PainExam Podcast

David Rosenblum, MD
  • 4.0 (29)
  • Medicine
  • Updated Monthly

David Rosenblum, MD, creator of PainExam.com and Director of Pain Management at New York Based, AABP Pain Management discusses Pain Board Review and issues relevant to pain physicians. Marketing, practice management and Board Prep are discussed. For more information and CME Credit's go to PainExam.com Also, be sure to check out Dr. Rosenblum's children's book: Welwyn Ardsley and the Cosmic Ninjas: Preparing your child and yourself for anesthesia and surgery. Available at Amazon.com and www.MyKidsSurgery.com

  1. NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science?

    1d ago

    NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science?

    PainExam Podcast Show Notes NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science? Hosted by: PainExam Podcast Presented by: NRAP Academy (Neuromodulation, Regional Anesthesia & Pain) Host: David Rosenblum, MD Episode Overview In this episode of the PainExam Podcast, we explore the growing interest in NAD+ (Nicotinamide Adenine Dinucleotide) supplementation and its potential role in pain management, inflammation reduction, cellular recovery, and healthy aging. NAD+ is a naturally occurring coenzyme found in every living cell and is essential for energy production, mitochondrial function, DNA repair, and cellular resilience. As NAD+ levels decline with age, chronic stress, inflammation, and disease, researchers have begun investigating whether restoring NAD+ levels may improve outcomes in chronic pain conditions and inflammatory disorders. We review the current science, discuss potential mechanisms of action, and examine how NAD+ therapy is being integrated into regenerative medicine, wellness programs, and pain management practices. What is NAD+? NAD+ is a coenzyme involved in: ✅ Cellular energy production (ATP generation) ✅ Mitochondrial health ✅ DNA repair pathways ✅ Oxidative stress reduction ✅ Neuroprotection ✅ Cellular signaling ✅ Activation of longevity-associated proteins called sirtuins Without adequate NAD+, cells become less efficient at producing energy and managing inflammation. Why Might NAD+ Matter in Chronic Pain? Many chronic pain conditions involve: Mitochondrial dysfunction Oxidative stress Neuroinflammation Peripheral and central sensitization Impaired cellular recovery Researchers hypothesize that optimizing NAD+ levels may help address several of these pathways simultaneously. Potential areas of interest include: Neuropathic Pain NAD+ may support: Nerve repair Axonal recovery Mitochondrial function within neurons Reduction of oxidative injury Inflammatory Pain NAD+ influences inflammatory signaling pathways and may help modulate: Cytokine production Immune cell activity Cellular stress responses Fatigue and Recovery Patients with chronic pain frequently report: Fatigue Brain fog Reduced exercise tolerance Poor recovery Because NAD+ plays a critical role in energy metabolism, some clinicians report improvements in energy and recovery following supplementation. Potential Mechanisms of Action 1. Improved Mitochondrial Function Mitochondria generate ATP, the body's energy currency. Reduced NAD+ levels are associated with: Cellular aging Impaired energy production Increased inflammation Supplementation may help restore mitochondrial efficiency. 2. Activation of Sirtuins Sirtuins are proteins involved in: Cellular repair Longevity Metabolic regulation Inflammation control NAD+ serves as a critical substrate for sirtuin activity. 3. DNA Repair Support NAD+ is required for enzymes known as PARPs (Poly ADP Ribose Polymerases), which participate in DNA repair processes following cellular injury. 4. Reduction of Oxidative Stress Chronic inflammation often produces excessive reactive oxygen species (ROS). NAD+ may help maintain cellular antioxidant defenses and reduce oxidative injury. Routes of NAD+ Supplementation Intravenous (IV) NAD+ Most commonly marketed in wellness and recovery clinics. Potential advantages: Direct systemic delivery Avoids gastrointestinal absorption issues Allows higher dosing protocols Potential limitations: Cost Time commitment Variable evidence base Oral Precursors Rather than NAD+ itself, many supplements provide precursors such as: Nicotinamide Riboside (NR) Nicotinamide Mononucleotide (NMN) These compounds are converted into NAD+ within the body. What Does the Evidence Show? Current evidence remains preliminary. While preclinical and mechanistic studies are promising, large-scale randomized controlled trials evaluating NAD+ specifically for chronic pain are still limited. Areas under active investigation include: Neuropathic pain Neurodegenerative disorders Chronic fatigue syndromes Recovery optimization Healthy aging Patients should understand that NAD+ therapy remains an emerging treatment rather than a standard evidence-based pain intervention. Safety Considerations Reported side effects may include: Nausea Flushing Chest tightness during rapid infusions Headache Fatigue Lightheadedness Most adverse effects appear infusion-rate dependent and can often be minimized through slower administration protocols. Patients should discuss treatment with a qualified healthcare professional, especially if they have: Cardiovascular disease Active cancer Significant medical comorbidities Clinical Pearls for Pain Physicians ✔ Consider NAD+ as a potential adjunct—not a replacement—for evidence-based pain care. ✔ Continue emphasizing exercise, sleep optimization, nutrition, behavioral health, and appropriate interventional therapies. ✔ Discuss realistic expectations with patients. ✔ Recognize that evidence continues to evolve. ✔ Focus on patient-centered outcomes rather than laboratory markers alone. Key Takeaways NAD+ is essential for cellular energy production and repair. Declining NAD+ levels may contribute to aging, inflammation, and chronic disease. Early evidence suggests possible benefits in inflammation, recovery, fatigue, and nerve health. Robust pain-specific clinical trials remain limited. NAD+ therapy should currently be viewed as an adjunctive and investigational strategy in pain management. Resources for Physicians Pain Medicine Board Preparation Prepare for the ABA Pain Medicine Boards with: 🎯 Comprehensive Question Banks 🎯 Virtual Pain Fellowship 🎯 Flashcards and Mock Exams 🎯 Weekly Board Review Content 👉 Pain Management Board Prep at NRAP Academy Hands-On Ultrasound Courses – New York Learn: Peripheral nerve imaging Ultrasound-guided injections Regenerative medicine procedures Diagnostic musculoskeletal ultrasound Advanced pain intervention techniques 👉 NRAP Ultrasound Courses in New York Ultrasound & Regenerative Medicine Training – Costa Rica Join physicians from around the world for immersive training in: 🌴 Playa Grande, Costa Rica ☀️ Small-group hands-on instruction 🦴 Regenerative medicine applications 📡 Ultrasound-guided pain procedures 👉 Costa Rica Ultrasound Training Courses Connect With PainExam 🌐 NRAP Academy Website 🎙️ Search PainExam Podcast on your favorite podcast platform. 📚 Explore the Virtual Pain Fellowship, Board Review Programs, Ultrasound Training, and CME opportunities. References Hudson Health. NAD+ Infusion Therapy: Full Clinical Review and Background Paper. 2023. Verdin E. NAD⁺ in aging, metabolism, and neurodegeneration. Science. 2015. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD⁺ metabolism and its roles in cellular processes. Nature Reviews Molecular Cell Biology. 2021. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules. Cell Metabolism. 2018. Katsyuba E, Auwerx J. Modulating NAD⁺ metabolism for health and longevity. Nature Reviews Endocrinology. 2017. Disclaimer: This podcast is intended for educational purposes only and should not be construed as medical advice. Always consult qualified healthcare professionals before initiating any treatment.

