Chronic Pain – Where to start?

[JWebar]

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Hi guys!

Im starting a fellowship in Interventional Chronic Pain in Canada next July. I have some free time before and want to prepare myself as much as possible cause in my residency Chronic Pain exposure was 0, so im pretty at a lost with everything. I just finished a regional fellowship so US and blocks related stuff is pretty solid.

TL;DR = Looking for recommendation on good textbook/sources to start getting acquainted with this field.

As always, thanks in advance.

 

[deleted162650]

A psychiatry text with an emphasis on personality disorders.

 

[Ronin786]

A psychiatry text with an emphasis on personality disorders.

To self reflect on why he went into pain?

 

[dhb]

To self reflect on why he went into pain?

After doing a regional fellowship 😉

 

[deleted162650]

After doing a regional fellowship 😉

He had a gap year to fill before his OB fellowship starts.

 

[JWebar]

Thanks for the bumps! Still waiting for some helpful answers though 🙄

 

[dhb]

Maybe ask in the pain forum?

 

[10KHertz]

Warfield’s “Pain Medicine” textbook is one gold standard in our field...

 

[deleted697535]

Where are you doing the fellowship? I thought Canada had moved fully to a 2 year pain residency?

 

[sevo00]

there's a separate pain forum

 

[Aether2000]

US blocks used in regional anesthesia have almost no relevance to chronic pain blocks. Treatment of chronic pain often is 80% blocks/RF/SCS because it is more lucrative than other modes of treatment, but if I had to design a chronic pain pre-program, it would be heavy in psych and physiatry. You will learn interventional procedures during fellowship. What is most difficult about the field is to recognize that 95%+ of cases, you are palliating pain long term, and overall are doing so with very modest success. This is very much unlike regional blockade procedures for surgery.

 

[Beach bum]

Two prior partners, neither of which had much pain exposure during residency decided to go back and do pain fellowships, neither continued to practice pain. I had considerable exposure in residency and never had desire to practice pain as a career. Not sure that this helps other than I would encourage some sort of exposure to the field before committing significant time.

 

[TheLoneWolf]

One of the most important papers I had read. Anyone who is considering a pain fellowship or will be caring for pain patients should read this paper.

 

[JWebar]

Seems like I have to explain myself regarding my choice: I have spent part of my regional fellowship to get some exposure in chronic pain (procedures and some clinic) and I DO like it. I haven't had the chance to study any of it, and as I said I didn't get to during my residency, thats the reason for this thread. The way it works (in Canada, where I plan to work after the fellowship) is that anesthesiologists are part of a multi–disciplinary team that includes psychiatrist, physical therapists, pain physicians from other background, pharmacists, etc. Most anaesthetists will work 1-2 days in the chronic pain department (1 day of clinic + 1 day of OR) and the rest in the general OR. During the fellowship they get enough education in this areas to screen pts and be able to refer them when necessary. Their chronic pain OR day is spent doing procedures indicated by the chronic pain team or themselves. They'll start building a patient base since most of the procedures are done on a periodic basis. Most of the ones I know ended up moving their whole schedule to chronic pain rather than come back to the OR. Dunno, guess it depends on your experience in the field.

Anyway, thanks for the input!

PS: I didn't knew about the Pain Medicine forum, thanks for pointing that out!

 

[dhb]

One of the most important papers I had read. Anyone who is considering a pain fellowship or will be caring for pain patients should read this paper.

In residency there was a preop survey which had 3 consecutive boxes for headache, back pain and depression, if one box was ticked you could be >98% sure that the other 2 would be.