We treated a patient with segmental zoster paresis (SZP) due to herpes zoster diagnosed five months before. At his first visit, he had difficulty in abducting the left shoulder joint and decreased hand grip strength. He had been treated with acyclovir, acetaminophen, pregabalin, and neurotropin^®. We started phototherapy and duloxetine 20 mg/day. After duloxetine was increased to 40 mg/day, the pain decreased. The paralysis improved steadily. Appropriate analgesia and rehabilitation were effective for the treatment of SZP.