Show cover of The PainExam podcast

The PainExam podcast

A podcast featuring PainExam.com's creator David Rosenblum, MD, discussing Pain Management Board Preparation, keywords, and current topics relevant to any pain patient or physician who practices pain management. David Rosenblum, MD has been preparing physicians for the pain boards since 2008, and is currently the director of Pain Management at Maimonides Medical Center, AABP Pain Management , and CEO of QBazaar.com.

Tracks

Is Degenerative Disc Disease an Infectious Disease? The role of L-PRP. Journal Club
Journal Club:  Treating Degenerative Disc Disease with Leukocyte Rich PRP Dr. Rosenblum discusses an article written by Dr. Gregory Lutz describing Leukocyte RIch PRP's role in treating Degenerative Disc Disease and the theory that there is an infectious disease component to disc injury.  Dr. Lutz describes multiple articles, as well as anectodal experience in which bacterial infectious was demonstrated in pathological discs, and PRP was successful in alleviating symptoms, modic changes and improved clinical as well as radiographic appearance. Other Announcements from NRAP Academy: PainExam App almost ready  Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org   Live Workshop Calendar   Ultrasound Interventional Pain Course Registration      For Anesthesia Board Prep Click Here! References Lutz, Gregory E. "Intradiscal Leukocyte Rich Platelet Rich Plasma for Degenerative Disc Disease." Physical Medicine and Rehabilitation Clinics of North America 34.1 (2023): 117-133.https://www.binasss.sa.cr/bibliotecas/bhm/feb23/61.pdf
19:45 5/20/24
Iliopsoas Dry Needling for Acute Lumbar Radiculits and CMS' Trigger Point Policy!
Dr. Rosenblum reviews an article by Dr. Reuben Ingber regarding the use of iliopsoas trigger point dry needling and therapeutic stretching in the treatement of 6 consecutive patients wiht acute lumbar radiculitis and foot drop.     Other Announcements from NRAP Academy: PainExam App almost ready  Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org   Live Workshop Calendar   Ultrasound Interventional Pain Course Registration      For Anesthesia Board Prep Click Here! References Reuben S. Ingber, Iliopsoas trigger point dry needling and therapeutic stretching in the treatment of a series of six consecutive patients presenting with acute lumbar radiculitis and foot drop, Journal of Bodywork and Movement Therapies, Volume 36, 2023, Pages 1-4, ISSN 1360-8592, https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57702#:~:text=No%20more%20than%203%20Trigger,group%20are%20not%20billed%20separately. CMS National Coverage Policy
17:09 5/2/24
Chronic Pain after Shoulder Joint Replacement: RFA Revisited
 Dr. Rosenblum describes a patient with chronic shoulder pain who failed shoulder replacement, steroid injections, nerve blocks, cryotherapy, and peripheral nerve stimulation of the axillary and suprascapular nerve block.  In this podcast, he discusses his perfomance of Shoulder Radiofrequency Ablation targeting the articular branches of the suprascapular nerve, axillary nerve, nerve to subscapularis and lateral pectoral nerve.   Reference: https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2020/11/01/how-i-do-it-shoulder-articular-nerve-blockade-and-radiofrequency-ablation   Other Announcements from NRAP Academy: PainExam App almost ready  Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org   Live Workshop Calendar Ultrasound Interventional Pain Course Registration      For Anesthesia Board Prep Click Here!
14:36 4/17/24
Pain Docs Lobby for more Oversight of Independent Review Organizations
Advocating for Transparency and Oversight in Pain Management Introduction: Welcome back to Painexam, where we delve into the latest advancements and challenges in pain management. Today's episode highlights a significant advocacy effort made by leading Interventional Pain Physicians and industry experts. Summary of Lobbying Effort: On March 20, 2024, a group of widely known and respected pain physicians and industry leaders, including Drs. Sean Li, Peter Staats, Mehul J. Desai, David Reece, Hemant Kalia, and David Rosenblum, alongside industry figures Mark Stultz, Christopher Conrad, and Cecelia Ruble, visited Capitol Hill to advocate for greater oversight and transparency in independent review organizations. Despite their busy schedules, they recognized the critical need to address the 0% turnover rate in appeals for denied treatments, which disproportionately affects patients seeking alternatives to surgery and opioid medication. Importance of Transparency: The issue extends beyond pain management, impacting patients across various medical fields. While opioid therapy may seem economically favorable initially, the long-term consequences, including delayed care and medication side effects, often outweigh the costs. The group emphasized the importance of an unbiased review for  accessible, cutting-edge treatments to improve patient outcomes and reduce overall healthcare expenses. Purpose of the Lobbying Effort: Contrary to pushing any specific company agenda, the initiative aims to highlight the challenges patients and physicians encounter in securing optimal treatment outcomes.   For Board Prep, Ultrasound Training and more, visit: Dr. David Rosenblum, a pioneer in interventional pain medicine, particularly in ultrasound- guided procedures and regenerative pain medicine, underscores the necessity of addressing these issues for the benefit of countless patients suffering from chronic pain. Conclusion and Actionable Steps: To schedule a consultation with Dr. Rosenblum, patients can visit www.AABPpain.com or contact the Brooklyn Office at 718-436-7246 or the Garden City Office at 516-482-7246. Stay tuned for more updates on advancements and advocacy efforts in pain management. Outro: Thank you for joining us on this episode of Painexam. Be sure to subscribe for future discussions on navigating the complexities of pain management.
29:05 4/3/24
Interventional Psych and Pain? The Stellate Ganglion, Scope of Practice, Ketamine & Magnesium and more!
Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions.  Other Announcements from NRAP Academy: PainExam App almost ready  Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org   Live Workshop Calendar   Ultrasound Interventional Pain Course Registration      For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full   References   Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik M, Kawka M, Grzegorzewska A. Magnesium in Ketamine Administration in Treatment-Resistant Depression. Pharmaceuticals (Basel). 2021 May 3;14(5):430. doi: 10.3390/ph14050430. PMID: 34063604; PMCID: PMC8147622.   https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.513068/full   https://www.sutterhealth.org/services/behavioral-health/interventional-psychiatry   Hanling SR, Hickey A, Lesnik I, et al Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial Regional Anesthesia & Pain Medicine 2016;41:494-500.   https://www.psychiatrist.com/jcp/oral-ketamine-for-depression/  
17:26 3/13/24
Rudy Malayil, MD WVSIPP President, Stellate Ganglion for Hot Flashes and more!
Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course.  Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City.  After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360. https://pain360.org https://www.malayilmd.com   Ultrasound Interventional Pain Course Registration      For Pain Management Board Prep Go to: References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full
23:00 2/28/24
Rethinking Hip Pain: PNS, Biologics and Cryoablation
In this episode, Garden City (long island) based Pain Physician, Dr. David Rosenblum explores Peripheral Nerve Stimulation, Biologics and Ablations for hip pain. He reviews a case report of a 67-year-old female with a history of a mechanical fall causing injury to her lumbar spine and pelvis resulting in hip and pelvic pain is presented. The patient had hypertrophic non-union of the right iliac wing fracture and displacement of the pubic symphysis and right sacroiliac joint. Medications were not effectively managing her pain, so she sought treatment at a pain management clinic. The patient underwent diagnostic obturator and femoral articular nerve branch injections, as well as a middle cluneal nerve steroid injection, all guided by fluoroscopy and ultrasound. She experienced improvement in her pain following these procedures. Subsequently, she had a peripheral nerve stimulator (PNS) trial and underwent implantation of leads targeting the right middle cluneal nerve and right obturator and femoral articular nerve branches. The patient reported significant relief in both the posterior and anterior distribution of her pain. Her activities of daily living improved, and she was able to sleep without pain after the PNS implantation. The successful use of combined fluoroscopy and ultrasound in targeting the specific nerves and replicating the patient's pain distribution before permanent PNS implantation is highlighted in this case. Additionally, the show notes mention an events calendar located at this link: https://www.nrappain.org/pages/ultrasound-course-calendar. Upcoming Course schedule for NRAP Academy includes the following events: Ultrasound Guided Pain & Regional Anesthesia Course in New York City on February 10, 2024. This course will cover nerve blocks, joint injections, and more. Attendees will have the opportunity to scan live models after the didactic session. MSK Pain & Regional Anesthesia Course in Miami, Florida on February 18, 2024. This course will focus on ultrasound-guided nerve blocks and MSK (musculoskeletal) pain management. Ultrasound Guided Pain Course in Key West, Florida on February 23, 2024. This 4 CME (Continuing Medical Education) course will cover ultrasound-guided nerve blocks, MSK, PRP (platelet-rich plasma), BMAC (bone marrow aspirate concentrate) targets, and regional anesthesia. Regional Anesthesia and US Guided Pain Management Course in New York City on March 9, 2024. This course will provide training in ultrasound-guided interventional pain management and regional anesthesia. Ultrasound Guided IPM (Interventional Pain Management) Course in West Virginia on April 14, 2024. This course is part of the Appalachian Regional Spine and Pain Meeting and will be conducted by NRAP Academy. It will focus on interventional pain management using ultrasound guidance. Regenerative Pain Medicine Course in New York City on May 4, 2024. This course will cover PRP (platelet-rich plasma) and other regenerative pain medicine techniques. In addition to the live training, attendees will receive bonus material including access to the On Demand Ultrasound Guided MSK Interventional Pain Management Course, a course workbook and certificate, post-course guidance and discounts, and the opportunity to join the mailing list for calendar updates. Please note that these course details are subject to change, so it's recommended to visit the NRAP Academy website for the most up-to-date information. Reference Fu E, Elsharkawy H #35977 Peripheral nerve stimulation implant for chronic post-traumatic hip and pelvic pain Regional Anesthesia & Pain Medicine 2023;48:A193.
17:21 2/8/24
Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves: Journal Club
Painexam Podcast Show Notes: Journal Club on "Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves" Special Thanks to Robert Stall, MD Introduction: Welcome to another episode of the Painexam Podcast! In today's journal club edition, we delve into a fascinating study by Dr. Joel E. Pessa on cerebrospinal fluid (CSF) circulation in human nerves. Background: The study addresses the growing evidence of CSF circulation in human nerves and its implications in various conditions encountered by plastic surgeons. Conditions such as nerve transection, stretch injuries, and peripheral neuropathy may be related to dysregulation of the CSF system. Methods: Dr. Pessa and his team developed the ventricular infusion technique using buffered saline in 2017. The technique was applied to eight fresh cadavers before dissecting the median nerve. Fluorescent imaging and nanoprobe injections were combined with ventricular infusion in selected specimens. Results: The eight cadaver specimens (six female, two male) aged 46–97 underwent successful ventricular infusion. Ventricular cannulation was performed successfully using specific coordinates. Results suggest that CSF flows in neural sheaths, including pia meninges, epineurial channels, perineurium, and myelin sheaths (neurolemma). Conclusions: Ventricular infusion and nanoprobes effectively identify CSF flow in neural sheaths of human nerves. CSF flow in nerves is described as an open circulatory system occurring via channels, intracellular flow, and cell-to-cell transport associated with glial cells. Neural sheaths, including neurolemma, may play a role in glucose and solute transport to axons. The techniques showcased in this study can be utilized in anatomic dissection and live animal models and have been extended to the central nervous system to identify direct ventricle-to-pia meninges CSF pathways. Significance: This study opens new avenues for understanding the intricate mechanisms of CSF circulation in neural tissues. Plastic surgeons and researchers can benefit from these techniques in studying and addressing conditions related to CSF dysregulation in nerves. The findings have implications not only for nerve-related conditions but also for broader applications in the central nervous system. Closing: Thank you for joining us on this insightful journey through Dr. Joel E. Pessa's study. Stay tuned for more engaging discussions on pain management and neurology in future Painexam Podcast episodes! Reference Pessa JE. Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves. Plast Reconstr Surg Glob Open. 2022 Feb 17;10(2):e4126. doi: 10.1097/GOX.0000000000004126. PMID: 35198353; PMCID: PMC8856590.
