Treatment
Neural therapy: a possible addition to pain treatment
A painful area repeatedly makes you avoid a movement. Previous treatments may have helped only temporarily, and now another option has been suggested: neural therapy. Before deciding on an injection, you want to know what is actually being treated and what change you can expect.
Open individual sections or all the details on this page.
Which risks should you know about?
Possible effects include pain or bruising at the injection site, circulatory reactions and infections. Intolerance or allergic reactions to the medicine used may also occur. Depending on the location and depth of the injection, neighbouring structures may be injured. Rarely, local anaesthetics can cause serious reactions, for example if too much of the medicine enters the bloodstream.
We discuss in person which risks are relevant to the planned procedure. Report new symptoms during treatment or observation to the practice team immediately. After the medicine is given, you remain at our practice for monitoring for at least 30 minutes. Please allow for this time. Depending on how you feel, longer care may be needed. If you develop breathlessness, impaired consciousness or circulatory collapse after leaving the practice, call 112 immediately and do not wait for a reply from us or your GP practice. Increasing redness, swelling, worsening pain or fever requires prompt medical assessment. During consultation hours, please contact our practice immediately and follow the aftercare instructions provided. If our practice cannot be reached straight away, have urgent, non-life-threatening symptoms assessed by your GP practice during consultation hours. Outside consultation hours, 116117 can help if treatment cannot wait.
Understanding
A closer look
At OrthoCoast, neural therapy forms part of our orthopaedic pain treatment services. Whether it may be suitable for you is assessed from your symptoms, the examination and the course so far. The key question is: does this option fit a clear goal within your treatment plan?
What does neural therapy mean?
Neural therapy involves injecting medicines that numb an area at selected sites. These medicines are called local anaesthetics. They can temporarily inhibit the transmission of pain signals. This is a known effect of the medicine.
Treatment aims to provide relief that remains helpful beyond the immediate feeling of numbness. However, whether this happens and how long it lasts cannot be inferred from the mechanism of action. Local anaesthesia does not repair damaged tissue.
Which question needs to be answered before an injection?
We want to understand where your symptoms are likely to come from and which factors keep them going. This includes, for example, which movement causes pain, whether it radiates and what a previous treatment changed. A tender spot alone does not explain the entire symptom picture.
Neural therapy is therefore not an automatic answer to pain for which no clear explanation has yet been found. Sometimes a different assessment is important first. During the consultation, we discuss whether an injection appears useful at all and which question still needs to be answered beforehand.
Further information
What do we know about possible benefit?
Some published studies of neural therapy report improvement. Their conclusions are limited, however: some studies lack a comparison group, while others compare different injection procedures and extents of treatment. This leaves uncertainty about how much of the observed change is specifically attributable to neural therapy.
Benefit needs to be assessed separately for a particular condition and the specific proposed approach. Results from other anaesthetic or injection procedures cannot be applied across the board. We discuss this uncertainty with you before you decide. A previous positive experience is helpful, but does not guarantee another response.
How does treatment fit with movement and other options?
The goal should be noticeable in everyday life, for example making a movement you previously avoided easier to perform again. When an injection is considered, it remains important to think about appropriate physical demands and activity. Temporary pain relief alone does not mean that greater exertion is already suitable.
Depending on the cause, adjusted movement, exercises, coordinated medication or other conservative options form part of the decision. We explain which may be suitable and how they relate to each other. You do not have to try every available procedure.
How does neural therapy differ from PRT?
The term neural therapy does not automatically mean an injection close to the spine. PRT specifically treats the area around a nerve root. An epidural injection targets a particular space within the spinal canal. Each of these procedures requires its own conditions to be met and its own explanation and consent discussion.
Regional anaesthesia for an operation is also a different treatment situation. If an injection has been recommended, therefore, ask where it is intended to be given and exactly which procedure is planned. Our page on image-guided injections and PRT explains these options separately.
Your contacts and your decision
At OrthoCoast, neural therapy injections are performed by Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. We first explain the medical options and alternatives. You can consider a recommendation in your own time and decide later.
If you are covered by German statutory health insurance and wish to pay yourself for a service your health insurer does not cover, you receive a cost estimate beforehand. We discuss the scope of the service and the expected costs. The service is provided only after you have signed confirmation of your wish for treatment and acceptance of the costs.
What to expect and next steps
What should you bring to your consultation?
Please bring existing medical letters and relevant examination findings to your agreed appointment at our practice. If images are already available, also bring access to them or the CD. You do not need to arrange new images yourself solely for this appointment.
Your current medication plan, complete with any printed code, or a medication list is also helpful. In particular, mention blood thinners, known allergies and previous reactions to local anaesthetics. Before the planned procedure, tell us about any current infection, possible pregnancy and important coexisting conditions. Please do not stop medication on your own.
How is treatment prepared?
Before a decision, we explain the intended treatment site, the medicine, possible benefits and risks. Please also mention if injections worry you or if you have previously had circulatory problems with them. This helps with planning.
The skin is prepared hygienically before the injection. The needle may briefly feel uncomfortable; depending on the procedure, the treated area may feel numb for a time. The extent of treatment, further appointments and review of the result are agreed according to your progress. The name neural therapy does not imply a fixed series of treatments.
What matters afterwards?
Before treatment, clarify when you may drive again and arrange someone to accompany you if needed. Do not drive while treatment affects your ability to drive safely. Suitable activity afterwards depends on the treatment and your situation.
A brief note helps with further planning: what changed, how long did it last and what became easier as a result? A lack of improvement is also important feedback. There should be a clear reason to continue; new symptoms are assessed by a doctor beforehand.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileThese doctors discuss with you whether an injection treatment suits your symptoms. Together, we address your questions and clarify the next steps.
Frequently asked questions
Is neural therapy a treatment without medicines?
No. Medicines with a local anaesthetic effect are used. Allergies, coexisting conditions and your other medication are therefore important to the decision.
How many sessions will I need?
There is no general number. The specific procedure, your response and the treatment goal are decisive. Continuing treatment is discussed on the basis of progress.
Can I book neural therapy recommended elsewhere directly?
Please bring an external recommendation to your consultation. We consider it alongside your symptoms and findings before agreeing treatment at our practice.
Do I need another consultation after your recommendation?
Not solely to arrange the appointment. If OrthoCoast has already discussed and recommended the treatment with you, use the agreed follow-up route, even if you decide later. Please tell us beforehand about changed symptoms or new medical circumstances.
Your next step
