Persistent pain can affect sleep, movement, work and family life. Algology evaluates pain mechanisms and coordinates management with the relevant specialties. MPGCARE arranges specialist assessments at Medical Park and Liv Hospital in Türkiye. The receiving center confirms the physician’s expertise, accepted age group and available services. The aim is meaningful improvement in function and quality of life; complete or lasting pain relief cannot be guaranteed.

Condition	Symptoms and points to notice	Tests and assessment the physician may select
Lumbar disc herniation and sciatica	Low back pain radiating into a leg, tingling or weakness. New bladder problems or progressive weakness require urgent assessment.	Neurologic examination; MRI if it will change management, selected EMG. A scan finding alone does not identify the pain source.
Cervical disc herniation and neck–arm pain	Neck pain radiating into an arm; numbness or reduced grip. New gait or hand coordination problems need prompt review.	Strength, sensation and reflex assessment; selected cervical MRI or EMG. Neurosurgical review if compression is suspected.
Facet-joint pain	Localized spinal pain, sometimes worse with extension or rotation; symptoms overlap other causes.	Clinical assessment; a selected diagnostic medial branch block may help assess suitability for radiofrequency treatment.
Sacroiliac-joint pain	Pain around the buttock or pelvis, often with movement. Inflammatory disease may require rheumatology review.	Provocation tests; selected imaging to assess other causes, and an image-guided diagnostic injection when indicated.
Migraine	Recurrent headaches with nausea or light sensitivity, sometimes aura. Keep a headache and medicine-use diary.	Headache history and neurologic examination; imaging for atypical findings or warning signs, not automatically. Neurology coordination.
Tension-type headache	Pressing or tightening head pain. Frequent pain medicine use can contribute to medication-overuse headache.	Clinical evaluation, medicine-use review and neurologic examination; further tests only for relevant findings.
Trigeminal neuralgia	Brief electric-shock facial pain triggered by touch, chewing or brushing teeth. Dental and other facial causes need distinction.	Neurologic and facial assessment; selected brain MRI to investigate causes and guide neurology/neurosurgery decisions.
Postherpetic neuralgia	Burning or touch-sensitive pain persisting after shingles. Eye symptoms with a new rash need urgent care.	Rash history and sensory examination; tests only for an unclear diagnosis or another suspected cause.
Painful diabetic peripheral neuropathy	Burning, tingling or numb feet, sometimes worse at night. Inspect feet and report wounds or color changes.	Sensory, foot and circulation examination; glucose/HbA1c, selected B12 and kidney tests, nerve studies if atypical.
Complex regional pain syndrome (CRPS)	Disproportionate limb pain with swelling, temperature/color or sweating changes after injury; movement may become difficult.	Clinical Budapest criteria and exclusion of alternatives; selected imaging or tests for another cause. Early rehabilitation review.
Fibromyalgia	Widespread pain, fatigue and unrefreshing sleep. Symptoms are real even when routine imaging is normal.	Clinical assessment; selected tests for conditions such as thyroid disease or inflammation. No single test confirms fibromyalgia.
Myofascial pain syndrome	Regional muscle pain and tender trigger points, often with restricted movement.	Muscle and movement examination; selected investigations if another diagnosis is suspected, rather than routine MRI.
Osteoarthritis-related joint pain	Knee, hip or shoulder pain and stiffness with activity. A hot swollen joint with fever needs urgent assessment.	Joint examination; selected X-ray, ultrasound or labs if needed. Orthopedic/rheumatology coordination and rehabilitation assessment.
Persistent postsurgical pain	Pain continuing after an operation, including spine surgery. New pain should not automatically be attributed to scar tissue.	Operation report, neurologic examination and selected imaging; investigate infection, recurrent disease or nerve injury when suspected.
Phantom limb and residual-limb pain	Pain felt in a missing limb or at the remaining limb. Poor prosthesis fit, wounds and infection need assessment.	Residual-limb, skin and nerve examination; selected ultrasound/imaging for neuroma or other causes; rehabilitation/prosthesis review.
Cancer-related pain	Pain from cancer, metastases or treatment, including breakthrough pain. Report new severe back pain or neurologic changes promptly.	Oncology records, examination and targeted imaging/labs according to the suspected cause; coordinated oncology and palliative care.
Pain after spinal cord injury	Burning or other persistent pain after cord injury, sometimes alongside muscle spasms.	Neurologic and rehabilitation assessment; selected imaging for new changes and review of bladder, skin and other potential triggers.
Pain associated with peripheral vascular disease	Leg pain with walking or at rest, coolness or wounds. A suddenly cold, pale and painful limb is an emergency.	Pulse/circulation examination, selected Doppler and vascular assessment. Pain care does not replace treatment of impaired circulation.