    14 min
  2. Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the Pain Medicine Boards

    May 29

    Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the Pain Medicine Boards

    PainExam Podcast Show Notes Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the ABA Pain Medicine Boards In this episode of the PainExam Podcast, Dr. David Rosenblum reviews two frequently tested topics on the ABA Pain Medicine Board Examination: Occipital Neuralgia and Vertebral Compression Fractures, including the indications, techniques, complications, and evidence surrounding vertebroplasty and kyphoplasty. Whether you are preparing for the ABA Pain Medicine Boards, ABPM, ABIPP, FIPP, or simply looking to strengthen your interventional pain knowledge, this episode covers essential board pearls, anatomy, diagnosis, imaging findings, and treatment options. Episode Highlights Occipital Neuralgia Topics discussed include: Anatomy of the greater, lesser, and third occipital nerves C2 dorsal ramus anatomy and clinical relevance Diagnostic criteria for occipital neuralgia Differentiating occipital neuralgia from: Cervicogenic headache Migraine Cluster headache Tension headache Physical examination findings Occipital nerve blocks Pulsed radiofrequency ablation Cryoneurolysis Peripheral nerve stimulation (PNS) Board Pearl The greater occipital nerve originates from the dorsal ramus of C2 and temporary pain relief following a diagnostic occipital nerve block strongly supports the diagnosis. Vertebral Compression Fractures Topics reviewed include: Osteoporotic vertebral compression fractures Thoracolumbar fracture patterns MRI findings STIR sequence interpretation Patient selection for vertebral augmentation Conservative treatment versus intervention Vertebroplasty technique Kyphoplasty technique Cement leakage and other complications Evidence supporting vertebral augmentation procedures Board Pearl Bone marrow edema on MRI STIR imaging is one of the most important findings suggesting an acute compression fracture. Kyphoplasty vs Vertebroplasty Vertebroplasty Direct injection of PMMA cement into the vertebral body Stabilizes micro-motion within the fracture Can provide rapid pain relief Kyphoplasty Balloon tamp creates a cavity before cement placement May partially restore vertebral body height May reduce risk of cement extravasation Often preferred in selected patients with significant vertebral collapse Commonly Tested Complications Cement leakage Pulmonary cement embolism Adjacent level fractures Infection Neurologic injury (rare) High-Yield ABA Pain Medicine Keywords Occipital Neuralgia Greater Occipital Nerve C2 Dorsal Ramus Third Occipital Nerve Cervicogenic Headache Peripheral Nerve Stimulation Vertebral Compression Fracture Kyphoplasty Vertebroplasty PMMA Cement STIR MRI Osteoporosis Cement Extravasation Upcoming Educational Meetings & Conferences 2026 ASPN Annual Meeting – Miami Learn more about the upcoming meeting hosted by the American Society of Pain and Neuroscience: 📍 ASPN Annual Conference & Miami Meeting Information PainWeek 2026 – Las Vegas Join thousands of pain physicians, APPs, nurses, and industry professionals at: 📍 PAINWeek Las Vegas 2026 Latin American Pain Society Meeting – Brazil For information regarding the upcoming regional pain meeting in Brazil: 📍 Latin American Pain Federation (FEDELAT) Information CME, Ultrasound & Board Review Resources NRAP Academy CME Courses, Virtual Pain Fellowship, Ultrasound Workshops, Regenerative Medicine Training, and Board Review Programs: 📍 NRAP Academy Website CME Calendar Upcoming Ultrasound Workshops, Regenerative Medicine Courses, Board Review Programs, and Conferences: 📍 NRAP Academy CME Calendar Virtual Pain Fellowship Comprehensive longitudinal pain management education: 📍 Virtual Pain Fellowship Program Pain Management Board Review Prepare for: ABA Pain Medicine Boards ABPM ABIPP FIPP 📍 PainExam Board Review Resources Connect With Dr. David Rosenblum Patients Seeking Care Appointments and consultation requests: 📍 AABP Integrative Pain Care & Wellness Physician Education CME, Ultrasound Training, Regenerative Medicine, and Board Review: 📍 NRAP Academy References Margetis K, Patel A, Petrone B, et al. Percutaneous Vertebroplasty and Kyphoplasty. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Updated April 6, 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK525963/ Daher M, Kreichati G, Kharrat K, Sebaaly A. Vertebroplasty versus Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: A Meta-Analysis. World Neurosurgery. 2023;171:65-71. Masala S, Fiori R, Massari F, Simonetti G. Kyphoplasty: Indications, Contraindications and Technique. Radiologia Medica. 2005;110(1-2):97-105. Headache Classification Committee of the International Headache Society (IHS). International Classification of Headache Disorders (ICHD-3). Cephalalgia. 2018. Bogduk N. The Clinical Anatomy of the Cervical Dorsal Rami. Spine-related anatomy and occipital nerve pain syndromes. Subscribe to the PainExam Podcast For weekly board review content, ultrasound-guided procedures, regenerative medicine updates, pain medicine literature reviews, and expert interviews, subscribe to the PainExam Podcast and visit: 📍 PainExam Podcast & Board Review Resources 🎓 Earn CME and advance your skills through the NRAP Academy and Virtual Pain Fellowship.

    14 min
  3. CRPS and Intrathecal Pumps- ABA Pain Medicine Board Pearls and more!

    May 12

    CRPS and Intrathecal Pumps- ABA Pain Medicine Board Pearls and more!

