The KindlyMD content creation team is constantly scanning headlines looking for important medical information that might benefit our patients. We recently ran across a Romper piece discussing backside pain after giving birth. It is a fascinating piece well worth reading.
This post will discuss some of the highlights from the Romper piece. Don't worry. We won't give away the store here. You can still go read the original article if you want all the details. With that said, let's get started.
If you have ever given birth yourself, you don't need a doctor or pain clinic telling you just how stressful the process is on the human body. It is a lot of work. Not only that, but it’s also hard work that comes with an ample supply of pain. But what about the pain that comes afterward?
Pain resulting from childbirth is generally considered acute pain. It is almost always caused by the stress of childbirth itself. The first thing new mothers should know is that any pain felt in the backside is normal. Under most conditions, it is nothing to worry about. As for the potential causes, there are plenty of choices.
According to one of the doctors interviewed for the Romper piece, most pain in the backside originates in the tailbone. Pushing during labor puts tremendous stress on the tailbone. Therefore, it is not abnormal for mothers to feel backside pain immediately following the birthing experience.
Excessive pressure on the tailbone can cause inflammation. Likewise, inflammation can cause pain in the backside. Treatment options run the gamut from anti-inflammatory drugs to physical therapy and back massage. More comfortable bedding can be very helpful until the pain subsides. And yes, it will subside.
Backside pain not related to stress on the tailbone can actually be very specific. The Romper piece mentions three other possible causes common among postpartum women. Here they are:
Anal fissures are not exclusive to women who have just given birth. They are actually a fairly common problem that can go undiagnosed because symptoms are not severe. That said, a woman with existing anal fissures can experience acute and sharp pains immediately after giving birth due to the stress of the exercise.
Like anal fissures, hemorrhoids are a common problem across the general population. They can be aggravated by the process of giving birth due to the strenuous pushing. They can also be quite severe after an especially difficult birth. With proper self-care though, relief will eventually come.
The one potentially serious cause of backside pain following birth is infection. A mother can develop an infection as a result of internal tears incurred during labor. An infection can also occur after an episiotomy. Infections can be treated with prescription medications.
Finally, we want to encourage you with the fact that backside pain following birth is almost always acute pain that goes away in short order. Still, do not be afraid to talk to your doctor if you are concerned that your pain is too severe or abnormal in any way.
Should you develop chronic postpartum pain, there may be something else in play. Schedule an appointment with your doctor or a pain management physician as soon as you decide there is something more serious going on. Don't put it off.
Yes, pain in the backside is normal after giving birth. It is generally nothing to worry about and should resolve fairly quickly. It is just the body's response to a very stressful birthing experience. But if your pain does linger, we recommend visiting a local pain clinic like KindlyMD.
Visiting a pain clinic for the first time can be an intimidating experience. After all, pain medicine is an entirely separate specialty from primary care. Preparing for a first visit often means not knowing exactly what you have gotten yourself into. As pain medicine specialists, we can assure you there is nothing to worry about.
Whether you visit KindlyMD or another pain clinic, we trust you will be pleasantly surprised by the care you receive. To help ease any fears you might have, we have put together a brief description of what you can expect from your first pain clinic visit.
All the staff employed by the typical pain clinic are fully trained professionals in their respective fields. For example, pain medicine doctors are fully trained and licensed medical doctors with a specialty in pain management. Being certified by the American Board of Pain Medicine requires up to nine years of medical training.
The nursing staff will also be fully trained and licensed. The same goes for the technicians. The entire team will rely on their training and experience to work together for your benefit. That is the way medicine should be.
Be prepared for lots of questions during your first pain clinic visit. Asking questions is the best way for a pain management physician to understand what you are experiencing. Routine questions include things like:
Remember that questions are a two-way street in pain medicine. Here at KindlyMD, we love it when patients ask us questions. Questions and answers are the fuel of constructive discussions between medical providers and those they serve.
Expect your pain management physician to discuss different therapy options with you. Giving patients options is one of the hallmarks of the pain management specialty. Simply put, your typical pain management doctor does not adopt a one-size-fits-all approach to treating patients. Rather, individualized treatment plans are preferred.
Going the individualized route allows doctors and their patients to customize treatments as needed. We feel this is a far better approach than writing prescriptions and sending patients on their way.
