I completed my pain rotation last month. It was surprisingly one of my favorite rotations to date. I loved everything about it: procedures, mind puzzles, strange physical exam maneuvers, and satisfied patients. I worked in clinics from 8 to 5 and during that time we might be seeing patients and helping them figure out how to manage their pain or we may be in the procedure room placing and injecting needles into precise locations around their spine or performing nerve blocks.
Our patients had such a wide variety of pain symptoms. I was surprised to see how many middle aged and younger patients we had. Some people had been in car accidents and never fully recovered, others had arthritis, cancer pain, unexplained back pain, overly sensitized pain nerves, and others had been on opiates for years and were looking for ways to manage their pain. What was awesome about the pain clinic I was at was that they didn't use narcotics for pain control and didn't even prescribe them. In fact, we know anyway that opiates actually worsen your pain symptoms - so why would treat chronic pain like that? We wouldn't! There were amazing options available to patients such as blocking the nerve that was actually causing the pain or putting local anesthetic into the joint of the spine that is causing the discomfort.
I also was surprised to see how imaging studies (MRI, CT scans) do not usually indicate the cause or severity of the chronic pain. Every patient performed a series of physical exam bending and twisting and based on what symptoms the patient was having and the overall clinical picture, that then determined the cause of the pain and the treatment options available. I read a study that showed a high percentage of people walk around with some spinal disc herniation and don't have any symptoms. Most people that came to clinic thought their pain was due to something based on an image but their symptoms were pointing to something else entirely! Proper diagnosis and treatment of the underlying cause of pain helped so many patients.
My favorite part of the rotation , the patients were so enjoyable! They were so grateful and happy that someone was finally able to help their pain. After procedures people would bring donuts, give hugs, and sometimes cry with joy.
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