Medical School | PM&R Rotation - How to Treat Back Pain

[@IanALane]

They best way I've heard the field summed up is as follows: "PM&R is non-operative orthopedics, plus neurology."

[@orealade9989]

Hi Jenny! I just want you to know that you inspire me so much. It's amazing that you're using your life to help other people and that's exactly want I want to do with my life also. I'm only in high school, but medicine is everything to me. I just want to say thank you for posting!

[@drjennale]

Thanking for taking the time to watch!! And good luck on your medical journey :)

[@thedoctorslounge1521]

I have watched so many of your other videos and somehow only just now found this one! I just matched into a PM&R Residency at National Rehabilitation Hospital this year and feel you did a great job. If anyone is looking for more information I would be more than happy to help answer more questions! Thanks for giving PM&R some love!

[@nicholemarie4572]

I never comment on youtube videos but I just really wanted to thank you for posting this! I've been wanting to shadow a PM&R physician but they're scarce where I live. Thank you for giving me a glimpse into their life and for teaching us along the way!

[@drjennale]

Thank you so much for watching! There are so many subspecialties of PM&R you will learn much much more when you shadow. Good luck :)

[@Kay_3b]

This video is so cool! I'm currently taking the physical therapy route but had no idea about PMR until I came across your video. I learn so much from your videos thanks for posting them :)

[@drjennale]

Thank you so much for watching !

[@ministryofdressing]

Thank you you answered better than the belgian orthopédists I went to see for my lower back pain, I just woke up and it actually hurt again, my case is not traumatic but arthritis but the two doctors I went to did not do anything except take my money I am disappointed but glad you made this video ! Thank you darling 😘

[@drjennale]

Thank you so much for watching. I hope you are able to find some sort of pain relief.

[@krissy4265]

This was fun to watch. Keep killin it girl!

[@drjennale]

Thanks so much for watching! Even when I've been on the struggle bus with the lighting.

[@jadehymel]

Loved it! I can watch your videos all day :)

[@lubricator]

Thank you for the insightful information. I have back pain and may need injections. Your thoughtful video gave me a good idea what will be done.

[@flammo9]

Great bit on the issue with opiods.

[@DoctorNikkiP]

Such a cool and informative video! It's a really interesting field and I wish your friend the best!

[@drjennale]

Thank you! I'll be sure to let her know :)

[@SLPtoMD]

Among other sub specialties, I'm interested in PM&R in the trauma centre, rehab unit type of setting. Had a placement as an SLP student in that setting and loved it. Would prefer to work in medicine in that setting though haha.

[@ministryofdressing]

And does laying back, while sleeping, is considered as an extension of the spine

[@MedaPeutics]

Extension of the spine can only be considered extension in three parameters; cervical, thoracic, and lumbar. Each section has its own angular considerations for extension. The cervical curve is lordotic as well as the lumbar where as the thoracic curve is kyphotic. If you google these terms, you'll see what I mean. But laying down flat does allow gravity to be distributed evenly and takes the 'curve compression' out leaving an 'extension' idea. Does that help?

[@MedaPeutics]

What soft tissue is the target beneath the scottie dog? The local is understood, but what exactly is the target? Also, do you check for visceral referred pain away from the spine when pain presents?

[@drjennale]

Rebekah Depends on what type of injection you are planning to perform. If you are doing a transformational epidural steroid injection then your target is the epidural space. Compared to a medical branch block you are aiming to block that specific nerve - same with ablation. When seeing patients you would always do a thorough history and physical exam so If patients did have any visceral-somatic pain, you would find it then.

