Pain Procedures in Residency

[RainbowYoshi]

Hey everyone,

So I recently got a chance to do a PM&R rotation and to see some of the procedures they do fairly often in the outpatient setting. I was wondering how much exposure neurology gets to some of these procedures in residency / in general without doing a pain fellowship. In trigger point injections or steroid joint injections for back and hips seem pretty easy, and a lot of times people get referred to neuro with back pain even if there is no nerve involvement. It seems nice to be able to offer that service to those patients rather than just another referral.

TlDR: did you see / do any pain procedures in residency?

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[Thama]

No, this isn't something you would routinely do in residency unless you set up a special elective. Most pain clinics are anesthesia run, not neurology run.

Also, every neurology clinic I've ever worked in has a categorical "no back pain" referral policy, because 99.9% are musculoskeletal, and the tiny percentage that aren't need to see people that aren't neurologists anyway.

 

[Postictal Raiden]

We do nerve blocks for headache routinely at my program. That’s the extent of it tho.

 

[DrSatan]

You could probably fairly easily get into Botox clinics for spasticity or dystonia if you do electives;

 

[Thama]

You could probably fairly easily get into Botox clinics for spasticity or dystonia if you do electives;

That's not even remotely the same as pain injections. Also, I don't know how it is at other institutions, but at mine BTX for dystonia is not something they will let a resident do except on rare occasions where they are already accepted to stay on as a fellow.

 

[RainbowYoshi]

We do nerve blocks for headache routinely at my program. That’s the extent of it tho.

So is it mostly just occipital nerve blocks or do you get a chance to learn / practice more?

 

[Postictal Raiden]

So is it mostly just occipital nerve blocks or do you get a chance to learn / practice more?

Occipital, supraorbital, and trochlear. We also do some leading in Botox (for migraine).