11:41 1/24/24
Ultrasound Guided Nerve Blocks in the Treatment of Headaches
  Exploring the Role of Ultrasound in Headache Evaluation and Treatment A Journal Club based on Dr. Andrea Trescott's article:   Ultrasound for evaluation and treatment of headaches. Anaesth Pain & Intensive Care 2017;21(2):241-253. Click Here to Claim CME for reflecting on content presented in this journal club. David Rosenblum, MD Accepting New Patients Patients Interested in scheduling a consultation with Dr. David Rosenblum can call  516 482 7246 (Garden City) or 718 436 7246 (Brooklyn) In this Podcast, Dr. Rosenblum discusses patient's in his practice who responsed to ultrasound guided nerve blocks in the treatment of headaches.  He discusses the use of ultrasound injections as opposed to medication to manage the pain and references Dr. Trescott's comprehensive article on the various nerves and clinical presentations of headaches related to terminal nerve entrapment or irritation.  Dr. Rosenblum discusses Supraorbital Neuralgia Auriculotemproal Nerve Anatomy Clinical presentation Interventional Pain Therapies Summary of Dr. Trescott's Article and Key Points: Headaches, affecting 28 million people in the US, pose a significant burden on society in terms of medical costs and lost labor. They are complex neurologic disorders with diverse origins and causes. Headaches are often viewed as the primary pathology, but they are fundamentally a symptom. Understanding them is an evolving science, and their patterns can be recognized for effective diagnosis and treatment. In 2003, Pareja et al proposed the term "epicrania" for headaches triggered by extracranial causes, suggesting a link between intracranial components and extracranial nerves. Peripheral Triggers and Plastic Surgery: Plastic surgeons noted relief of migraines through corrugator muscle resection and botulinum toxin injection, indicating peripheral headache triggers. Severe migraines post-head or neck injury may have an extracranial origin, suggesting peripheral nerve irritation. Traditional migraine medications may offer modest relief. Primary treatment involves inhibiting nerve irritation through interventional pain techniques, turning off the pain origin and associated migraine centers. Ultrasound Advantages: Evaluation and injection of nerves have traditionally used landmarks and fluoroscopic images, but ultrasound offers unique advantages. Nerves often travel with arteries, potentially contributing to "throbbing" pain. Ultrasound provides a more precise and dynamic visualization of these structures. Exploring Extracranial Causes: The International Classification of Headache Disorders (ICHD) categorizes headaches as primary or secondary. While valuable, it broadly defines peripheral nerve contributions as "Other Terminal Branch Neuralgias." The study of extracranial peripheral nerve entrapments and dysfunction reveals overlap between ICHD-defined headaches and potential nerve entrapments causing these pain patterns. Collaboration with disciplines like pain management enriches the understanding and treatment options for headaches. Conclusion: Headaches, often seen as isolated intracranial phenomena, may have extracranial triggers. Understanding and treating these triggers, especially through ultrasound-guided techniques, present a promising avenue in headache management. NRAP Academy also offers: Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training  Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops)   Private Ultrasound Training Available Email Info@NRAPpain.org Reference: Trescot A. Ultrasound for evaluation and treatment of headaches. Anaesth Pain & Intensive Care 2017;21(2):241-253. Publication Details: Received: 15 Aug 2015, Reviewed: 2 Jun 2016, Accepted: 28 Jun 2016. This podcast explores the dynamic relationship between intracranial and extracranial factors in headaches, shedding light on potential breakthroughs in their evaluation and treatment.   #interventionalpain #painboards #painfellowship #painexam  #regionalanesthesia #ultrasoundguidedpain #ultrasoundpain #ultrasoundmsk   #paincme #paincmecourse
21:09 1/10/24
Intra-articular & PENG Phenol Injections for Hip Pain- Journal Club
Phenol in the treatment of Hip Pain   Bonus CME Available ($15 Processing Fee) The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wo9gDI   Dr. Rosenblum discusses the use of phenol injected into the pericapsular nerve group, hip joint and outcome a isolated case reports.  Also discussed, phenol, its mechanism of action and a refractory case of neuralgia paresthetica.  Pain from hip cancer, pain from DVT and IPACK or articular branch of the tibial nerve block discussed for knee pain.    Dr. Rosenblum discusses his ultrasound training programs, the migration of the PainExam platform to the new NRAPpain.org website and offers a testimonial from a previous ultrasound course from the student who inspired this podcast.   Patients interested in scheduling a consultation with Dr. Rosenblum can call 516 482 7246 or 718 436 7246 For our Live Course Calendar, Click here     Board Prep for PM&R, Pain and Anesthesiology Boards   References Monagle, John; Ee, Joanne1. Treatment of chronic hip osteoarthritic pain with intra-articular phenol. Indian Journal of Pain 27(1):p 41-43, Jan–Apr 2013. | DOI: 10.4103/0970-5333.114866  Marcio V. Pimenta, Amanda T. Nakamura, Hazem A. Ashmawi, Joaquim E. Vieira, Hermann dos Santos Fernandes, Ultrasound-guided pericapsular nerve group and obturator nerve phenol neurolysis for refractory inpatient hip cancer metastasis pain: a case report, Brazilian Journal of Anesthesiology (English Edition), 2021, Rocha Romero, A., Carvajal Valdy, G. & Lemus, A.J. Ultrasound-guided pericapsular nerve group (PENG) hip joint phenol neurolysis for palliative pain. Can J Anesth/J Can Anesth 66, 1270–1271 (2019). https://doi.org/10.1007/s12630-019-01448-y
20:36 12/27/23
Traumeel and Possible Use for Spine Pain
PainExam Podcast Show Notes: Exploring Traumeel as an Alternative for Back Pain Relief  Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/HoEWFd   Board Prep and Continuing Education    Introduction: Today, Long Island Based Pain Physician David Rosenblum, MD  delves into the latest advancements and alternative treatments for pain management. In today's episode, we shine a spotlight on Traumeel®, a homeopathic alternative gaining traction for its anti-inflammatory properties, with fewer reported side effects compared to corticosteroids. Understanding Traumeel: Traumeel, a fixed combination of diluted plant and mineral extracts, has been available over-the-counter in Europe for over 60 years. Contrary to corticosteroids, Traumeel's popularity has surged due to its limited side effect profile, with reported contraindications primarily linked to allergies [9]. View Full Calendar Scientific Insights: A study by Lussignoli et al. demonstrated Traumeel's efficacy in decreasing systemic interleukin-6 production and reducing edema, countering an unregulated inflammatory response [10]. In vitro studies revealed Traumeel's inhibition of pro-inflammatory mediators (IL-1β, TNFα, IL-8) in immune cells, suggesting its potential in stabilizing the immune system [8]. Notably, Traumeel's effectiveness seems to surpass the sum of its