Preparing for the treatment

You do not have to make any preparations at home, unless specifically stated.

You do not have to fast on the day of the treatment. Please note: If you are taking anticoagulants (blood thinners) such as Sintrom, Acenocoumarol or Marcoumar, Phenprocoumon for which checks by the thrombosis service are necessary, you must temporarily stop taking these. The amount of time to stop varies from person to person, it is best to contact the thrombosis service as soon as you know the date of treatment. They know exactly how long in advance you should stop.

On the day of the treatment a check of the coagulation of the blood is necessary. After the treatment you are not advised to drive the same day, therefore, you should make sure that someone else can take you home.

The treatment

You’ll arrive at the clinic about fifteen minutes before the treatment. An employee of Yasa Erim Gedik Pain Clinic guides you to a relaxation area. Before the procedure starts, a nurse and/or doctor will bring you to the adjacent treatment room.

During the procedure you usually lie on your back or on your side, on the treatment table. The skin is disinfected. A special needle is placed at the level of the nerve which is to be treated. A special current is sent through the needle with the aid of special equipment, which will activate the nerve and move the muscles.

If the correct nerve is located, the pain conduction is interrupted, using a radio frequency current and an anesthetic (0.5-1 ml lidocaine 2%). This way the pain stimulus can no longer reach the brain. The treatment takes about 6-8 minutes per nerve. Optionally, an anti-inflammatory medication is injected (depomedrol 40-80 mg). If no pain reduction has occurred, your doctor may suggest numbing a different nerve or structure that may be involved in the pain. The next test will have to be performed another day, because the effects from the first test must be completely worn off. It is possible that you have to undergo several trials before the right nerve or structure is found.

After the treatment

People hardly experience side effects of the treatment and you may go home about fifteen minutes after the treatment. Keep in mind that you may temporarily experience a loss of strength, because of the the local anesthetic wears off (about one to several hours after the treatment) post-operative pain may occur. This is because the needle is positioned in the agitated area.

The pain may increase the first few days. However, this only lasts for one to several days. You can take painkillers to help with the pain. This can be your own pain medication or paracetamol according to the dosage on the package leaflet.

During the day of the treatment it is advisable to take it easy. You may do what feels okay, but physical labour is strongly discouraged. Please note: After the treatment you are not allowed to drive. You need to make sure someone else can bring you home.

Possible side effects

As a result of the treatment, it is possible that you experience one or more of the following side effects:

• Numb feeling in arms, chest, legs, pubic area or other areas, depending on which nerve root is treated. This goes away after several hours, when the anesthesia wears off.
• Loss of strength: in arms or legs, if a nerve in the arm or leg has been treated. This is temporary and should disappear within 8 hours after the procedure.
• Bruising: this can occur if a blood vessel is damaged. This causes a bruise, and sometimes pain or discomfort.
• Muscle pain: on the spot of the injection.
• Post-operative pain, as a result of the injection. This can last for several days. You can take painkillers to help with the pain. This can be your own pain medication, or paracetamol according to the dosage on the package leaflet. The anti-inflammatory drug may cause hot flashes as a side effect in women and can disrupt the menstrual cycle for a short time. The contraceptive pill is no longer reliable until the next menstrual period.
• Patients with diabetes who use insuline, sometimes notice that their blood sugar is elevated for a few days. Based on the cause of your pain, your specialist will assess if a physical treatment is necessary. Based on the medical history the necessity of additional tests will be decided.