    🎙️ PainExam Podcast Show Notes CRPS & Intrathecal Pain Pumps — High-Yield ABA Pain Board Review 🔥 Episode Overview In this episode of the PainExam Podcast, David Rosenblum reviews two essential ABA Pain Medicine Board topics: Complex Regional Pain Syndrome (CRPS) Intrathecal Drug Delivery Systems (Pain Pumps) This episode focuses on: High-yield board pearls Clinical decision-making Interventional treatment strategies Common exam pitfalls Whether you are preparing for the: ABA Pain Medicine Boards ABPM ABIPP FIPP —or looking to sharpen your interventional pain knowledge—this episode delivers practical and testable concepts. 🧠 Topic 1: Complex Regional Pain Syndrome (CRPS) 🔬 What is CRPS? CRPS is a chronic neuropathic pain condition characterized by: Disproportionate pain Autonomic dysfunction Sensory abnormalities Motor and trophic changes 📋 CRPS Types CRPS Type I No confirmed nerve injury Formerly "Reflex Sympathetic Dystrophy" CRPS Type II Confirmed nerve injury Formerly "Causalgia" ⚠️ Pathophysiology CRPS involves: Peripheral sensitization Central sensitization Sympathetic dysfunction Neurogenic inflammation Cortical reorganization 🩺 High-Yield Clinical Features Burning pain Allodynia Hyperalgesia Temperature asymmetry Skin color changes Edema Weakness and trophic changes 📚 Budapest Criteria (BOARD FAVORITE) Diagnosis requires: Continuing pain disproportionate to injury Symptoms in ≥3 categories Signs in ≥2 categories 💊 Treatment First-Line Physical therapy (MOST important) Early mobilization Medications Gabapentin Pregabalin TCAs Interventional Sympathetic blocks Spinal cord stimulation 🚨 Board Pearls Early treatment improves outcomes CRPS may spread beyond the initial site Immobilization worsens symptoms 💉 Topic 2: Intrathecal Drug Delivery Systems (Pain Pumps) 🔬 What Are Intrathecal Pumps? Intrathecal pumps deliver medications directly into the CSF, allowing: Lower systemic doses Better analgesia Reduced systemic side effects 🎯 Indications Failed back surgery syndrome Cancer pain Refractory neuropathic pain Severe chronic pain not responsive to conservative therapy 💊 Common Intrathecal Medications Opioids Morphine Hydromorphone Non-Opioid Ziconotide Other Baclofen (spasticity) ⚠️ Ziconotide — HIGH-YIELD BOARD PEARL Ziconotide: Blocks N-type calcium channels Does NOT cause respiratory depression Can cause psychiatric side effects ⚠️ Major Complications Infection Catheter malfunction Pump failure Withdrawal syndromes Catheter-tip granuloma formation 🚨 Granuloma Formation High-dose intrathecal opioids may cause: Catheter-tip inflammatory masses Cord compression Neurologic deficits 📋 Trialing Patients typically undergo: Bolus trial Continuous infusion trial before permanent implantation. 🎯 Board Pearls Ziconotide = no respiratory depression Pump failure can cause life-threatening withdrawal Granulomas are associated with opioid concentration 📝 High-Yield Board Takeaways CRPS Budapest criteria = critical Early PT = first-line Autonomic dysfunction = hallmark Intrathecal Pumps Ziconotide is highly testable Know granuloma risks Understand pump complications and withdrawal 🎓 Pain Board Prep Resources Prepare for your ABA Pain Medicine boards with: 👉 https://painexam.com 👉 https://nrappain.org 🏆 Why Physicians Choose NRAP Academy Comprehensive board prep High-yield MCQs Virtual Pain Fellowship Ultrasound-guided pain training Interventional pain education 🎤 Upcoming Training Join upcoming: Ultrasound-guided procedure workshops Regenerative medicine courses Pain board review sessions 📢Register today! If you're serious about: ✅ Passing your pain boards ✅ Mastering interventional pain ✅ Improving patient outcomes Subscribe to the PainExam Podcast and join the Virtual Pain Fellowship. 👉 https://nrappain.org 👉 https://painexam.com Reference  https://dontforgetthebubbles.com/complex-regional-pain-syndrome/ https://www.ncbi.nlm.nih.gov/books/NBK459151/