individual components, indicating a synergistic interaction [9-10]. Clinical Applications: Traumeel has shown efficacy comparable to nonsteroidal anti-inflammatory drugs (NSAIDs) in treating various inflammatory conditions. It is available in oral, topical, and injectable preparations, making it a versatile option for pain relief [8-9]. Research Gaps and Potential: Despite its established use, current research lacks information on Traumeel's efficacy in epidural injections for short-term back pain relief. No studies have compared Traumeel to corticosteroid injections, although the TRARO study protocol proposes a potential avenue for comparison in rotator cuff syndrome patients [11]. Pain Management Board Prep Clinical Cases: Five patients seeking back pain relief opted for Traumeel injections due to either a contraindication to or a preference against steroids. This real-world scenario lays the groundwork for further exploration into Traumeel's efficacy in epidural injections, providing additional pain-relieving options for patients unable to tolerate corticosteroid injections. Conclusion: Traumeel presents a promising alternative for pain management, particularly in cases where corticosteroids may be unsuitable, however the FDA has yet to approve it and therefore it has failed to gain traction in the US. [14] As we wrap up, stay tuned for future developments in the research landscape surrounding Traumeel and its potential role in enhancing pain relief options. Disclaimer: Consult with a healthcare professional before considering any alternative treatments. The information provided in this podcast is for educational purposes only and does not replace medical advice.   David Rosenblum, MD President, NRAP Academy Clinical Assistant Professor  Department of Anesthesiology SUNY Downstate Medical Center  Director of Pain Management Maimonides Medical Center   References  1. Cassidy JD, Carroll LJ, Côté P: The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998, 23:1860-66. 10.1097/00007632-199809010-00012  2. Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR: The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007, 131:293-301. 10.1016/j.pain.2007.01.012  3. Fyneface-Ogan S: Anatomy and Clinical Importance of the Epidural Space. Epidural Analgesia - Current Views and Approaches. IntechOpen. IntechOpen (ed): IntechOpen, Internet; 2012. 1-14. 10.5772/39091  4. Waldman SD: Complications of cervical epidural nerve blocks with steroids: a prospective study of 790 consecutive blocks. Reg Anesth. 1989, 14:149-51.  5. McGrath JM, Schaefer MP, Malkamaki DM: Incidence and characteristics of complications from epidural steroid injections. Pain Med. 2011, 12:726-31. 10.1111/j.1526-4637.2011.01077.x  6. Watters WC 3rd, Resnick DK, Eck JC, et al.: Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: injection therapies, low-back pain, and lumbar fusion. J Neurosurg Spine. 2014, 21:79-90. 10.3171/2014.4.SPINE14281  7. Understanding Potential Complications Of Epidural Steroid Injections . (2011). Accessed: October 1, 2019: https://www.practicalpainmanagement.com/treatments/interventional/injections/understanding-potentialcomplications-ep….  8. Schneider C: Traumeel - an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med. 2011, 4:225-34. 10.2147/IJGM.S16709 9. Grech D, Velagala J, Dembek DJ, Tabaac B: Critical literature review of the homeopathic compound Traumeel for treatment of inflammation. Pharmacology & Pharmacy. 2018, 9:67-83. 10. Lussignoli S, Bertani S, Metelmann H, Bellavite P, Conforti A: Effect of Traumeel S®, a homeopathic formulation, on blood-induced inflammation in rats. Complement Ther Med. 1999, 7:225-30.  10.1016/S0965-2299(99)80006-5  11. Vanden Bossche L, Vanderstraeten G: A multi-center, double-blind, randomized, placebo-controlled trial protocol to assess Traumeel injection vs dexamethasone injection in rotator cuff syndrome: the TRAumeel in ROtator cuff syndrome (TRARO) study protocol. BMC Musculoskelet Disord. 2015, 16:8. 10.1186/s12891- 015-0471-z  12. Birnesser H, Oberbaum M, Klein P, Weiser M: The homeopathic preparation Traumeel® S compared with NSAIDS for symptomatic treatment of epicondylitis  13. Ehlert, Dianna, and Ariel Majjhoo. "Traumeel® Epidural Injection: A Viable Alternative to Corticosteroids-A Five-Patient Case Study." Cureus 11.11 (2019) 14. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/medinatura-inc-596269-06112020  
20:54 12/11/23
The Iliohypogastric Nerve: Anatomy, and Entrapment Syndrome
Dr. Rosenblum reviews the anatomy of the ilioinguinal nerve and entrapment syndromes related to the nerve and its relationship to the iliohypogastric nerve. He describes cases in which patients have a tender spot (tinel’s) over the lateral iliac crest. Live Regenerative Medicine and Ultrasound Workshops For  up to date Calendar, Click Here! #painboards #painfellowship #abpm #aspn #abipp #Asipp #nans #painexam #painexampodcast #regionalanesthesia #regemed #regenerativepainmedicine #jointinjections #prppain #bmac #painqbank #uspaininjections #Usjointinjections #interventionalpain   References https://assets.cureus.com/uploads/review_article/pdf/94743/20220610-32009-17da8fm.pdf https://www.bizwan.com/en/index.php?view=article&id=82:proximal-entrapments-of-the-lower-extremity&catid=86&start=1
12:24 11/27/23
Shoulder RFA: The Technique
  Dr. Rosenblum reviews an ASRA Newsletter article discussing the technique, relevant anatomy and more for performing Shoulder Articular Branch Radiofrequency ablation for chronic pain.  David Rosenblum, MD practices Interventional Pain Medicine in New York. To schedule a conusultation call 718 436 7246 for Brooklyn and 516 482 7246 for Garden City locations or go to www.AABPpain.com The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/PFcXGy Upcoming Workshops and Events   NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, October 28, 2023 8:00 AM   NRAP Academy:  Regenerative Pain Medicine Course NYC Saturday, November 11, 2023 8:00 AM   NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, December 16, 2023 7:30 AM   NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, January 6, 2024 7:30 AM    For  up to date Calendar, Click Here!   Reference https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2020/11/01/how-i-do-it-shoulder-articular-nerve-blockade-and-radiofrequency-ablation
10:39 10/25/23
Maximizing Profit: Understanding the 2024 Physician Fee Schedule
The 2024 Physician Fee Schedule and Remote Patient Care with Rachel Trobman, CEO of Upside Health. Dr. Rosenblum and Rachel Trobman cover topics ranging from Remote Patient Care coding, acronyms, implementation, reimbursement and much more! Upcoming Workshops and Events ASPN Webinar: Continuing Eduction and Board Prep October 4, 2023 8PM Maximizing Profit: Understanding the 2024 Physician Fee Schedule Wednesday, September 20, 2023 8:00 PM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, October 28, 2023 8:00 AM Charleston, SC  Regional Anesthesia and  Pain  Ultrasound CME  Workshop Sunday, October 29, 2023 9:00 AM NRAP Academy:  Regenerative Pain Medicine Course NYC Saturday, November 11, 2023 8:00 AM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, January 6, 2024 7:30 AM  
37:44 9/26/23
Coaching, Physician Masterminds and more!
