes down the hamstring and sometimes into the ankle/foot. Occasionally I'll get muscle fasciculations in the thighs when I sit more than 5-10 minutes & the nerve pain increases. Despite the burning feet-is better for me to stand & walk than to sit. I sleep with a pillow between my knees if I lie on side to keep the hip/SI joint from being aggravated by misalignments. I sleep on an air mattress, b/c hard mattress aggravates the entire spine & nerve pains-especially when I'm having an "outbreak". Naprosyn helps with some of the pain. I tried wearing magnets, taking valerian, holy basil, bromelain,lysine, l-theanine to calm down inflammation (I'm guessing there's an immune/inflammatory response going on too). The herbals don't really do much but they help a little for sleep relaxation. Or I'll pop a few benadryl for sleep problems due to the neuropathy. Acyclovir helps a little with nerve pain, but I've been on it twice daily for the past 2 months without any resolution of nerve pain-prior to that I was on it about 2wks out of the mth for episodic flareups. There seems to be a correlation b/t hormones and outbreaks. The problems occur a week or so before the menstrual cycle & does tend to calm a little after the end of the cycle, but the nerve twinges are intermittent during the remainder of the month. I'm a female, late 30's & the guy I dated didn't know he had herpes. When I got the outbreak & asked him if he had symptoms he stated he had had burning/itching about two weeks prior-which made sense. STD testing should include a blood HSV2 test. They test you for everything else, but that. This "common STD" seems to cause more nerve pain & problems than any of the "treatable" STD's. I think b/c the docs put it in a "manageable or prophylactic" category they don't do research & don't really realize how damaging this problem is. I honestly believe that if you have continued inflammation of the nervous system the brain re-programs itself & I think it may put you at risk for increasing nerve problems or even autoimmune type symptoms. We'll see where the research leads. I think b/c complications from this are not considered physically debilitating it's blown off as "manageable". I do believe some people will get weakness and other nerve problems & maybe even nerve damage from this in the long run, but again we'll see where the "research if any is done" will lead. I also have many food intolerances,sulfa,shellfish,latex,adhesive allergies, so I guess in people like me who are already "sensitized the nervous system will suffer worse symptoms from Herpes, whereas the guy who gave it to me had minimal symptoms & no apparent lesions-go figure. Blood testing should be automatic.