You and your doctor may discuss prescription or OTC medications. You might discuss things like physical therapy, exercise, and lifestyle changes. Even alternative treatments that are not necessarily considered mainstream could be up for discussion.
Finally, you can expect genuine concern for your health from all the clinic's staff. While it is true that all medical professionals seek to improve patient health, there is something unique about pain medicine. The doctors, nurses, and other staff members at a typical pain clinic offer a unique kind of compassion that is hard to find in other specialties.
We cannot speak for any other pain clinics, in Utah or elsewhere. But we can say that our goal here at KindlyMD is to help you feel better. That is the sole reason behind everything we do. We understand that you live with pain as a normal part of your life. But we also believe you deserve to live a quality life where pain isn't in control.
You may find your first visit to a pain clinic somewhat intimidating. We hope that is not the case should you choose to visit a KindlyMD clinic. Please know that you have nothing to worry about. You will be in good hands.
About one in five American adults suffers from chronic pain. The condition affects an estimated 50 million people in the United States. Fortunately, researchers have recognized the need to develop new, non-addictive treatments for pain.
The National Institutes of Health (NIH) is the main U.S. government agency responsible for conducting and supporting medical research. In 2018, NIH launched its Helping to End Addiction Long-term (HEAL) Initiative. The initiative aims to provide scientific solutions to America’s dependence on dangerous painkillers.
The HEAL Initiative, like KindlyMD, focuses on patient-centered, “whole person” strategies for treating pain and minimizing addiction risks. So far, the initiative has supported more than 1,000 research projects across the country.
We are privileged to live in an era when technology plays an important role in our lives, including our healthcare. As pain management research continues, new and exciting ways to manage pain will surface. Here are some of the HEAL-funded technological solutions for pain relief that we find particularly fascinating.
Dr. Brennan Spiegel and colleagues at California’s Cedars-Sinai Medical Center predict virtual reality could be useful in treating pain. According to NIH, the group’s research has focused on three key areas.
Part of the research involves evaluating VR technology as a tool for teaching pain management techniques. The techniques are like the ones expectant mothers learn when preparing for childbirth, except they’re practiced in VR.
“In one example, VR users see a computer image of a tree. Changing how a person breathes alters the tree in a game-like scenario,” an NIH article about Spiegel’s research says.
Other VR research at Cedars-Sinai focuses on distraction from pain through immersion in a virtual environment.
“For example, some people with severe burns who used VR during wound care reported not noticing what is normally an excruciating process,” the article says.
Though VR pain therapy is not yet common, the FDA has already approved the first device.
Dr. Conor Walsh and his team at Harvard Design Lab are developing special “exosuits” for people with physically strenuous jobs. One of their exosuit designs features wide fabric straps that run from the shoulders to the thighs. When a worker bends to pick up an object, the suit monitors the worker’s movements and tightens the straps accordingly.
“The result is that back muscles need to work a lot less. For example, a person wearing the exosuit’s back muscle activity level lifting a weight of 13 pounds without the exosuit was the same as when lifting 22 pounds with it on. For people who perform a lot of heavy lifting, this may make a difference in long-term effects on their back muscles,” NIH wrote in an article about the exosuits.
Researchers hope these exosuits will help workers avoid overexerting their back muscles, which could lead to back pain. The team is also examining the exosuits’ potential use in physical therapy.
“We know that the best care for people with back pain is to get them moving as quickly as possible,” said physical therapist researcher Diane Dalton, D.P.T, one of the researchers working with Walsh. “We think that with the exosuit, they will be able to do more activities earlier and make quicker progress.”
Several other types of wearable pain relief devices are already on the market. Many use mild electrical stimulation to block pain perception and promote the release of endorphins, the body’s natural painkillers.
While pain relief strategies like prescription medicines and physical therapy are well-established, other methods should not be overlooked.
Dr. Andrea Cheville and her colleagues at Mayo Clinic are researching new ways to offer complementary and integrative care. One of their strategies involves changing their Electronic Health Record (EHR) system to present more information.
“Through the Mayo Clinic’s EHR system, Cheville’s team will offer surgery patients the chance to express interest in various complementary health approaches,” an NIH article explains.
Under Mayo Clinic’s modified EHR, patients scheduled for surgery encounter a “conversation guide” to help them manage post-op pain.