  Drawing from her own experience of transformation from being a burnout physician to regaining, designing, and retaining control of her physician life, Dr. Myrdalis Diaz-Ramirez created the maxAllure Mastermind. It is now her passion to help physicians who feel overwhelmed and lost in medicine to find a new path and control their lives through entrepreneurship. She is a born and self-made entrepreneur with experience in owning different clinics which she successfully sold in the past. She has also owned other businesses, including an entertainment company. Dr. Myrdalis Díaz-Ramírez is a dual Board-Certified Anesthesiologist and Interventional Pain Management Physician. She is also a Medical Expert, Professor, Author, Speaker, Podcaster, Entrepreneur, and Mastermind Facilitator. Through her Mastermind, physicians can transform their personal and professional lives. They have been able to define, plan, and execute a designed vision for their life and business that was once only a dream! Upcoming Workshops and Events Regional Anesthesia and  Pain  Ultrasound CME  Workshop- San Juan, PR Friday, September 15, 2023 8:00 AM Maximizing Profit: Understanding the 2024 Physician Fee Schedule Wednesday, September 20, 2023 8:00 PM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, October 28, 2023 8:00 AM Charleston, SC  Regional Anesthesia and  Pain  Ultrasound CME  Workshop Sunday, October 29, 2023 9:00 AM NRAP Academy:  Regenerative Pain Medicine Course NYC Saturday, November 11, 2023 8:00 AM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and  Pain  Ultrasound CME  Workshop Saturday, January 6, 2024 7:30 AM  
22:34 9/18/23
Superior Cluneal & Gluteal Nerve Stimulation
Dr. Rosenblum discusses posterior hip pain/buttock pain near scar after Total Hip Arthroplasty. Included in this episode: Patient Testimonial re: SPRINT PNS (superior gluteal and superior cluneal nerve) Superior Gluteal Nerve Anatomy Hip Innervation Upcoming Private and Group Ultrasound Training Upcoming Pain Management Conferences   Course Calendar 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR Oct. 28 Regional Anesthesia and Interventional Pain Medicine NYC Nov.11 Regenerative Pain Medicine Course: NYC   Dec. 16th Regional Anesthesia and Interventional Pain Ultrasound Training NYC 2024 Jan. 6 Regional Anesthesia and Interventional Pain Ultrasound Training NYC For  up to date Calendar, Click Here! Pain Management Board Review   Subscribe to Receive Free Content, Discounts and Course Updates! * indicates required Email Address * References Pierre Laumonerie and others, Sensory Innervation of the Hip Joint and Referred Pain: A Systematic Review of the Literature, Pain Medicine, Volume 22, Issue 5, May 2021, Pages 1149–1157, https://doi.org/10.1093/pm/pnab061 Pinho, A.R.; Leite, M.J.; Lixa, J.; Silva, M.R.; Vieira, P.; Nery-Monterroso, J.; Bezerra, M.C.; Alves, H.; Madeira, M.D.; Pereira, P.A. Superior Gluteal Nerve Anatomy and Its Injuries: Aiming for a More Secure Surgical Approach of the Pelvic Region. Diagnostics 2023, 13, 2314. https://doi.org/10.3390/diagnostics13142314 Lung K, Lui F. Anatomy, Abdomen and Pelvis: Superior Gluteal Nerve. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535408/
18:36 8/24/23
Cervical Plexus Block for Cervical Radiculopathy?
David Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, PainExam Pain Management Board Review and NRAP Academy’s Continuing Medical Education Programs, discusses: a case of paresthesia in the upper neck realted to C3 and C4 stenosis and considers a selective nerve root block while wondering if a deep cervical plexus block would suffice.   Rational : Desire to avoid epidural due to proximity to spinal cord Ultrasound approach of cervial plexus may anesthetize C3 and C4 roots and may be sufficient to do with ultrasound alone Unfortunately, no data found to support this particular situation, however, it may be safe and effective if performed properly.    Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/lubWXJ Also discussed on this podcast: The Superficial Cervical Plexus and applications for headache, neck pain, and clavicular fractures.  Caution: Phrenic Nerve Anatomy The cervical plexus is a complex network of nerves located in the neck region, originating from the anterior rami (branches) of the cervical spinal nerves, specifically those stemming from the upper cervical segments (C1 to C4). This intricate network serves to provide sensory and motor innervation to various structures within the neck and surrounding areas. The cervical plexus is positioned within a groove between the longus capitis and the middle scalene muscles in the neck. It is organized into different nerve loops and branches that radiate outwards to supply various regions. The cervical plexus can be divided into deep and superficial components, each with distinct functions and innervation patterns. Cervical Plexus: The plexus involves nerve loops and branches that provide both sensory and motor functions. The superficial sensory branches originating from adjacent anterior spinal nerves (C2 to C4) are responsible for providing sensation to specific areas of the skin, particularly in the head, neck, and shoulder regions. These sensory branches include the lesser occipital nerve (C2, C3), great auricular nerve (C2, C3), transverse cervical nerve (C2, C3), and supraclavicular nerves (C3, C4). These nerves typically run posteriorly and then penetrate the prevertebral fascia before reaching the skin and superficial structures. For Pain Management and Anesethesiology Board Review, go to For the Virtual Pain Fellowship Experience, Go to:   Subscribe to Receive Free Content, Discounts and Course Updates! * indicates required Email Address * Ultrasound Workshops and Courses Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR Regenerative Pain Medicine Course NYC- November 11, 2023 For  up to date Calendar, Click Here! Refereces Kim JS, Ko JS, Bang S, Kim H, Lee SY. Cervical plexus block. Korean J Anesthesiol. 2018 Aug;71(4):274-288. doi: 10.4097/kja.d.18.00143. Epub 2018 Jul 4. PMID: 29969890; PMCID: PMC6078883. Read more!
14:06 8/12/23
Reda Tolba, MD on the International Society of Pain & Neuroscience (ISPN)- Dubai 2023
ISPN Dubai 2023 David Rosenblum, MD interviews Reda Tolba, MD on the PainExam Podcast In this episode, we delve into the realm of Pain Management in the US and the Middle East. Our international pain experts discuss the upcoming ISPN (International Society for Pain and Neuroscience) meeting in Dubai this december.   Subscribe to the PainExam Newsletter to Receive Free Content, Discounts and Course Updates! Email Address *   Dr. Reda Tolba, MD, chairs the Pain Management Department at Cleveland Clinic Abu Dhabi. He's internationally recognized for his contributions to Pain Medicine, boasting a wealth of experience from institutions like Wake Forest University Medical Center and Ochsner Health System. Dr. David Rosenblum, MD, is the Director of Pain Management at Maimonides Medical Center and a driving force behind pain education platforms like PainExam.com and NRAP Academy. He's a pioneer in ultrasound-guided pain procedures, having trained thousands of physicians online and in person. Tune in to hear Dr. Tolba's journey to being named Chair of Pain at Cleveland Clinic, Abu Dhabi, and his impressive academic and clinical achievements.Dr. Rosenblum, on the other hand, is known through his contributions to safe pain management protocols, and his mission to spread knowledge through podcasts and educational events. Patients, interested he's scheduling an appointment with Dr. Rosenblum at his Long Island or Brooklyn Locations can go to AABPpain.com or call 718 436 7246 or 516 482 7246 To learn more about their work and educational initiatives, explore NRAPpain.org and PainExam.com/events. Join us in this episode to uncover insights from these leading figures in Pain Management. Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here!
29:10 8/3/23
Passive Income for Physicians with Greg Alerte
On this episode, Dr. Rosenblum has a chat with Premier Heritage's Greg Alerte. Greg has over 15 years of experience helping families and small business to achieve their financial goals. As co-owner and Certified Financial Planner at Premier Heritage, he focuses on helping people to preserve and grow their wealth, and to leave a legacy for future generations to build on. Greg’s research and professional opinions, have been quoted in several financial publications, including Wall Street Journal, NerdWallet, Financial Planning magazine, and the Huffington Post. Greg’s favorite quote is by the late Mia Angelou “when you learn teach, when you get give” For more information, Email: galerte@premier-heritage.com David Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, PainExam Pain Management Board Review and NRAP Academy’s Continuing Medical Education Programs, discusses:   Attend and NRAP Course! Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here!  