    12 min
  4. Corticosteroids & Contrast Agents for the Pain Boards

    Apr 29

    Corticosteroids & Contrast Agents for the Pain Boards

    🎙️ PainExam Podcast Show Notes Corticosteroids & Contrast Agents in Pain Management + Evidence-Based Steroid Selection 🔥 Episode Overview In this high-yield episode of the PainExam Podcast, David Rosenblum breaks down a must-know board topic: 👉 Injectable corticosteroids vs contrast agents in interventional pain procedures This episode goes beyond basics and dives into: Particulate vs non-particulate steroids Comparative profiles of dexamethasone, betamethasone, triamcinolone, and methylprednisolone Contrast agent selection and safety Critical complications including embolization and neurotoxicity A recent study comparing steroid effectiveness in transforaminal epidural injections This is essential for physicians preparing for the ABA Pain Medicine boards and for clinicians performing spine interventions. 🧠 Core Concept Corticosteroids = therapeutic (reduce inflammation) Contrast agents = diagnostic + safety tools (confirm needle placement) 👉 Board pearl: Steroids treat pain — contrast prevents complications 💉 Corticosteroids — High-Yield Comparison 🔬 Mechanism Inhibit phospholipase A2 Reduce inflammatory mediators Decrease nerve root irritation ⚖️ Key Steroids Compared Steroid Type Particle Profile Key Advantage Major Risk Dexamethasone Non-particulate No aggregation Safest for TFESI Possibly shorter duration Triamcinolone Particulate Large particles Longer depot effect Embolic infarction Methylprednisolone Particulate Aggregates Strong anti-inflammatory Avoid in cervical TFESI Betamethasone Mixed Depends on formulation Potent Acetate = particulate risk 🚨 Major Steroid Risks Local: Tissue atrophy Depigmentation Systemic: Hyperglycemia Adrenal suppression Immunosuppression Catastrophic (Board Tested): Spinal cord infarction Stroke 👉 Caused by intra-arterial injection of particulate steroids 📊 Contrast Agents — High-Yield Review Common Agents Iohexol (Omnipaque) Iopamidol (Isovue) Iodixanol (Visipaque) 🎯 Purpose Confirm needle placement Detect intravascular injection Prevent intrathecal injection ⚠️ Risks Allergic reaction Anaphylaxis Contrast-induced nephropathy 👉 Board pearl: Shellfish allergy ≠ contrast allergy ⚠️ Critical Safety Topic: Gadolinium Gadolinium-based contrast agents are: ❌ NOT approved for epidural or intrathecal use ❌ NOT safe substitutes for iodinated contrast in spine procedures 🚨 Intrathecal Gadolinium Risks Encephalopathy Seizures Respiratory distress Death 👉 Extremely high-yield board concept 📚 Evidence-Based Medicine Segment Study Review: Steroid Selection in TFESI A recent study comparing: Dexamethasone Methylprednisolone Betamethasone 🔑 Key Findings Dexamethasone showed comparable or better outcomes No clear advantage of particulate steroids Similar rates of: Repeat injections Surgical progression 🎯 Clinical Implication 👉 Efficacy differences are smaller than previously thought 👉 Safety is driving practice change 🚨 Board-Level Takeaway Non-particulate steroids = safer Outcomes ≈ similar Technique matters more than steroid choice 👉 Best exam answer: dexamethasone for TFESI 🎯 Board Prep Summary Dexamethasone = safest for transforaminal injections Particulate steroids = embolic risk Contrast must be used before steroid injection Gadolinium = dangerous in neuraxial space Clinical outcomes often similar across steroid types 🎓 Pain Board Prep Resources Prepare for your ABA Pain Medicine boards with: 👉 https://painexam.com 👉 https://nrappain.org 🏆 Why Physicians Choose NRAP Academy High-yield board review content Thousands of MCQs Virtual Pain Fellowship Ultrasound + regenerative training Real-world clinical integration Register Today! 