There was more pain after the procedure than I had anticipated. Not pain that wasn't manageable, but pain nonetheless. I'm surprised I hadn't looked into this before but the AI summary of why bone pain exists with bone marrow aspirates sure was an eye opener:
“Bone marrow aspiration causes pain primarily because the procedure must pass through the periosteum, a thin, fibrous membrane covering the outer surface of the bone that is packed with nerve endings. While the hard bone itself has few nerves, the periosteum, surrounding tissues, and the marrow cavity itself contain sensory fibers that react to the pressure, drilling, and suction involved in the procedure.
Here is why it hurts:
The Periosteum (Most Painful Part): The outer covering of the bone (periosteum) is rich in sensory nerve endings. Piercing this layer with the needle causes sharp, acute pain.
Intramedullary Pressure: Bone marrow is enclosed in a rigid, non-compliant casing. Inserting a needle and removing fluid (aspiration) changes the pressure inside the bone, which stimulates nerve endings within the marrow cavity.
The Suction Feeling: The aspiration (sucking out) of liquid bone marrow creates a temporary, deep, pulling, or aching sensation.
Nerve Sensitivity in Marrow: Although the bone is hard, the bone marrow receives sensory and sympathetic innervation, meaning nerves do exist within the marrow cavity, particularly around blood vessels.
Why Local Anesthetic Doesn't Stop All Pain:
While doctors use local anesthetics (like lidocaine) to numb the skin and the outer surface of the bone, it is difficult to completely numb the deeper bone marrow cavity, leading to the intense, brief pain reported when the syringe is actually used.”
So this is absolutely fascinating to me. I don't want to say this with 100% certainty, but I am pretty sure this was not part of my physical therapy education and I find that absolutely mind boggling.
This new(ish?) knowledge to me will absolutely help me in caring for my patients who have sustained traumatic or elective bone related injuries/interventions.
We got to explore around the area and went to Edelman Fossil Park & Museum in New Jersey and the Mutter Museum in Philly. No photos allowed at Mutter but here are a few from Edelman Fossil Park:
Turns out New Jersey was under water during the time of the meteorite impact and a said tsunami washed land dinosaurs from Pennsylvania out to sea where the perfect conditions were present for fossils. This has allowed them to find both marine and land dinosaurs in their archaeological site on the grounds.
Checking out from our rental tomorrow and headed to Reading Terminal Market before returning to the airport for my long trip home.
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