13:52 7/11/23
Central Post Stroke Pain
  David Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, PainExam Pain Management Board Review and NRAP Academy’s Continuing Medical Education Programs discusses Central post-stroke pain (CPSP).   Central Post Stroke Pain is a debilitating condition that affects a significant number of stroke survivors. It is characterized by persistent neuropathic pain, often described as burning, shooting, or electric shock-like sensations, in the areas of the body affected by the stroke. CPSP can significantly impact a patient's quality of life and functional recovery, making it crucial for physicians to have a comprehensive understanding of its pathophysiology. Earn CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/HQ69sg Ultrasound Workshops and Courses Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here! Neuropathic Pain and Central Sensitization:CPSP is classified as a neuropathic pain syndrome, which means it arises from a dysfunction or damage to the nervous system. The exact pathophysiology of CPSP is complex and multifactorial, but it often involves the phenomenon of central sensitization. Central sensitization refers to the increased excitability and responsiveness of neurons within the central nervous system (CNS) in response to peripheral input. Cortical Reorganization and Plasticity: One key aspect of CPSP pathophysiology is cortical reorganization and plasticity. Following a stroke, the brain undergoes structural and functional changes as a result of the injury. This neuroplasticity, particularly in the somatosensory cortex, can contribute to the development of CPSP. Maladaptive plasticity may occur, leading to abnormal sensory processing and the generation of pain signals in response to non-painful stimuli. Disrupted Pain Modulation Pathways:The pain perception and modulation pathways in the CNS play a crucial role in regulating pain signals. In CPSP, these pathways can be disrupted, leading to abnormal pain processing. Alterations in the descending inhibitory pathways, such as reduced inhibitory neurotransmitter release or impaired endogenous opioid system function, can result in increased pain sensitivity and the persistence of pain signals even after the resolution of the initial injury. Inflammatory Processes and Neurotransmitter Imbalances:Inflammation within the CNS and imbalances in neurotransmitter systems also contribute to CPSP. Following a stroke, there is an inflammatory response that involves the release of pro-inflammatory cytokines and activation of immune cells. This inflammation can lead to sensitization of nociceptive neurons and exacerbate pain signaling. Additionally, imbalances in neurotransmitters, such as glutamate, serotonin, and norepinephrine, may disrupt the normal pain processing pathways, further amplifying pain perception. Peripheral and Central Lesions:CPSP can arise from both peripheral and central lesions. Peripheral lesions, such as damage to the spinothalamic tract or thalamus, can directly affect the transmission of pain signals. Central lesions, on the other hand, involve damage to the somatosensory cortex, thalamus, or other brain regions involved in pain processing. Both types of lesions can contribute to the development of CPSP through various mechanisms, including altered neuronal activity, disrupted connectivity, and aberrant sensory processing.  The complex interplay of cortical reorganization, disrupted pain modulation pathways, inflammatory processes, and peripheral and central lesions contribute to the development and persistence of CPSP. Further research is needed to unravel the intricacies of CPSP's pathophysiology, leading to the development of targeted therapies to alleviate the burden of this debilitating condition. References Liampas, A., Velidakis, N., Georgiou, T. et al. Prevalence and Management Challenges in Central Post-Stroke Neuropathic Pain: A Systematic Review and Meta-analysis. Adv Ther 37, 3278–3291 (2020). https://doi.org/10.1007/s12325-020-01388-w SYSTEMATIC REVIEW article Front. Neurol., 18 August 2021Sec. Stroke Volume 12 - 2021 | https://doi.org/10.3389/fneur.2021.678198
13:40 6/28/23
Phenol Neurolysis and the Genicular Nerve
David Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, PainExam Pain Management Board Review and NRAP Academy’s Continuing Medical Education Programs, discusses: Genicular Nerve Ablation with Phenol The history of phenol The mechanism of action Indications Complications Clinical concerns when considering neurolysis with phenol   Claim CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/9GkVWu Ultrasound Workshops and Courss Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here! References D'Souza RS, Warner NS. Phenol Nerve Block. [Updated 2023 Jan 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.     Risso CR e tal.Chemical Ablation of Genicular Nerve with Phenol for Pain Relief in Patients with Knee Osteoarthritis: A Prospective StudyVolume21, Issue4. April 2021Pages 438-444
17:08 6/21/23
Regional Anesthesia for Neurosurgery
Blocks for Head, Neck, and Spinal Surgeries Claim CME Credit: The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/t3z3kR In this episode, we will explore the various regional anesthesia techniques used in neurosurgery, specifically focusing on blocks for head, neck, and spinal surgeries. Segment 1: Blocks used in Head and Neck Surgeries Scalp Block: The scalp block involves blocking six nerves that provide sensory innervation to the scalp. It is performed by subcutaneous infiltration of local anesthetics (such as bupivacaine, ropivacaine, or levobupivacaine) for each nerve. Ultrasound guidance has improved the precision of block administration. The main indication for a scalp block is awake craniotomy, but it is also used in other procedures like deep brain stimulation and cranioplasty surgery. Scalp block offers advantages such as accurate neurological evaluation, pre-emptive analgesia, and hemodynamic stability during surgery. It also reduces postoperative pain, the need for rescue analgesics, and pain scores in the early postoperative period. Infraorbital Block (IOB): The infraorbital nerve block targets the infraorbital nerve, which supplies the skin and mucous membrane of the upper lip, lower eyelid, and cheek. The IOB can be performed using the classical landmark technique or ultrasound guidance. Ultrasound guidance provides real-time visualization and accurate needle placement. IOB combined with general anesthesia is beneficial for postoperative pain relief in procedures like endoscopic trans-nasal trans-sphenoidal (TNTS) approach for pituitary tumor excision. Other regional techniques like sphenopalatine ganglion block and maxillary nerve blocks have also been attempted for transsphenoidal surgeries. Trigeminal Nerve Block: Trigeminal nerve block is used for patients unresponsive to medical management of trigeminal neuralgia. Traditionally performed using the paresthesia technique, ultrasound guidance allows real-time visualization and confirmation of local anesthetic spread. Ultrasound guidance helps locate the Gasserian ganglion and visualize the trigeminal ganglion, providing a safe and radiation-free procedure for pain relief. Segment 2: Blocks used for Spinal Surgeries Cervical Plexus Block (CPB): CPB is commonly used in carotid endarterectomy (CEA) and cervical spine surgery. Different levels of CPB can be performed depending on the depth of injection. Superficial CPB involves injecting local anesthetic superficially into the deep cervical fascia. Deep CPB requires depositing local anesthetic deep to the prevertebral fascia. CPB helps in monitoring cerebral blood flow during CEA and provides postoperative pain relief. Ultrasound guidance can be used for superficial CPB, ensuring accurate needle placement and local anesthetic spread. Erector Spinae Block (ESB): ESB is used for pain control in spinal surgeries. It involves depositing local anesthetic in the plane between the erector spinae muscle and the transverse process. ESB provides effective postoperative analgesia and reduces opioid consumption. Regional anesthesia techniques play a crucial role in neurosurgery, providing effective pain relief and improving patient outcomes. Blocks like scalp block, infraorbital block, trigeminal nerve block, cervical plexus block, and erector spinae block offer numerous advantages in specific procedures. Ultrasound guidance has enhanced the precision and safety of block administration. These techniques contribute to improved surgical outcomes and patient satisfaction in neurosurgical procedures. Upcoming Courses and Workshops! Course Calendar Practice Management Webinar: The End of the Public Health Emergency. What’s Changed and what Opportunities Remain! Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here! References Kaushal A, Haldar R. Regional Anesthesia in Neuroanesthesia Practice. Discoveries (Craiova). 2020 Jun 29;8(2):e111. doi: 10.15190/d.2020.8. PMID: 32637571; PMCID: PMC7332314.
