Placements When You Have Chronic Pain

An image of a blurred rocky shore with a focus on 8 small pebbles stacked on each other.

I started my Occupational Therapy BSc in 2020, which was a terrible time for me pain wise.  The lockdown meant that I was unable to access my pilates classes, and I was unable to go out and keep the standard of fitness which was critical for me.  I have Ehlers Danlos Syndrome, and key to this is strength.  So starting university and hauling a backpack around, sitting at a desk; I was in pain.

My GP allowed me to increase my morphine dose by 10mg morning and night, which we both agreed would be a temporary measure.  I upped my antidepressants from 50mg to 100mg, as my mental health was not doing great, with the pandemic, the stress of university, 2 kids with autism, and my diagnosis of SAD (seasonal affective disorder).

The medication increases really did help me – I coped well with the pain, and my husband noticed an improvement in my mood quite quickly.  I won’t lie – there were some quite anxious days, and some teary days!  It is really hard going back to studying at 37, but I felt supported by the majority of the cohort.  This is when I really started to notice my neurodiversity, as I was forced to work with others who didn’t know me as well.  My closest friends started to tell me when I was being ‘too much’ or saying the wrong thing, being too loud etc.

By the time spring was rolling around, my pain levels were improving, and I had managed to reduce the pain meds and just take the extra 10mg in the morning.  However, my placement was about to start.  This was causing me a huge amount of anxiety.  

Due to the pandemic, lots of health professionals hadn’t had their holidays, and finding placements was proving difficult, so my placement was finalised just over a week prior to me starting.  It was almost an hour driving each way to get there.  However my educator and the team could not be more supportive.  I increased my medication to twice per day, and the driving started to take a toll on my hands towards the end of the placement.   There was a desk set up with an ergonomic keyboard, mouse and a chair from someone who left and they kindly allowed me to use this as my desk for the time I was there.  They offered me a few days working from home over the 6 weeks to save me driving the journey if I was only doing paperwork rather than visits.  Other times I could go early and finish my work at home.  Placements can be flexible if they want to be.  I was assured that if I had any issues at all I could speak to them and they would be more than happy to support me.  I wore my hand / wrist splints or compression gloves quite a bit in the office and that was encouraged.  During clinic time, I would remove them, and we were in full PPE with gloves, goggles, apron at that time due to covid anyway.

My next placement started in October of my second year, and this is when my pain always starts to increase, as it is getting cold. This time I got my placement 7 weeks prior to starting, which was great, as I was able to contact them and go on a visit to learn more about where I would be based. 

Prior to starting on this placement I had just managed to stop taking 10mg in the morning aswell as evening.  However, I was having a lot of problems with migraines (which I do struggle with anyway), which were happening a lot and constant headaches.  My GP gave me codeine for when it was bad and did some tweaking over multiple appointments (during my study time).

So I started placement taking the increased morphine just in the day – which actually was enough.  I took the codeine just in the morning if I had a bad headache as I only needed to get through the working day.  By week 6 of my 8 week placement, my migraines had been sorted by the medication tweaks, but I was still having headaches.  Post placement I was diagnosed with cervicogenic headaches which are caused by problems with my cervical spine, but the codeine was helping this.

 Since my placement I am on my normal meds – plus my additional new tweaked ones, which has now been increased for the cervicogenic headaches.  That is it.  No extra pain meds.  I am actually quite impressed with that.  Even with the head pain I am coping quite well now.  I think being at university every day, my body has got used to all the extra physical activity, and carrying the bags around. 

As an OT student, getting the half a day study per week was really helpful, as I was able to use this to rest if needed.  I could do my studying during the weekend or at night.  Do what suits your body.

The first week of a placement is really exhausting and also really emotional, and you wonder how you will get through the whole placement, but you do. It does get easier!  

The most important thing to remind yourself is pacing and planning.  

Prior to the placement you need to PLAN.  What will you have to do during that time?  

  • I am scout leader – and during my placement I was out 2 evenings every week!  This is exhausting.  To enable me to be able to cope, I planned all of the sessions, and organised all of the resources that I would need prior to starting the placement.  
  • At home I set up an 8 week meal plan document to take the guess work out of ‘what will we have for dinner?’  I printed the plan off and stuck it on the wall.  
  • I also printed a plan of what everyone was doing and when, so that me and my husband knew what was going on.  Things such as dress down days, Christmas play etc.
  • Prior to placement ensure that you have a support plan, which explains what you need to be successful.  This should be done with the university, however if they don’t suggest one, we can send you a template for you to complete prior to your placement, which may suit your needs.  
  • If you haven’t already, apply for disabled students allowance – this will really support your studies at home, and if you are working from home at any point.
  • Don’t wait until you start placement to declare a disability.  Get things in place before you start university.  Contact inclusive support and the placement educator and ask for a meeting to discuss your disability and requirements on placement (and during lectures / day to day uni).
  • One really important thing to do preparing for a placement is to set realistic expectations, but not sell yourself short.  You would not be on your course if you would not make an incredible OT!  You have the potential, but it may be that you need some changes to be made and some support to be put in place to enable you to have the best experience. 

Don’t suffer in silence –  if things go wrong, or aren’t right, speak out.  Speak to your educator, placement lecturer, placement visiting tutor, or the university complaints department.  There are loads of people who can help you.  

It can feel really overwhelming at times, but it is really important to remember that it is over in just a few short weeks.  

Good luck!

~Natalie x

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