🎤 Upcoming Training Ultrasound-guided pain procedures Regenerative medicine courses (PRP, biologics) Hands-on workshops Register Today! 📢 Call to Action If you're serious about passing your boards and practicing safer interventional pain medicine: ✅ Subscribe to the PainExam Podcast ✅ Join the Virtual Pain Fellowship ✅ Visit https://nrappain.org   References Calvo N, Jamil M, Feldman S, Shah A, Nauman F, Ferrara J. Neurotoxicity from intrathecal gadolinium administration: Case presentation and brief review. Neurol Clin Pract. 2020 Feb;10(1):e7-e10. doi: 10.1212/CPJ.0000000000000696. PMID: 32190427; PMCID: PMC7057078. Moreira, Alexandra M., et al. "Comparing the effectiveness and safety of dexamethasone, methylprednisolone and betamethasone in lumbar transforaminal epidural steroid injections." Pain physician 27.5 (2024): 341.

    17 min

  5. Apr 16

    Facet Mediated Pain for the Pain Boards

    🎙️ PainExam Podcast & Video Show Notes Facet-Mediated Pain, RFA, and Advanced Interventional Strategies 🔥 Episode Overview In this episode of the PainExam Podcast, David Rosenblum delivers a high-yield, board-focused deep dive into: Lumbar, cervical, and thoracic facet-mediated pain Medial branch blocks (MBB) and radiofrequency ablation (RFA) Key Medicare / LCD criteria for performing procedures Advanced therapies including multifidus stimulation and regenerative medicine (PRP) This episode is essential for pain physicians preparing for the ABA, ABPM, ABIPP, and FIPP board exams — and for those looking to refine their interventional practice. 🧠 Key Topics Covered 🦴 Facet-Mediated Pain (Lumbar, Cervical, Thoracic) Axial, non-radicular pain Worse with extension and rotation Cervical facet pain → often post-whiplash Thoracic facet pain → underdiagnosed 🔬 High-Yield Anatomy & Innervation Dual innervation of facet joints L5–S1 facet → L5 dorsal ramus (board favorite) C2–3 facet → third occipital nerve 💉 Diagnosis & Medicare Criteria Gold standard: Medial branch blocks (NOT imaging) Medicare requires: Chronic pain ≥ 3 months Failed conservative therapy Two diagnostic blocks with ≥80% relief ⚡ Interventional Treatment Radiofrequency ablation (RFA) 6–12 month relief Repeatable Proper needle placement and stimulation techniques 🚀 Advanced & Emerging Therapies Multifidus stimulation Restores spinal stability Treats underlying dysfunction PRP / Regenerative Medicine Targets inflammation and tissue healing Growing role in pain management 🎯 Board Prep Takeaways Facet pain = axial + extension-based Diagnosis = medial branch blocks Know cervical vs lumbar differences Medicare requires dual blocks before RFA L5 dorsal ramus = high-yield exam concept 🎓 Pain Board Prep & CME Resources If you're preparing for your boards or want to advance your clinical skills: 👉 Start your Pain Board Review: https://nrappain.org 👉 Access Question Banks, Lectures & Virtual Fellowship: https://nrappain.org 👉 PainExam Platform: https://painexam.com 🏆 Why Pain Physicians Choose NRAP Academy Comprehensive ABA / ABPM / ABIPP / FIPP board prep High-yield lectures + MCQs Ultrasound-guided procedure training Regenerative medicine education Virtual Pain Fellowship curriculum 🎤 Upcoming Live Training & Conferences Join Dr. Rosenblum at upcoming events: ASPN 2026 Annual Meeting — Ultrasound & regenerative medicine labs PainWeek 2026 — Lectures on: Image-guided interventions Ultrasound integration Regenerative pain therapies AI in pain management 🔗 Connect & Learn More 🌐 NRAP Academy: https://nrappain.org 📚 PainExam Board Prep: https://painexam.com 🎥 YouTube: NRAP Academy 🎓 Courses: Ultrasound & Regenerative Medicine Training 📢 Call to Action If you're serious about passing your pain boards and mastering interventional pain: ✅ Subscribe to the PainExam Podcast ✅ Join the Virtual Pain Fellowship ✅ Attend a live ultrasound or regenerative medicine course