18:44 6/4/23
Prolotherapy, Ligaments, Spine and more!
Long Island and Brooklyn based Pain Physician, David Rosenblum, MD describes prolotherapy and discusses mechanism of action, evidence and protocols.  Also mentioned in this podcast, Prolotherapy protocols, low dose version high dose dextrose prolotherapy, spine prolotherapy, Spine ligaments Intertransverse ligament, Ilolumbar ligament pain and more! The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/IjV2JT For Pain Management Board Review go to   References Geonhyeong Bae, Suyeon Kim, Sangseok Lee, Woo Yong Lee, Yunhee Lim. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis Anesth Pain Med 2021;16(1):81-95. Solmaz, İ. & Örsçelik, A. (2022). Approximately Three Years of Prolotherapy Experience of a Traditional and Complementary Medicine Center: An Epidemiologic Study . International Journal of Traditional and Complementary Medicine Research , 3 (2) , 64-70 . DOI: 10.53811/ijtcmr.1040648   Harmon, Dominic, and Vladimir Alexiev. "Sonoanatomy and injection technique of the iliolumbar ligament." Pain Physician 14.5 (2011): 469.   https://clinicaltrials.gov/ct2/show/NCT04680936 David Rosenblum, MD   Sit, R.W.S., Wu, R.W.K., Reeves, K.D. et al. Efficacy of intra-articular hypertonic dextrose prolotherapy versus normal saline for knee osteoarthritis: a protocol for a triple-blinded randomized controlled trial. BMC Complement Altern Med 18, 157 (2018). https://doi.org/10.1186/s12906-018-2226-5
15:09 5/23/23
2023 Update to CMS' Covered Indications for Sacroiliac Joint Injection
  2023 Update to the Sacroiliac Joint  CMS Covered Indications for SI Joint Injection   Long Island Based Interventional Pain Physician, David Rosenblum, MD discusses Sacroiliac Joint Dysfunction, and CMS’s Covered Indications for Sacroiliac Joint Injection and Diagnostic Nerve Block   The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/ryGmAg  For Board Review, Click Here!   Sacroiliac Joint Injections are considered necessary and reasonable when all of the following criteria are met:   Moderate to severe low back pain primarily experienced over the anatomical location of the SI joints between the upper level of the iliac crests and the gluteal fold, AND Low back pain duration of at least three (3) months, AND Low back pain below L5 without radiculopathy, AND Clinical findings and/or imaging studies do not suggest any other diagnosed or obvious cause of the lumbosacral pain (such as central spinal stenosis with neurogenic claudication/myelopathy, foraminal stenosis or disc herniation with concordant radicular pain/radiculopathy, infection, tumor, fracture, pseudoarthrosis, or pain related to spinal instrumentation), AND At least three positive findings with provocative maneuvers: FABER, Gaenslen, Thigh Thrust or Posterior Shear, SI Compression, SI Distraction and Yeoman Tests,3,4 AND Low back pain persists despite a minimum of four weeks of conservative therapies.5   Workshop and Calendar   Regenerative Pain Medicine Course NYC- May 13   Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023    Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023   Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023   Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR   For  up to date Calendar, Click Here!     References https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39383&ver=9
14:20 5/2/23
The End of the PHE: What's Changed and What Opportunities Remain!
Practice Management Webinar: The End of the Public Health Emergency. What’s Changed and what Opportunities Remain! Join digital health leader and Upside Health CEO Rachel Trobman and PainExam.com founder Dr. David Rosenblum in a conversation about the impact of the end of the public health emergency in May could have on your pain management practice. We'll specifically discuss the changes to telehealth and remote patient monitoring. The webinar will close with one of Upside Health's clients outlining the launch and successes of RTM in their practice and be available for Q&A. Course Calendar Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here!   For more questions Email Rachel Trobman at Rachel@upside.health
34:31 4/27/23
Ultrasound Guided, Flouro Confirmed: Cervical Intra-Discal PRP Injections
Regenerative Medicine Journal Club   Dr. Rosenblum reviews a case report discussing Platelet Rich Plasma Intra-discal Injection using ultrasound and fluoroscopy. The author mentions use of ultrasound to avoid the Internal jugular vein, carotid artery, phrenic nerve, esophagus and neural structures.  The author mentions mixing lidocaine with PRP and Dr. Rosenblum comments on his experience and knowledge of the technique.  Dr. Rosenblum mentions the risk of disci tis.     Course Calendar   Practice Management Webinar: The End of the Public Health Emergency. What’s Changed and what Opportunities Remain! Register to our Free Upcoming Practice Management Webinar on April 24th   Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023   Regenerative Pain Medicine Course NYC- May 13   Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023   Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023   Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023   For  up to date Calendar, Click Here!   Claim CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wpE4BfThe CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wpE4Bf   References Ultrasound-Guided Lumbar Intradiscal Injection for Discogenic Pain: Technical Innovation and Presentation of Two Cases Tsung-Ju Wu et al. Journal of Pain Research Published online: 16 Nov 2022
13:55 4/12/23
Minimally Invasive Lumbar Decompression- The MOTION Study
The MOTION Study: Minimally Invasive Lumbar Decompression   CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/W8x3jd   Journal Club. Minimally Invasive Lumbar Decompression (mild® Procedure) with Conventional Medical Management vs. Conventional Medical Management Alone. Descripton of Procedure, Safety, Technique, study outcome, personal experience with this minimally invasive technique that interventional pain physicians are using to treat neurogenic claudication related to ligamentum flavum hypertrophy.    Dr. Rosenblum discusses spinal stenosis pathophysiology and neurogenic claudication. Dr. Rosenblum also mentions upcoming courses and webinars:     Upcoming Courses and Workshops!   Course Calendar   Practice Management Webinar: The End of the Public Health Emergency. What’s Changed and what Opportunities Remain!   Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023   For  up to date Calendar, Click Here!   References Timothy R Deer, MD, Shrif J Costandi, MD, Edward Washabaugh, MD, Timothy B Chafin, MD, Sayed E Wahezi, MD, Navdeep Jassal, MD, Dawood Sayed, MD, The MOTION Study: A Randomized Controlled Trial with Objective Real-World Outcomes for Lumbar Spinal Stenosis Patients Treated with the mild® Procedure: One-Year Results, Pain Medicine, Volume 23, Issue 4, April 2022, Pages 625–634, https://doi.org/10.1093/pm/pnac028
16:19 3/29/23
PRP and the Nerve, A2M and more!
