Pain management
Pain that lasts beyond the healing of the injury that started it is treated as a condition in its own right. Dr. Djunda runs the pain clinic at the University of Calabar Teaching Hospital and holds advanced pain training from the Delhi Pain Management Centre, including ultrasound-guided intervention.
The numeric rating scale
Every pain consultation starts with this question. It is not a test, and there is no right answer — it is simply the fastest way to describe something only you can feel.
0
No pain
Nothing to report.
1-3
Mild
You notice it, but you can work, sleep and move through your day.
4-6
Moderate
It interrupts sleep, work and concentration. This is the point at which most people should be assessed.
7-9
Severe
It dominates the day. Ordinary activity stops. Bring this forward rather than waiting it out.
10
Worst possible
Go to the nearest emergency department now. Do not wait for a reply from this website.
What is treated
A full consultation for pain that has lasted beyond the expected healing time: back and neck pain, nerve pain, joint pain, pain after surgery or injury. The first visit is about finding the cause, not only quieting the symptom.
Targeted injections and nerve blocks placed under ultrasound, so the medicine reaches the structure that is generating the pain. Trained through the Ultrasound Pain Intervention course at the Delhi Pain Management Centre.
Epidural and other analgesia for childbirth, discussed before the day so you know your options. Labour pain management has been part of his practice at every stage of his career.
Post-operative pain planning and prescribing, including care in the post-anesthesia care unit, so that recovery is not held back by pain that could have been controlled.
Ongoing pain control during serious illness, coordinated with the team already treating you.
Long-standing pain changes sleep, mood and movement, and those changes feed the pain back. Formal training in cognitive behavioural therapy for pain supports the medical treatment rather than replacing it.
The first visit
Where the pain is, what it feels like, when it started, what makes it worse, what you have already tried, and what it is stopping you from doing. This part takes the longest, and it is the part that usually gives the answer.
A physical examination directed at the structures that could be producing your pain, including how you move and where sensation has changed.
What is causing the pain, what can be done about it, and in what order. That may be medication, a targeted injection or nerve block, referral for imaging, physiotherapy, or a combination.
Pain treatment is adjusted against how you actually respond. A follow-up is part of the treatment, not an afterthought.
Bring with you: any medication you are currently taking, in the packet if you can; any scan reports, X-rays or test results you already have; and the name of any other doctor treating you for this.
Training behind it
Pain medicine sits on top of a consultant anesthesia practice and a fellowship of the West African College of Surgeons. The pain-specific training was taken through the Delhi Pain Management Centre.
Member, Society for the Study of Pain, Nigeria.
Send your name, your number and where it hurts. He replies by phone or WhatsApp to agree a time.