    9 min
  6. Phantom Limb Pain & Sacroiliac Joint Dysfunction — High-Yield Pain Board Review

    Mar 25

    Phantom Limb Pain & Sacroiliac Joint Dysfunction — High-Yield Pain Board Review

    🎙️ PainExam Podcast Show Notes Phantom Limb Pain & Sacroiliac Joint Dysfunction — High-Yield Pain Board Review 🔥 Episode Overview In this episode of the PainExam Podcast, David Rosenblum delivers a high-yield review of two must-know topics for the ABA Pain Medicine Board Certification exam: Phantom Limb Pain — mechanisms, risk factors, and advanced treatment strategies Sacroiliac (SI) Joint Dysfunction — diagnosis, provocative testing, and interventional management Whether you're preparing for the ABA, ABPM, ABIPP, or FIPP boards, or looking to sharpen your clinical practice, this episode focuses on testable concepts, real-world applications, and interventional pearls. 👉 Explore full board prep and CME: PainExam.com 🧠 Topic 1: Phantom Limb Pain — Key Points Phantom limb pain is a neuropathic pain syndrome following amputation, driven by both peripheral and central mechanisms. High-Yield Pearls Caused by cortical reorganization + central sensitization Strongly associated with pre-amputation pain Distinct from: Phantom sensation (non-painful) Stump pain (localized) Clinical Features Burning, cramping, or electric pain Perceived in the missing limb May be triggered by stress or environmental factors Treatment Strategies First-line: gabapentinoids, TCAs Advanced: ketamine, neuromodulation Key non-pharmacologic therapy: mirror therapy 🚨 Board Pearl Preemptive analgesia reduces the risk of phantom limb pain 🦴 Topic 2: Sacroiliac Joint Dysfunction — Key Points SI joint dysfunction is a major cause of axial low back pain, accounting for up to 25% of cases. High-Yield Pearls Pain is typically: Unilateral Buttock-dominant Radiates to posterior thigh (rarely below knee) Physical Exam Positive provocative tests: FABER Gaenslen Thigh thrust Compression 👉 3 or more positive tests = high diagnostic accuracy Diagnosis Confirmed with image-guided intra-articular injection Imaging alone is NOT diagnostic Treatment Physical therapy SI joint injections Lateral branch RFA SI joint fusion (refractory cases) 🚨 Board Pearl Diagnostic SI joint injection is the gold standard 🎯 Board Prep Takeaways Always distinguish central vs peripheral mechanisms in neuropathic pain Know diagnostic confirmation strategies (blocks vs imaging) Focus on first-line vs interventional escalation pathways Understand procedure indications for boards 🎓 Upcoming Events & Live Training 🏆 ASPN 2026 Annual Meeting Join Dr. Rosenblum for: Ultrasound-guided peripheral nerve blocks Spine interventions Regenerative medicine techniques (PRP, biologics) Hands-on procedural training 💉 Ultrasound-Guided Regenerative Medicine Course Learn: PRP injection techniques Ultrasound-guided joint and nerve procedures Real-world workflows for integrating regenerative medicine into your practice 👉 Hosted through NRAP Academy 🎤 PainWeek 2026 Lectures Dr. Rosenblum will be presenting on: Precision image-guided pain procedures Ultrasound integration in clinical practice Regenerative medicine in interventional pain Future directions: AI and neuromodulation 🔗 Resources 🌐 Pain Board Review: PainExam.com 🎓 Courses & CME: NRAPPain.org 📺 YouTube: NRAP Academy 🧠 Question Bank + Virtual Fellowship: Available now 📢 Call to Action If you're preparing for the pain boards or want to elevate your clinical skillset: ✅ Subscribe to the PainExam Podcast ✅ Join our Virtual Pain Fellowship ✅ Attend a live ultrasound or regenerative medicine course

