Postgraduate Studies Reflective Blog

SURG0129: Neuromodulation Student No: 22180482   I was really looking forward to starting this module, as it’s the closest thing I've come to medically so far that wouldn’t be amiss in an episode of Star-Trek! Neuromodulation devices are implanted within the body in the brain or next to nerves or within the epidural space in the spinal cord and are used to stimulate neurons via the delivery of pharmaceutical agents or electrical signals. This aims to modulate the abnormal neural pathway, thus relieving pain or restoring normal activity. Whilst not a panacea for all ills, neuromodulation can be utilised in a variety of ways. The following uses below are ones I personally found the most interesting when reading around the subject: 1. Spinal cord stimulation, where the dorsal aspect of the spinal cord is stimulated for the relief of pain, giving an alternative option where traditional pharmacological therapies have failed or become ineffective. 2. Peripheral nerve stimulat...

Module 6: SURG0130: Strategies for the self-management of pain. As an osteopath, all my clinical work treating a variety of musculoskeletal pain patients involves hands-on treatment plus providing a tailor-made exercise/rehabilitation plan for that particular patient. This module was interesting, as it addresses how we can help pain using a non-pharmacological, non-invasive approach, ie a lot of what I do every day. I particularly liked the tutorial given by J Proskewitz on non-specific lower back pain. I feel that he and I are very similar in our assessment, treatment and rehabilitation approaches and philosophies. I am in agreement that patients most definitely do want a clear explanation given to them about their condition, as usually, they have seen many therapists before getting to me, all of whom often contradict each other. The poor patient ends up confused, and wonders if there’s anyone out there who understands them and their needs, which of course contributes to central s...

Module 5:  SURG0131: Headache, Paediatric and Abdominopelvic Pain Out of all the modules in this degree programme, this was the one I was looking forward to the most. I feel it's only fair to say I was also disappointed. This wasn't because the content was sub-par, far from it, but because the length of the module time-wise wasn’t really long enough to do it justice. I think this module would be better done as 3 single modules to allow for greater depth of the information conveyed. That said, I do appreciate we cover a lot of subjects throughout this degree programme. Headaches are among the top 3 conditions I treat patients for in my osteopathic practice. This is hardly surprising, as according to Page (2011), Approximately 47% of the world’s population suffers from a headache, and 15-20 per cent of those headaches are cervicogenic . I would also agree with their claim that women are 4 times more likely than men to suffer from them. I am known in my area as someone who ...

Module 3: Chronic Pain – SURG0133 Chronic pain is defined by IASP as pain that persists or recurs for longer than 3 months. It is a frequently encountered condition, as approximately 20% of the population worldwide suffers from it. It presents a challenge to treat, as chronic pain is multifactorial. Chronic pain comprises biological, psychological and social factors, which together contribute to the patient's symptoms and degree of suffering. Fortunately, there are many forms of therapy available to help sufferers, but all have their limitations depending on the individual to whom they are being applied. Also, the bio-psycho-social factors, co-morbidities, age, resilience etc. can also limit the effect of any therapy being tried. I was looking forward to this module with some personal interest, as I am a chronic pain sufferer, due to having multi-joint pain as a ‘bonus symptom’ of Crohn’s Disease, along with the usual gastro-intestinal symptoms, fatigue etc. Lucky me! So I was...

  SURG0132: Pain in Cancer Patients As I pause to reflect on this module, the 4th in the degree so far, I am struck by how quickly it’s all passing by! I feel that I have learned so much, yet have so much more to learn. As the title suggests, this module was about bone pain in cancer patients. I had not really given this much thought, as it’s not something I come across in clinical practice very often, in some years, not at all. I had always attributed bone pain to the presence of a tumour itself, although I was aware that pressure or distortion from the tumour upon the surrounding tissues would be likely to cause pain. I was also aware of the distortional effects through the myofascia, or from the literal mechanical effects of cancer – eg a tumour compressing a nerve. Considering the underlying patho-neuro-physiological changes that are taking place is a new concept for me. Patients who have had treatment for cancer often tell me about their experiences of the detrimental...

Module 2 - SURG0134  - has introduced us to Acute Pain. Personally, and I think this will be a recurring theme throughout this degree, it was a fairly steep learning curve. The module began with the physiology and pharmacology relating to acute pain. Some of the content I last read many years ago, so although challenging, I have really enjoyed re-visiting the neuro-physiology and this time I feel I have gained a deeper understanding of it! I have no prescribing experience, and at this stage of the osteopathic profession, we cannot learn independent prescribing. I therefore only had some knowledge of commonly prescribed pain medications when I began this module. I also don’t work in a hospital environment, so some of the medications mentioned I only know about from being on the receiving end as a patient.  The analgesic ladder is a great tool, it clarifies how one makes the most appropriate patient-centred decision when choosing a drug for the patient peri and post-operative...