Harry: Which part of the his body is affected?

Shelly: Across his torso.

Harry: All right, that is shingles of the body. I'm going to tell you a bit about this problem of pain following shingles. The shingles itself lasts a few days or a week or two and consists of pain with blisters, which usually disappear within a short period. The big problem, mainly with elderly people, is that after the shingles clears up the pain persists. And this pain can be very severe and it can last for many days, weeks, months and even years. It's a problem that has been very, very difficult to treat. All sorts of things have been tried like painkillers, anti-depressants, anticonvulsants, injecting anaesthetic into the nerve and cutting the nerve. One of the treatments that I've mentioned from time to time and it does seem to work in a proportion of patients is the use of an ointment called Capsacin, which formally was only obtainable overseas but I believe it is now available in South Africa. But none of these treatments really had any substantial effect, especially in long standing pain following shingles - the medical term for which is post-herpetic neuralgia. However, what has emerged now is that in the recent issue of the New England Journal of Medicine, which is one of our medical bibles, there is a report from Japan of a very careful Japanese study. Something like 300 patients were involved in this study and all of them had severe pain after shingles lasting at least one year. All other treatments had been tried and had failed. Now they did a very careful clinical trial in which they divided the patients into three groups of 100 each. The one group was just given a local anaesthetic. The other group was given no treatment whatsoever. The third group was given a particular type of cortisone via a lumber puncture once a week, for up to four weeks. This is a fairly simple treatment and had virtually no complications. The results were really very interesting indeed and very encouraging - there was a 70% reduction in the intensity of the pain. So here we seem to have a significant advance in the management and treatment of this very common complication of pain following shingles. The study was done only in patients with shingles involving the body. These people did not have shingles of the neck and head.

Shelly: So is this treatment available in South Africa?

Harry: Yes, it's a very simple treatment and can be done anywhere in South Africa. The best person to do it would probably be a surgeon or a neurologist. All it involves is a lumbar puncture and through the lumbar puncture needle you inject cortisone together with a local anaesthetic. You do it once a week for up to four weeks and as I said, the results showed that there was a 70% improvement in the pain. And the other thing that I must stress is that because the treatment is so simple, it was free of any complications. So it can be done in a small town or a big town, wherever you are in South Africa. Shelly: Would the fact that he's in his 70s count against him?

Harry: Not at all. In fact the majority of people that have got this prolonged pain after shingles are senior citizens. So there is no problem at all with being in your 70s.