“The guide explains the likelihood of pain after surgery and the reasons for limiting [dangerous prescription painkillers], and it offers several non-medicine options a patient can choose to add to his or her pain management plan,” NIH’s article says.
The pain management options include yoga, Tai chi, massage, acupuncture, hot and cold therapy, paced breathing, meditation, and aromatherapy.
Many Mayo Clinic patients who received these options as part of their care were glad to see suggestions other than medications.
“One of the things we’ve heard from patients is ‘I was validated and given permission to talk about these approaches with my provider,’” Cheville told NIH.
It’s exciting to see some of the scientific discoveries and breakthroughs that could define the future of pain relief. We find it comforting that researchers continue to find new ways to handle one of mankind’s oldest challenges.
No one should have to live with untreated chronic pain, especially now, since numerous effective treatments are available. If you’re living with pain, call us at 801-851-5554 or click here to make an appointment with one of our pain specialists.
Pain medicine is a form of medicine that seeks to treat chronic and acute pain through management strategies implemented in a holistic manner. Most pain management therapies can be divided into one of two categories: traditional and interventional pain management.
Neither traditional nor interventional therapies are superior. As any good pain management physician can tell you, the best therapy for any patient is the one that works best with the fewest negative side effects. With that said, a lack of knowledge about interventional pain management among patients prevents far too many from seeking interventional therapies.
Traditional pain management is designed around treatments that in no way invade the body. Typical examples include prescription medications, over-the-counter (OTC) pain relievers, hot compresses, and cold packs.
Interventional pain management calls for minimally invasive procedures that interrupt the pain cycle rather than simply masking the pain. The interventional approach is designed to prevent pain signals from ever reaching the brain.
The most common type of interventional pain management therapy is injection therapy. It is easily observed in patients suffering from lower back pain as a result of inflammation. The doctor injects the site of the inflammation with a combination of anti-inflammatories and anesthesia.
The anesthesia provides immediate pain relief while the anti-inflammatory medication addresses the root cause of the pain. A steroidal anti-inflammatory can reduce inflammation and keep it at bay for months at a time.
Again, neither traditional nor interventional pain management is superior. Both have their place. In the traditional pain management setting, it should be noted that prescription pain killers and OTC medications are not the only options. For pain management to truly succeed, every option needs to be on the table.
Equally important is the holistic approach that pain medicine physicians and clinics tend to focus on. The holistic approach to medicine treats the entire person rather than just the particular symptoms that person is complaining of. We have found that the holistic approach leads to better pain management.
Interventional pain management fits very well with the holistic approach for the simple fact that interventional therapies do not preclude the use of other treatments. Patients are often encouraged to combine interventional therapies with lifestyle changes, nutritional changes, and even physical and occupational therapy.
Traditional pain management was born out of a general dissatisfaction with the anesthesia model of treating acute and chronic pain. Likewise, interventional pain management was developed as an alternative to relying mainly on medication to treat pain. Both disciplines have proven successful over the years.
Which approach is right for you? It is not an either-or thing. You and your pain management doctor should look at both. You deserve nothing less. In fact, you deserve something that works – whether said therapy is considered traditional or interventional.
Most of the patients seen by pain management physicians suffer from chronic pain. This is not to say that acute pain cannot be treated at a pain management clinic but, rather, that it is normally treated by GPs and other specialists. Chronic pain is what pain clinics specialize in.
Chronic pain is any pain that is experienced daily, or at least on a regular basis, for at least several months. If chronic paint is something that you live with, are you and your doctor working together to manage it? If not, we invite you to check out KindlyMD. We focus less on the differences between traditional and interventional pain management and more on helping our patients feel better.
Between 1999 and 2020, more than 263,000 people died of overdoses involving prescription painkillers in the United States. Pain is one of the most common reasons people seek medical care, so making safer treatments available is critical.
According to the CDC, about one in five American adults suffers from chronic pain. As healthcare providers, we have a responsibility to help people manage their pain safely and effectively.
KindlyMD aims to stop America’s dependence on dangerous, addictive pain medications through an integrated, patient-focused approach to healthcare. We combine traditional medications, behavioral health services, and, for many patients, alternative treatments for managing pain.
As one of our patients, you’ll benefit from the expertise of a prescriber, a behavioral health clinician, and a care coordinator. During each visit, this “Integration Team” works closely with you to develop a customized pain management strategy.