Biologics and the Peripheral Nerve.   Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TgB18M   Dr. Rosenblum discuss his upcoming talk at the Appalachian Region Spine and Pain Meeting:  Incorporating Ultrasound into a Spine and Pain Practice on April 14-16 2023 and the topics he plans to include: Ultrasound Guided Knee therapies, cluneal nerve, caudal, brachial plexus and more!   Today’s podcast (inspired by TOBI and Dr. Sudhir Diwan, Dr. Sheldon Jordon and Dr. Rikin Patel's ASIPP Lectures)  focuses on the risk and benefits of performing PRP injection onto a nerve.  Dr. Rosenblum discusses:    Possible fibrosis of the ulna nerve after using PRP for partial ulnar collateral ligament tears  Best Time for PRP Injection after Nerve Regeneration  Alpha 2-macroglobulin (what is it?)  PRP for moderate to severe carpal tunnel syndrome   Featured Courses!   May 25, 2023 Private Pain Group   Ultrasound Course- NYC (Sold out) Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 see the full schedule for our July and August US IPM Courses!   References Robert G. Thompson, Kendall Bradley, Gary M. Lourie, Ulnar nerve dysfunction at the elbow after platelet-rich plasma treatment for partial ulnar collateral ligament injuries,JSES Reviews, Reports, and Techniques,Volume 1, Issue 1,2021,Pages 41-44,ISSN 2666-6391,   Si-Ru Chen, Yu-Ping Shen, Tsung-Yen Ho, Tsung-Ying Li, Yu-Chi Su, Yu-Ching Chou, Liang-Cheng Chen, Yung-Tsan Wu,One-Year Efficacy of Platelet-Rich Plasma for Moderate-to-Severe Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial,Archives of Physical Medicine and RehabilitationVolume 102, Issue 5,2021, Pages 951-958,ISSN 0003-9993,https://doi.org/10.1016/j.apmr.2020.12.025.   Rehman, A.A., Ahsan, H. and Khan, F.H. (2013), Alpha-2-macroglobulin: A physiological guardian. J. Cell. Physiol., 228: 1665-1675. https://doi.org/10.1002/jcp.24266   Muhammad Pandunugrahadi, Komang Agung Irianto, Oen Sindrawati, "The Optimal Timing of Platelet-Rich Plasma (PRP) Injection for Nerve Lesion Recovery: A Preliminary Study", International Journal of Biomaterials, vol. 2022, Article ID 9601547, 7 pages, 2022. https://doi.org/10.1155/2022/9601547
15:52 3/21/23
BMAC vs. PRP (Leukocyte Rich vs Poor) for Knee Pain and Osteoarthritis
Knee Osteoarthritis and Regenerative Pain Medicine   Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TJXGw0     Dr. Rosenblum reviews the latest evidence comparing Bone Marrow Aspirate and Platelet Rich Plasma for knee pain. He also reviews the latest publication by Di Martino et al’s study which compared Leukocyte-rich PRP vs. Leukocyte-poor PRP in the treatment of knee osteoarthritis.    Upcoming Courses Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023  Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 References El-Kadiry, A.EH., Lumbao, C., Salame, N. et al. Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study. BMC Musculoskelet Disord 23, 23 (2022). https://doi.org/10.1186/s12891-021-04910-5   Hede, Kris, et al. "Combined bone marrow aspirate and platelet-rich plasma for cartilage repair: two-year clinical results." Cartilage 13.1_suppl (2021): 937S-947S.   Anz AW, Plummer HA, Cohen A, Everts PA, Andrews JR, Hackel JG. Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 2 Years: A Prospective Randomized Trial. The American Journal of Sports Medicine. 2022;50(3):618-629. doi:10.1177/03635465211072554     Di Martino A, Boffa A, Andriolo L, et al. Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial. The American Journal of Sports Medicine. 2022;50(3):609-617. doi:10.1177/03635465211064303
15:15 3/11/23
Carpal Tunnel Syndrome for the Pain Boards and Your Practice
Carpal Tunnel Syndrome Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/JiPKnm   Diagnosis, Pathophysiology, Clinical Findings and Management of the Carpal Tunnel Syndrome  In this episode, we will be discussing Carpal Tunnel Syndrome, a common condition that affects millions of people worldwide. But before we dive into the topic, we want to tell you about a great opportunity to advance your medical knowledge through the NRAP Academy CME courses offered on our website. Discussion on Carpal Tunnel Syndrome: Carpal Tunnel Syndrome is a condition that occurs when the median nerve, which runs from the forearm to the hand, becomes compressed or squeezed at the wrist. This compression can lead to pain, numbness, and tingling in the hand and arm, which can be debilitating. There are many causes of Carpal Tunnel Syndrome, including repetitive hand movements, wrist injuries, pregnancy, and medical conditions such as diabetes and thyroid disorders. Treatment options for Carpal Tunnel Syndrome range from non-invasive approaches like rest, ice, and wrist splints to more invasive treatments like surgery. It's important to diagnose and treat Carpal Tunnel Syndrome early to prevent long-term damage to the median nerve. A proper diagnosis can be made through a physical exam and imaging tests like an electromyography (EMG) or nerve conduction study (NCS). Don't forget to check out the NRAP Academy CME courses offered on our website, www.painexam.com/events page, to continue your medical education and enhance your patient care. NRAP Academy Events Hands on Training for medical professional looking to enhance your knowledge and skills in pain management? Offering courses are designed to help you stay up-to-date with the latest advances in pain management and to help you improve patient outcomes. Visit our website, www.painexam.com/events page, to learn more about the courses available and to sign up today. References Sevy JO, Varacallo M. Carpal Tunnel Syndrome. [Updated 2022 Sep 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448179/   Sevy JO, Varacallo M. Carpal Tunnel Syndrome. 2022 Sep 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 28846321.
15:39 2/25/23

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