    9 min
  7. Red Light Therapy for Pain

    Mar 4

    Red Light Therapy for Pain

    PainExam Podcast Show Notes Red Light Therapy (Photobiomodulation) for Pain Evidence, Mechanisms, and Clinical Applications Host: Dr. David Rosenblum Red light therapy, also known as photobiomodulation (PBM) or low-level laser therapy (LLLT), is an emerging non-invasive treatment modality increasingly used in pain medicine, rehabilitation, and regenerative medicine practices. In this episode of the PainExam Podcast, Dr. Rosenblum reviews the mechanisms, clinical evidence, indications, and safety considerations surrounding photobiomodulation therapy for pain. Red and near-infrared wavelengths stimulate mitochondrial activity, increase ATP production, reduce inflammatory mediators, and promote tissue healing. These physiologic effects may translate into analgesic benefits for a variety of musculoskeletal and neuropathic pain conditions. Clinical research suggests potential benefit in temporomandibular disorders, chronic neck pain, and inflammatory oral conditions, though results vary due to differences in dosing parameters and treatment protocols. Despite these limitations, PBM has a favorable safety profile and is increasingly being integrated into multimodal pain management strategies. Key Topics Covered • What is photobiomodulation therapy (PBM) • How red and near-infrared light interact with mitochondria • Mechanisms of analgesia and tissue repair • Evidence from clinical trials in TMD, neck pain, and oral inflammatory pain • The biphasic dose response (Arndt-Schulz law) • Safety profile and contraindications • How PBM may integrate with regenerative pain medicine Mechanism of Action Photobiomodulation works primarily through stimulation of mitochondrial chromophores, particularly cytochrome c oxidase. This leads to: • Increased ATP production • Modulation of inflammatory cytokines • Increased angiogenesis and tissue repair • Reduced oxidative stress These effects may improve pain, inflammation, and healing in certain musculoskeletal conditions. Evidence Discussed in This Episode Temporomandibular Disorders Randomized trial demonstrating improvements in pain and mandibular function with red light therapy. De Carvalho et al., Pain Research and Treatment (2019) https://onlinelibrary.wiley.com/doi/full/10.1155/2019/8578703 Chronic Neck Pain Clinical trial demonstrating improvements in pain scores and pressure pain thresholds after photobiomodulation therapy. Chen et al., Lasers in Medical Science (2022) https://link.springer.com/article/10.1007/s10103-022-03540-0 Oral Pain and Dental Inflammation Randomized study demonstrating reduced pain and improved healing following PBM treatment. Almeida et al., BMC Oral Health (2023) https://link.springer.com/article/10.1186/s12903-023-02784-8 Who May Benefit From Photobiomodulation? Red light therapy may be considered as an adjunct treatment for: • myofascial pain • cervical spine pain • temporomandibular disorder • tendinopathy • peripheral neuropathy • musculoskeletal injury recovery Safety and Contraindications Photobiomodulation has a very favorable safety profile. Reported adverse effects are rare and usually mild: • transient erythema • warmth at treatment site • headache • eye irritation without proper protection Precautions include: • avoiding direct retinal exposure • avoiding treatment over malignancy • avoiding application over the uterus during pregnancy • caution in photosensitive disorders Resources For Patients Seeking Treatment Learn more about integrative and regenerative pain treatments including PRP, ultrasound-guided injections, and advanced pain therapies: AABP Integrative Pain Care & Wellness https://www.AABPpain.com For Pain Physicians and Advanced Practice Providers Training in ultrasound, interventional pain procedures, and pain board preparation: NRAP Academy CME Education https://www.NRAPpain.org

    11 min
  8. Why Utilize Regenerative Medicine in a Pain Practice? My Recent ASIPP Regen Med Lecture

    Feb 12 ·  Video

    Why Utilize Regenerative Medicine in a Pain Practice? My Recent ASIPP Regen Med Lecture