[@MedaPeutics]

Yes, the history is the no-brainer aspect :) So for the space itself, you are actually taught to target the nerve for pain, not necessarily soft tissue, therefore are doing a paralysis type injection with the epidural? Am I thinking of this correctly? I'm thinking about how referred pain can actually present in one area but be a derivation of the root or visceral....so if the pain is somato-visceral in nature, what would be the focus? Ive studied thus far under DOs and chiropractors that steer clear from injections as it does numb rather than cure, so Im really interested in your videos from the MD aspect :)

[@drjennale]

Rebekah I agree that injections are not the cure, but it is an better alternative to opioids. Injections are also coupled with things like physical therapy in hopes to push the body's natural healing processes. Somato-visceral pain is thought that some somatic dysfunction is causing a visceral pain. Hence we would look to treat to somatic dysfunction whether it be with osteopathic manipulative treatment, injections, etc. We had a patient with Complex regional pain syndrome (know sympathetic process) where we blocked the stellate ganglion to allow relief. It's a complicated topic but it's a basic concept you'll be learning soon in med school. Hope that cleared some things up.

[@MedaPeutics]

Right somato-visceral or vise versa; leading word is the paradigm for malfunction. I understand the concept clearly. My conflict is that 'blocking' still isnt curing, so Im struggling with 'pain management' protocol if that makes better sense. What aims do they focus for cure?

[@MedaPeutics]

I worked for NIH after my masters for about 3 years in this area....sad to say, but most focuses are management. Im strongly interested in curing. Right now, I am doing an internship in a non-surgical ortho office. The PRP injections are interesting. If there were evidence on restoration ability of inter-vertebral discs, wow, that would be groundbreaking. I actually spent two years in a chiro program before deciding to change directions; which has all of the first 20 months identical to MD (I didnt know that before matriculation). Im honestly not finding many practices that actual attempt at cures. Have you found any?

[@alishia.jinn1233]

I have posture problem because of heavy book bag I carry everyday my back pain hurt everyday because it curve down and I could straight up but it hurt a lot to control the muscle I’m in grade 8 and I’m 14

[@speedstackinggurl]

What happens with the medicine that is in injected in their back? Like if they get several injections doesn't the material kind of build up somewhere? Never knew PM&R was a thing so I learned something today thanks to you!

[@drjennale]

You body naturally metabolizes the medication. Its like taking medication by mouth, your body absorbs and metabolizes the medication to get the desired effect - in this case pain relief.

[@pixielove26]

Hey Jenny! My dad has severe rheumatoid arthritis and I was wondering what he can do to help it. He's constantly taking pain medication and in chronic pain. I know you're not a specialist yet but I trust you.

[@tomare6479]

Has he seen a specialist? Definitely a good idea to see a specialist.

[@drjennale]

Rheumatoid arthritis is an inflammatory disorder that can affect all joints. Usually a rheumatologist would know the right choice of medication to help with your dad's pain based on his symptoms. Non pharmacotherapies include understanding the disease (opioid may not help the root of the problem), physical therapy, occupational therapy, rest, exercise, smoking cessation, cholesterol control, and nutrition/diet counseling. Sorry I couldn't be more help.

[@twofivetrends7062]

I just want to ask who takes care of your kids when you're in Med School? I am a undergrad student, 23 y/o with 18 mos old son and I'm currently pregnant due in november. :( I wanted to go to med school so bad but I don't know where to start and I don't know any options on leaving my kids. I feel like I will never be able to go to med school because I have 2 kids under 2 y/o.

[@drjennale]

I delivered at the end of my fourth year of medicinal school and had “new born electives” so was able to stay home with Wyatt until residency started. You really do need a good support system at home to be able to get through medical school ... especially with kids. I think you also need to ask yourself if you’re willing to sacrifice and be away a little more from your young children in order to peruse medicine ... or can you wait a couple years when they’re in school?

[@KIM-kp9tq]

I miss these tutorial and explanation videos:(

[@counselingmom]

Crazy you don't have a baby bump. My daughter is the same age and I had a bump for Xmas pics.

[@drjennale]

+Counseling Mom I don't think I started really showing until about 6 months!

[@counselingmom]

I love your Videos by the way. I love reading medical books even tho I've never worked in the medical field. Your video just started playing after a video I was watching and I'm glad.