The prescriber determines which drugs, whether traditional or alternative, are most appropriate for treating the patient’s pain. Prescription painkillers have legitimate uses, and we’ll continue to prescribe them for people who need them. But many of our patients find that alternative treatments, including herbal medicines, are much better at easing their pain.
The behavioral health clinician (BHC) supports the patient’s healthcare goals by listening to their needs and suggesting specific behavioral strategies. This portion of the visit is not a replacement for behavioral or mental health therapy. But the BHC may refer the patient to a therapist, if desired.
The care coordinator assists the patient with tasks like billing and scheduling.
Although many people with chronic pain share common symptoms, we believe each patient deserves personalized care. Our providers and staff members understand the importance of listening to your needs as you progress toward your healthcare goals.
By listening to your needs, we can develop and refine treatment plans for managing your pain successfully.
Put simply, we believe in treating the “whole person,” not just the symptom(s) for which the patient is seeking treatment.
We want our patients to feel empowered and in control of their health. When possible, we’ll present multiple options for managing their pain effectively. If one treatment plan isn’t working, we’ll continue to provide support and guidance as you explore your other options.
Fortunately, those options are expanding as more American states adopt programs allowing the use of plant-based medicine.
One benefit of using plant-based medicine is the incredible flexibility you have in setting your doses. Your healthcare provider or pharmacist may give you some recommendations for beginning this type of regimen.
After that, you’ll need to spend some time learning the doses and delivery methods that best suit your needs. This phase requires a little bit of experimentation on your part, and we recommend keeping a journal.
It may seem daunting, at first, to oversee part of your own medication schedule. But patients often find this process liberating and enjoy a newfound sense of empowerment and freedom.
Before long, you’ll be thankful for your ability to manage pain symptoms effectively, using your own experience to guide you.
America’s deadly painkiller epidemic has cost thousands of lives, and the need for a responsible solution is clear. We understand that pain affects different people in different ways and that personalized, integrated healthcare can save lives.
If you’re living with chronic pain, we want you to feel better without risking your life. KindlyMD’s pain clinicians will make you feel heard and understood as you work toward a healthier and happier lifestyle.
Call us at 801-851-5554 or click here to book an appointment and begin feeling better today.
Pain management and pain medicine are considered relatively new disciplines compared to some of the older disciplines in medicine. Actually, they aren't as as new as many people think. They only seem new because they fell out of favor some 30 years ago. But now, both are making a comeback.
For the record, pain management is a treatment philosophy while pain medicine is the actual practice of implementing that philosophy. Together, they help patients suffering from both chronic and acute pain live their best lives.
An anesthesiologist by the name of John Bonica is credited with being the father of modern pain management. He was trained in what was known at the time as the "specificity theory of pain". To make a long story short, he was unhappy with the results of his own treatment of pain via regional anesthesia. This was during WWII. After the war, he began a quest to find a better way treat pain.
By consulting with other clinicians involved in disciplines ranging from psychiatry to neurology, Bonica decided a better approach to treating pain was managing it through a multidisciplinary approach. This was in stark contrast to his training, training that taught him the best way to relieve pain was through anesthesia and analgesia.
Bonica's efforts resulted in the very first multidisciplinary pain clinic being opened in the 1950s. That first clinic was located at Tacoma General Hospital. It was later moved to the University of Washington, Seattle.
For the next four decades, Bonica and a number of colleagues who believed in his approach developed what would eventually become modern pain medicine. They enjoyed great success in state after state. Multidisciplinary pain clinics were opened all across the country. So what happened?
The adoption of CPT codes in the 1980s for medical billing put a heavy emphasis on the fee-for-service healthcare model. This particular model is counterproductive to a multidisciplinary approach because it favors single therapies and procedures that are easily coded and billed. The use of CPT codes made it very difficult to bill for multi-disciplinary treatments.
In addition, the rush toward managed care through the 1980s and into the early 90s led insurance carriers to drop coverage for certain types of treatments in the primary care setting. The managed care model required GPs to refer patients to specialists for treatments and therapies that used to be available in the primary care office.
Falling reimbursement rates and fewer referrals from GPs resulted in multidisciplinary pain clinics closing their doors. By the mid 1990s, there were only a few left. Doctors were content to treat pain by writing pain med prescriptions. Unfortunately, prescription writing all but eliminated the practice of pain medicine by the end of the decade.
