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 is good at treating pelvic girdle pain in pregnancy, perhaps because I had it severely during my first pregnancy. I was frustrated that there seemed nothing available to help me apart from a band of tubigrip and crutches. This inspired me to do a few CPD courses, as I was determined that no person’s pregnancy should feel as miserable as mine did. The upside is that it’s good to be able to empathise with your patients!

I also have a number of patients who have chronic pelvic pain. The main causes are endometriosis and post-prostatic surgery pain. These patients tend to have tried most standard medical approaches to help with their symptoms but to no avail.  Osteopathic treatment does seem to have a role to play in helping to relieve pain in such cases, even if it is likely never to be fully curative. My profession in the past has seemed to be reticent in doing the necessary research to investigate this further, which I find frustrating, but I’m sure that further studies will emerge in time.

I don’t see too many paediatric patients in pain. The usual scenario I see in this patient group is children who’ve encountered sprains and strains during play, sports events or training. However, it is always very interesting to learn about pain-related topics which aren’t on my usual patient list. I enjoy learning about the medications used and the dosing strategies. When my profession gets the opportunity to learn to prescribe certain medications, I feel that this knowledge will be beneficial in the future when I am studying for my non-medical prescribers course qualification.
I have never thought about children needing to have epidurals or PCA pain relief. I think however the need for clear communication with a child’s parents is vital, regardless of the setting or severity of the pain.

I enjoyed very much getting to learn in greater depth the underpinning neurophysiology of abdominal pain. It has helped me to understand the mechanisms behind many of the visceral osteopathic techniques I have been taught which aim to reduce certain types of pain. In college, one was taught ‘do this because it works’ rather than ‘here’s why it works’ necessarily. This is probably due to the lack of current research on such topics, as I've already mentioned. Or with some past tutors, the answer is ‘I don’t know, but we've always done it this way’ (possibly implying that they don’t understand it either).
Over time, such techniques eventually became routine, and I felt frustrated to a certain degree. I know I am a safe, competent practitioner, but the question of ‘why does this work or not work’ continued to nag away at me. I feel as I understand more, I can make a better-tailored plan of treatment, rather than using a ‘one-size-fits-all’ strategy.

 

Reference list:

Page, P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, [online] 6(3), pp.254–66. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201065/#:~:text=Approximately%2047%25%20of%20the%20global [Accessed 10 Nov. 2023].