The consultation reviews pain location, duration, triggers, sleep, mood, function, medicines and examination findings. Tests answer a specific clinical question and are not a standard package. Treatment may combine condition-specific medicines, graded activity, physical rehabilitation, sleep support and appropriately trained psychological support. Chronic primary and secondary pain require different approaches; pain is not dismissed because a scan is normal.

Nerve blocks or targeted injections require a defined indication. Epidural treatment may be considered for selected severe radicular pain; it is not routine treatment for all back pain. Radiofrequency treatment may suit selected confirmed pain sources, sometimes after a diagnostic block. Spinal cord stimulation or an intrathecal drug-delivery system requires specialist selection, discussion of alternatives and, where applicable, a trial. Cancer-related nerve procedures need oncology coordination. Availability is confirmed by the center; a consultation does not commit you to a procedure.

Discuss bleeding, infection, nerve injury, medicine reactions, temporary worsening, device complications and repeat-treatment needs according to the proposed method. Expected duration of benefit varies. Pain treatment does not repair every disc problem or replace indicated surgery.

Prepare dated MRI/CT/X-ray reports and original DICOM images, EMG/nerve study reports, operation/discharge summaries, oncology records if relevant and previous injection or rehabilitation details. Include age, symptom history, a pain/function diary, medicines with doses, allergies, prior response, anticoagulants, diabetes, kidney/liver disease, pregnancy and implanted devices. Ask MPGCARE for the agreed secure transfer channel and translation needs. Record review supports planning and does not replace examination.

Do not increase, stop or combine prescription medicines yourself. Report side effects, sedation, falls and new symptoms; some medicines require gradual clinician-led changes. Avoid sharing medicines. Agree realistic goals such as walking, sleep or daily activities and review benefit alongside harms. Family support should encourage safe participation rather than forcing painful activity. Ask the team about work, rehabilitation, interpreter or accompanying-person needs.

Seek urgent local care for new urinary retention/incontinence with back pain, saddle numbness, rapidly progressive weakness, sudden severe headache, stroke-like symptoms, chest pain or breathing difficulty, fever with severe spinal pain, or a suddenly cold/pale limb. New neurologic symptoms in someone with cancer are also urgent. Do not wait for travel or an international appointment. Stable persistent pain and planned second opinions can follow the routine specialist pathway.

Fasting, medicine changes and procedure preparation are supplied only after the center confirms the individual plan; do not stop blood thinners yourself. Before travel, confirm required visits, rehabilitation access and clinical scope. Before returning home, obtain results, a written treatment plan, warning signs and contact details. Follow-up requires agreement with a suitable local clinician; implanted devices may need programming and specialist access. Travel fitness and further visits are decided individually.

Contact MPGCARE to coordinate a pain specialist assessment and clarify the receiving hospital’s clinical scope.

Liv Hospital: Algology · NICE: Chronic pain · NICE: Low back pain · IASP: Neuropathic pain · NCI: Cancer pain · European Pain Federation: CRPS · NHS: Trigeminal neuralgia · NIH: Fibromyalgia · NIDDK: Diabetic neuropathy