Fast forward to the 2010s and we observe pain management beginning to make a comeback. Unfortunately, it took a crisis to encourage the medical community to once again consider a multidisciplinary approach to managing chronic pain.
It's unfortunate that prescription drugs became the big problem they did, but the silver lining is that pain management and pain medicine have returned. Multidisciplinary pain clinics are once again opening their doors to patients who desperately need their help.
This comeback is a good thing for the simple fact that there's no good reason to allow pain to ruin someone's life. Pain can be managed. It can be controlled. Best of all, doing so doesn't always require a prescription. Finding alternatives is what the multidisciplinary approach is all about.
It is easy to assume that chronic pain is a mere physical problem that can be treated with common therapies. Sometimes this is true. But for many chronic pain patients, what they feel goes beyond physical symptoms. Chronic pain actually effects their mental health as well.
Pain's ability to affect mental health is one of the many reasons we recommend patients seek out pain clinics when their primary care physicians run out of options. Pain clinics are staffed by pain management doctors with specialized training. They understand the finer details of chronic pain that often escape clinicians in other specialties.
Living with chronic pain isn't easy. The discomfort alone can lead to all sorts of feelings that could eventually lead to depression and anxiety. Believe it or not, up to 50% of all chronic pain patients also show symptoms of depression and anxiety.
This in no way suggests that a chronic pain sufferer is guaranteed to develop mental health issues. Nonetheless, the correlation between the two is undeniable. The good news is that proper treatment can reduce the risk that a patient will go on to develop mental health problems.
When depression and anxiety are not problems for a particular patient, the risk of other mental health concerns is still present. For example, pain is a known stress inducer. We all get stressed out when something hurts. Imagine the amount of stress experienced by someone who lives with chronic pain every single day.
We already know that stress can lead to increased heart rate, high blood pressure, and other physical changes in the body. Those changes all have an effect on the chemicals present in the brain. Over the long term, an imbalance in brain chemicals can alter how the brain actually functions, leading to psychological changes.
If you know someone who lives with chronic pain, you know that their emotions can be up and down. This is a normal reaction to pain. What you might not know is that the brain signals involved in expressing both physical and emotional pain are present in the same parts of the nervous system. In other words, physical and emotional pain signals work the same neighborhood in the brain.
Someone who lives with chronic pain may demonstrate mood swings. She can be happy and smiling one minute and very unhappy the next. It is not unusual for a chronic pain patient to find no enjoyment in something anyone else would be truly excited about.
If all these things aren't enough, chronic pain can even affect a person's cognition. If you are not sure what cognition is, it is the ability to make sense of the world around you by combining your senses with thoughts and experiences. Using simpler language, cognition is the ability to understand what is going on and think things through.
Persistent pain can inhibit cognition for a couple of reasons, the first being that the body and brain are so wrapped up in dealing with the pain that there isn't enough energy left for cognition. The second reason is that persistent pain can actually change how the brain works – to the extent that cognition is impaired.
In closing, we do not mention any of this to frighten you. Instead, we want to encourage you to visit KindlyMD or another local pain clinic for help managing your chronic pain. Pain doesn't have to dominate your life. It certainly doesn't have to lead you down the path of mental health issues.
Cancer is a diagnosis no one wants to hear. It means a forever altered life. Depending on the type of cancer and the stage it is currently in, a diagnosis could mean aggressive treatment or an unfavorable prognosis. Things are only made worse when pain becomes the defining symptom. As pain management doctors, cancer pain is something we see a lot of. And unfortunately, the pain can sometimes be difficult to relieve.
Pain is generally not considered a condition in and of itself. It is a symptom of something else. The number one reason it can be difficult to relieve is that there isn't just one cause. Doctors first need to figure out what's causing it. That can be tough enough on its own. But then the doctor also needs to figure out the most appropriate pain relief strategy.
The first thing pain doctors look at to diagnose cancer pain is tissue damage. As you probably know, cancer often manifests itself in tumors. These tumors can grow just about anywhere, and as they do they often damage surrounding tissue. Whether it is damage to bones, muscles, or any other type of tissue, the resulting pain can be debilitating.
Along similar lines, tumors can cause obstructions in hollow parts of the body. A tumor could obstruct the bowels, for example. Such a blockage would ultimately result in pain. The same goes for blockages in blood vessels, lymph vessels, etc.