    Dr. Rosenblum from NRAP Academy presented a webinar on the integration of regenerative medicine into pain practices, highlighting its benefits and applications. He discussed the evolution of treating pain, emphasizing the shift from neural blockade to addressing tissue health. Dave explained the use of PRP and BMAC in treating conditions like knee pain, and shared patient success stories. He addressed common misconceptions about regenerative medicine, including its cost and effectiveness. Dave also mentioned upcoming events and training opportunities in regenerative medicine.   Regenerative Medicine Pain Management Events Dr. Rosenblum  announced his upcoming involvement in two significant events: a webinar on regenerative medicine for ASIPP and co-directing the ASPN Ultrasound and Regenerative Medicine Pain Workshop in Miami with Dr. Ali Valimoed. He encouraged attendees to register for these events, emphasizing their importance in the field of pain management. He also mentioned a previous lecture he gave on the integration of regenerative medicine into pain practices, though the recording was not successful. Regenerative Medicine in Pain Practices Dr. Rosenblum  discussed the integration of regenerative medicine into pain practices, emphasizing its importance in 2026 and beyond. He explained that traditional approaches like steroids and RFA only manage pain without addressing tissue health, using the knee as an example. He suggested combining visco supplements with regenerative techniques like PRP or BMAC to preserve joints in patients seeking alternatives to knee replacement. He noted that while other stem cell products are promising, more research is needed for wider adoption, and he plans to focus on PRP and BMAC for now. Regenerative Medicine Patient Education Dr. Rosenblum  discussed the importance of educating patients about regenerative medicine and pain treatment options. He explained that while regenerative treatments cannot fully reverse severe issues like meniscus damage, they can help heal and repair tissues, reduce inflammation, and improve function. He highlighted the growing demand for non-surgical, opiate-sparing solutions and mentioned the role of government and physician-led campaigns in addressing the opiate crisis. PRP's Role in Chronic Pain Management Dr. Rosenblum discussed the growing demand for alternative treatments to opioids and surgeries, highlighting the role of Platelet-Rich Plasma (PRP) in addressing chronic pain by modulating inflammation and stimulating tissue repair. He emphasized the importance of using high-quality PRP preparation methods, such as a double-spin kit, to achieve optimal results, and criticized studies claiming PRP's ineffectiveness, often due to poor preparation techniques. David also noted that effective PRP treatments can improve pain and function better than corticosteroids, and he expressed hope that patients would refer others, leading to business growth. PRP Therapy: A Promising Alternative Dr. Rosenblum discussed the effectiveness of PRP (platelet-rich plasma) therapy compared to steroids and viscosupplements in treating various musculoskeletal conditions. He cited a meta-analysis showing that PRP provided better relief than steroid and viscosupplement treatments for patients with moderate arthritis after one year. David also shared a recent case where he used PRP to treat coccydynia, a condition involving pain in the coccyx, and mentioned its potential use in treating other conditions such as radiculopathy and foraminal stenosis. PRP Injection Treatment Flexibility Dr. Rosenblum discussed a medical procedure involving PRP and lidocaine injections in various areas of the body, including the coccygeal ligaments, caudal space, and transforaminal spaces, to address pain and inflammation. He emphasized the importance of tailoring treatment to individual patients rather than adhering to insurance company guidelines, which can limit the number of injections given in a single session. David highlighted that when patients pay out-of-pocket, practitioners have more flexibility to effectively treat their conditions, potentially avoiding surgery or improving post-surgical outcomes. PRP in Orthopedic Practice Dr. Rosenblum shared his experience treating a patient with PRP for post-operative knee surgery, despite the orthopedic surgeon's skepticism. He discussed how regenerative medicine can enhance a practice by positioning it as innovative and attracting younger patients who prefer non-surgical treatments. David noted that while some orthopedic surgeons may refer patients for PRP, others might be hesitant due to potential decreases in surgical procedures. He also mentioned that primary care doctors may not be aware of the growing evidence supporting PRP's effectiveness and safety. PRP: A Cost-Effective Alternative Dr. Rosenblum discussed regenerative medicine, particularly PRP, highlighting its potential to avoid surgeries and improve patient satisfaction with an estimated 70% success rate. He emphasized the financial benefits for physicians, as it provides a cash stream with no need for prior authorizations or denials. David also addressed patient responsibility in healthcare costs, comparing the cost of regenerative treatments to other lifestyle expenses. He noted that while training is necessary, most interventional pain physicians possess the skills to administer PRP treatments. PRP Treatment Success Stories Dr. Rosenblum shared patient testimonials highlighting successful outcomes from PRP (platelet-rich plasma) treatments for various pain conditions, including shoulder, back, and neck issues. Patients reported significant improvements in pain relief and mobility, with some noting long-lasting effects beyond cortisone shots or surgery. David emphasized the importance of individualized treatment approaches and quality care, encouraging both patients and physicians to reach out for training and consultations. He concluded by inviting listeners to share the content with colleagues and patients, emphasizing the value of PRP treatments when done correctly.

    17 min
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4
out of 5
29 Ratings

About

David Rosenblum, MD, creator of PainExam.com and Director of Pain Management at New York Based, AABP Pain Management discusses Pain Board Review and issues relevant to pain physicians. Marketing, practice management and Board Prep are discussed. For more information and CME Credit's go to PainExam.com Also, be sure to check out Dr. Rosenblum's children's book: Welwyn Ardsley and the Cosmic Ninjas: Preparing your child and yourself for anesthesia and surgery. Available at Amazon.com and www.MyKidsSurgery.com

Information

  • Creator
    David Rosenblum, MD
  • Years Active
    2015 - 2026
  • Episodes
    346
  • Rating
    Clean
  • Copyright
    © QBazaar.com LLC, Copyright 2015
  • Show Website
    PainExam Podcast

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