OBJECTIVE: Post-herpetic neuralgia (PHN, persistent pain following "shingles") is common, especially among older persons. The pain often lasts well beyond the acute episode, occasionally lasting for several years. This study explored the impact of chronic pain on perceived health status in patients with PHN. METHODS: This was a community-based survey where persons aged = 65 years with PHN were recruited via advertisements in 24 large US newspapers. Eligible subjects were sent a questionnaire to complete, which included items concerning PHN pain intensity in the prior week (current, average, worse, least), the EQ-5D, and a 100-point global health rating scale. RESULTS: A total of 385 persons participated in the study; 61% were age = 75 years. Mean (± SD) current, average, worst, and least pain due to PHN was 4.0 (± 2.7), 4.6 (± 2.1), 6.0 (± 2.4), and 2.9 (± 2.3) respectively. Mean values for the EQ-5D weighted health index and the global health rating scale were 0.61 (± 0.26) and 65.7 (± 21.1). There was a strong relationship between pain intensity and overall health rating. Subjects with "mild" worst pain (range: 0-4) had a mean health rating of 73.8 (± 17.5), while those with "moderate" (range: 4 - < 7) or "severe" (range: 7 - 10) worst pain had mean values of 65.2 (± 21.0) and 60.5 (± 22.6) respectively. Similar results were obtained for other measures of pain intensity. The EQ-5D weighted health index varied in a similar fashion in relation to pain intensity. Subjects with "mild" average pain had a mean EQ-5D weighted health index score of 0.69 (± 0.17) while those with "moderate" or "severe" average pain had mean values of 0.58 (± 0.27) and 0.25 (± 0.31) respectively. CONCLUSIONS: Pain intensity due to PHN is substantial and has a profound impact on self-reported health.