Another thing we frequently see at pain clinics is cancer pain related to nerve obstruction or damage. We call this neuropathic pain. Most incidences of neuropathic pain are the direct result of nerve compression or damage. This type of pain is fairly common for diabetics. In cancer patients, neuropathic pain can be the result of tumors pressing on nerves or actual nerve damage caused by the disease itself.
Neuropathic pain can be very difficult to relieve due to its nature. The nervous system is a tricky thing. So much so that it is entirely possible to block pain signals from reaching the brain and still not achieve the desired pain relief.
An extension of neuropathic pain is nociceptive pain. It is generally caused by inflammation that arises from ongoing tissue or nerve damage. Nociceptive pain is divided into two categories. The first is visceral pain, and its root cause is organ damage. The other category is somatic pain; it is pain that has its root in the bones.
All the previously mentioned types of pain can come about as a result of the disease itself. We know that cancer destroys tissue. We know tumors can press on nerves and create inflammation. We know the disease causes pain in various organs, the bones, etc. Unfortunately for cancer patients, any pain they might experience doesn't necessarily end with the disease itself. Some of their pain is caused by the very treatments intended to save their lives.
Cancer treatments tend to be aggressive and somewhat invasive. From radiation therapy to surgery and chemotherapy, the number one goal of cancer treatment is to eradicate any and all cancerous tissue. That's the only way to achieve remission. But it takes drastic measures to do so. Sometimes, those drastic measures cause pain.
Cancer pain is a very real thing. It can be difficult to relieve for the simple fact that so many things can cause it. Fortunately, pain medicine doctors specialize in this sort of thing. They are the ones to turn to when pain relief seems fleeting.
A rule of thumb here at Kindly MD is to not shrug off a new pain management therapy without doing some investigation. In light of that, the Veterans Administration (VA) is embarking on an entirely new pain management journey with the use of high-tech devices that bring virtual reality (VR) to the table.
We have known about the potential of virtual medicine for the better part of a decade. But potential and proof of efficacy are two different things. Still, it would appear as though the VA believes enough in VR treatment that they are willing to begin using it as a pain management tool.
According to news reports, doctors at eighteen VA health clinics now have the authority to refer chronic pain patients to an 8-week VR program approved by the FDA. Not only that, but the VA was also one of the earliest adopters of the technology. They have been using it to treat PTSD at more than 120 clinics for some two years.
We appreciate the idea of addressing pain management through alternative therapies. Far too often, chronic pain is addressed with medications and surgeries. Strangely enough, both approaches are more appropriate for acute pain. They don't work as well for treating chronic pain.
The Virtual Reality approach to pain management doesn't address the physical aspects as much as you might think. Rather, it approaches pain management from an emotional and mental standpoint. Why? Because pain perception involves all three aspects. Pain isn't just a physical symptom; it also has mental and emotional aspects.
One of the strategies of the VR approach involves distracting patients from their pain. Before you decide that this sort of thing doesn't work, think about your own experiences with pain. Maybe you've injured yourself playing a game of pickup basketball or softball. Yet it wasn't until after the game was over that the pain got really severe. Why was that?
The injury was the injury. But during the game, you were distracted enough that the pain seemed minimal to you. It only became more severe when you got home and sat down to relax. Your physical injury didn't change. All that changed the perception of pain was your mindset.
One of the things the VR treatment does is encourage patients to engage in physical activities that distract them from pain. One such activity involves throwing virtual snowballs at bears. This simple activity engages neural pathways that would otherwise carry pain signals to the brain. Because those pathways are busy dealing with other stimuli, the pain signals never reach their intended target.
How we feel about pain seems to matter in terms of its perception. People who are easily upset or discomfited by pain tend to have lower pain thresholds. On the other hand, people who are not bothered by pain seem to have higher thresholds. VR therapy plays into this concept to some degree. And guess what? It seems to work.
A 2021 study that examined an at-home, self-administered VR program for back pain showed that many patients reported improvement in how they experienced and coped with pain. A second study conducted a year later showed similar results.
There is not just one way to manage chronic pain. That's one of the most exciting aspects of pain medicine. The clinicians that staff pain clinics have access to all sorts of therapies above and beyond surgery and pain medication. Now, clinicians at eighteen VA clinics have access to VR therapy. We think that's pretty exciting.
