Explorez tous les épisodes du podcast The PMRExam Podcast
| Titre | Date | Durée | |
|---|---|---|---|
| Does Kratom Relieve Pain? Risks, Benefits and more! | 11 Dec 2025 | 00:11:14 | |
🎙️ PainExam Podcast Show Notes Kratom (Mitragyna speciosa): What Pain Physicians Must Know for the Boards In this episode, Dr. David Rosenblum reviews the current science, pharmacology, risks, and clinical relevance of Kratom — an herbal substance widely discussed by pain patients and increasingly appearing on pain-medicine board exams. The discussion focuses on evidence-based mechanisms, safety considerations, and counseling points essential for ABA/ABPM/ABIPP/FIPP board preparation. 🔍 Key Board-Relevant Takeaways 1. Pharmacology & Mechanism
Potential Benefits (mostly anecdotal or preclinical):
Major Limitations:
Commonly reported:
Serious risks:
Expect questions on:
Prepare for the ABA, ABPM, ABIPP, FIPP, and AOBPM exams with the PainExam Board Review and full curriculum at the NRAP Academy: Boost your procedural skills with live ultrasound-guided interventional pain and regional anesthesia workshops:
PainExam / NRAP Academy Training & Programs:
Learn More / Register: Prepare for:
Access Board Prep Courses & Q-Banks: AABP Integrative Pain Care (Brooklyn & Great Neck, NY) Dr. Rosenblum serves as Director of Pain Management at Maimonides Medical Center and Managing Partner at AABP Integrative Pain Care in Brooklyn, NY. He is recognized as an early adopter and leading educator in ultrasound-guided pain procedures, neuromodulation, and regenerative medicine. He has:
Awards (Selected):
✅ Join the NRAP Community Start here → https://NRAPpain.org | https://PainExam.com | |||
| Caudal Epidurals with PRP, Ultrasound Guidance & more! | 25 Nov 2025 | 00:18:28 | |
Caudal Epidural Steroid Injection with PRP Case Reports and a Testimonial! Upcoming Training Courses and Services
Private Coaching Services:
David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.
Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023
Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology. He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!
Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office. For an appointment go to AABPpain.com or call Brooklyn 718 436 7246 ReferenceIrvan J. Bubic, Jessica Oswald, Ruiz‐Lopez, Ricardo, and Yu‐Chuan Tsai. "A randomized double‐blind controlled pilot study comparing leucocyte‐rich platelet‐rich plasma and corticosteroid in caudal epidural injection for complex chronic degenerative spinal pain." Pain Practice 20.6 (2020): 639-646. #prppain #paincme #sciatia #ultrasoundmsk #ultrasoundprp #epidural #nypaindoctor #prppainwindsor | |||
| Supplements for Pain, the Evidence! | 19 Nov 2025 | 00:19:29 | |
Episode Overview In this episode, Dr. David Rosenblum discusses the role of supplements and complementary strategies in the management of chronic pain. Drawing from clinical practice at AABP Integrative Pain Care, as well as his teaching and training programs, Dr. Rosenblum reviews how nutraceuticals, regenerative therapies, ultrasound-guided procedures, and neuromodulation can work together to improve patient outcomes and reduce opioid reliance. This episode also highlights educational opportunities and exam-prep resources for pain fellows, residents, anesthesiologists, physiatrists, and APPs looking to expand their interventional pain, ultrasound, and regenerative medicine skill sets. Key Topics Discussed
PainExam / NRAP Academy Training & Programs:
Learn More / Register: www.AABPpain.com Prepare for:
Access Board Prep Courses & Q-Banks: AABP Integrative Pain Care (Brooklyn & Great Neck, NY) Dr. Rosenblum serves as Director of Pain Management at Maimonides Medical Center and Managing Partner at AABP Integrative Pain Care in Brooklyn, NY. He is recognized as an early adopter and leading educator in ultrasound-guided pain procedures, neuromodulation, and regenerative medicine. He has:
Awards (Selected):
References Frediani, Jennifer K., et al. "The role of diet and non‐pharmacologic supplements in the treatment of chronic neuropathic pain: A systematic review." Pain Practice 24.1 (2024): 186-210. Huang, Wei MD, PhD*,†; Shah, Shivani DO†; Long, Qi PhD‡; Crankshaw, Alicia K. MD†; Tangpricha, Vin MD, PhD§,∥. Improvement of Pain, Sleep, and Quality of Life in Chronic Pain Patients With Vitamin D Supplementation. The Clinical Journal of Pain 29(4):p 341-347, April 2013. | DOI: 10.1097/AJP.0b013e318255655d Haddad, H.W., Mallepalli, N.R., Scheinuk, J.E. et al. The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review. Pain Ther 10, 827–848 (2021). https://doi.org/10.1007/s40122-021-00266-9 Abdelrahman, K.M.; Hackshaw, K.V. Nutritional Supplements for the Treatment of Neuropathic Pain. Biomedicines 2021, 9, 674. https://doi.org/10.3390/biomedicines9060674 | |||
| ACL Tear Treatment with BMC and Platelet Products: Journal Club | 15 Oct 2025 | 00:18:16 | |
Pain Exam Podcast Recent Conference Activities
David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.
Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023
Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology. He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!
Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office. For an appointment go to AABPpain.com or call Brooklyn 718 436 7246 References
#pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp #aabppain | |||
| TENS: Mechanism of Action and Evidence | 01 Oct 2025 | 00:11:11 | |
Project Sync / Status Update Summary Podcast Episode Overview
David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures. Patients can go to www.AABPpain.com or call 718 436 7246 Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023 References Johnson M. Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Evidence. Rev Pain. 2007 Aug;1(1):7-11. doi: 10.1177/204946370700100103. PMID: 26526976; PMCID: PMC4589923.
Vance, C.G.T.; Dailey, D.L.; Chimenti, R.L.; Van Gorp, B.J.; Crofford, L.J.; Sluka, K.A. Using TENS for Pain Control: Update on the State of the Evidence. Medicina 2022, 58, 1332. https://doi.org/10.3390/medicina58101332 #painnyc #painbrooklyn #prpbrooklyn #prpspine #regionalanesthsia #pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp | |||
| ADSC (Adipose Stem Cells) vs BMAC for Knee OA | 19 Sep 2025 | 00:07:22 | |
Exploring the Efficacy of BMAC and ADSC Injections in Knee Osteoarthritis
Hosts: David Rosenblum,MD Overview: In this episode, we delve into a recent study published in the Indian Journal of Orthopaedics that compares the therapeutic efficacy of Bone Marrow Aspirate Concentrate (BMAC) and Adipose-Derived Stem Cells (ADSCs) for treating knee osteoarthritis (OA). The study aims to provide insights into the effectiveness of these regenerative treatments and their correlation with mesenchymal stem cell (MSC) cellularity. Key Points Discussed:
References:
Listener Engagement:
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| Steroid vs Ketorolac for Intra-Articular Injections: Journal Club | 06 Aug 2025 | 00:14:52 | |
Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers:
Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article for details. Subacromial Ketorolac Injections for Shoulder PainSubacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids:
These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and OsteoarthritisAdhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions:
Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. ConclusionKetorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). https://www.nrappain.org/pages/pain-management-cme-courses1. What is ketorolac and how does it work?Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions?Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like:
Randomized controlled trials found:
Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use?Ketorolac is not suitable for patients with:
Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use?Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids?Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed?More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary:
Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
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| Post Herpetic Neuralgia- An Update | 24 Jun 2025 | 00:27:40 | |
Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic OverviewDr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational OpportunitiesDr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic NeuralgiaDr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options OverviewDr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and DefinitionsDr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk FactorsDr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of LifeDr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and PathophysiologyDr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve DamageDr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and ClassificationDr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation PhenotypeDr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical ExaminationDr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and AssessmentDr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through VaccinationDr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment ObjectivesDr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral MedicationsDr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral TherapyDr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and OpioidsDr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and AntidepressantsDr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment SummaryDr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical AgentsDr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous InjectionsDr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local AnestheticsDr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral InjectionsDr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection ApproachesDr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural BlockadeDr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic NeuralgiaDr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral InjectionsDr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) EvidenceDr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes ZosterDr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal NeuralgiaDr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other InterventionsDr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final RecommendationsDr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and ConclusionDr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and ClosingDr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&ANo Q&A session in this lecture Pain Management Board Prep Ultrasound Training
Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights
David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.
Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023
Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology. He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!
Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office. For an appointment go to AABPpain.com or call Brooklyn 718 436 7246 Reference | |||
| The Neurolytic Celiac Plexus Block | 11 Jun 2025 | 00:14:34 | |
Summary In this Pain Exam Podcast episode, Dr. David Rosenblum discusses a journal club article on low volume neurolytic retrocrural celiac plexus blocks for visceral cancer pain. The study reviewed 507 patients with severe malignancy-related abdominal pain, with data retained for 455 patients at the 5-month mark. Dr. Rosenblum explains that the procedure involves injecting 3-5ml of 6% aqueous phenol at the T12-L1 level under fluoroscopic guidance, with an average procedure time of 16.3 minutes. The study found significant pain relief lasting up to six months, reduced opioid consumption, and improved quality of life for patients with primary abdominal cancer or metastatic disease. Dr. Rosenblum shares his personal experience with celiac plexus blocks, including the trans-aortic approach he trained on, and mentions his interest in ultrasound-guided approaches. He also announces upcoming teaching engagements at ASPN, Pain Week, and other conferences, as well as CME ultrasound courses available through nrappain.org. Additionally, he mentions a new community page on the website where users can share board preparation information, though he emphasizes that remembered board questions should not be posted as he is a board question writer himself. Pain Management Board Prep Ultrasound Training
Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights Introduction and Upcoming EventsDr. David Rosenblum introduces the Pain Exam Podcast and shares information about upcoming events. He mentions teaching ultrasound at ASPN in July, attending Pain Week in September, and participating in the Latin American Pain Society conference. Dr. Rosenblum also promotes his CME ultrasound courses available at nrappain.org and mentions he's considering organizing another regenerative medicine course in fall or winter. He offers private training for those wanting more intensive ultrasound instruction. Board Prep Community AnnouncementDr. Rosenblum announces a new community page on the nrappain.org website for board preparation. He explains that registered users can access free information and keywords relevant to board exams. He emphasizes that users should not post remembered questions as this would be inappropriate, noting that he himself is a board question writer for various pain boards. Dr. Rosenblum mentions that a post about phenol in this community inspired today's podcast topic. Journal Article Overview on Celiac Plexus BlockDr. Rosenblum introduces a journal article on low volume neurolytic retrocrural celiac plexus block for visceral cancer pain, a retrospective review of 507 patients with severe malignancy-related abdominal pain. He explains that the study assessed pain relief provided by this procedure, its duration, reduction in daily opioid consumption, and quality of life improvements. The patients received neurolytic blocks without previous diagnostic blocks due to multiple comorbidities, which Dr. Rosenblum acknowledges is sometimes necessary with very sick patients despite the typical preference for diagnostic blocks before neurolysis. Dr. Rosenblum's Personal Experience with Celiac Plexus BlocksDr. Rosenblum shares his personal training experience with trans-aortic celiac plexus blocks, where a needle is inserted through the aorta after confirming no plaques or aneurysms are present. He describes it as a safe and effective procedure despite sounding intimidating. He mentions he's only performed a handful of these procedures and doesn't do many now as an outpatient pain doctor. Study Methods and ResultsDr. Rosenblum details the study methods, noting that of 507 patients studied, data for 455 was retained at the end of the review. Patients were evaluated before and after the neurolytic retrocrural celiac plexus block under fluoroscopic guidance. Assessment included procedure duration, pain scores (0-10 scale), daily opioid consumption, and quality of life improvement. Follow-up was completed six months after the procedure, showing improved pain scores, reduced opioid consumption, and better quality of life throughout the study period. Some pain returned during months 4-6 due to disease progression and the anticipated duration of the neurolytic agent. The study noted a 6.7% initial vascular contrast uptake during the procedure while using digital subtraction angiography with fluoroscopy. Study Limitations and ConclusionsDr. Rosenblum discusses the study's limitations, including the need for a larger sample size and a prospective trial with a control group, though he acknowledges this is unrealistic given the patient population. He mentions that a proven quality of life questionnaire would be beneficial, and that comparing alcohol, phenol, and RF thermocoagulation would be interesting to evaluate duration effects and side effects. The study concluded that low volume neurolytic retrocrural celiac plexus block with phenol is safe, providing up to six months of pain relief for abdominal pain due to primary malignancy or metastatic spread. Detailed Procedure TechniqueDr. Rosenblum explains the detailed procedure technique used in the study. The retrocrural celiac plexus was targeted at L1 level with aim towards T12. Anterior and posterior radiographic imaging aligning the spinous process of T12-L1 junction was used with 15-20 degree oblique rotation. Local anesthetic (1% lidocaine with sodium bicarbonate) was infiltrated along the injection path. A 22 or 25 gauge 3.5-7 inch curved spinal needle was used depending on patient body habitus. Dr. Rosenblum notes he typically uses a 6-inch Chiba needle or 25 gauge spinal needle for such procedures. Procedure Execution and MonitoringDr. Rosenblum continues describing the procedure, noting that the needle was advanced to the anterior border of T12-L1 under multiple imaging views. Contrast dye studies verified spread and location, with digital subtraction angiography used to check for intravascular uptake. A test dose of 1ml of 0.5% bupivacaine with epinephrine per site was administered, which Dr. Rosenblum finds interesting as he typically doesn't mix bupivacaine with epinephrine. After confirming no vascular uptake, 3-5ml of 6% aqueous phenol was injected in 1ml aliquots while communicating with the patient. The average procedure time was 16.3 minutes with minimal or no sedation. Patients remained prone for 30 minutes afterward to avoid neuroforaminal spread, as phenol is heavier and more viscous than alcohol. Post-Procedure Care and Study EvaluationDr. Rosenblum explains that patients were monitored in recovery for one hour for adverse events and their ability to eat and void easily. They were discharged once hospital post-anesthetic criteria were met and received a follow-up call 24 hours later. Dr. Rosenblum praises the study and notes that the procedure looks similar to a lumbar sympathetic plexus block, which is also a sympathetic block. Ultrasound Considerations and Alternative ApproachesDr. Rosenblum shares his interest in ultrasound-guided celiac plexus blocks but acknowledges concerns about bowel perforation. He mentions a conversation with an interventional radiology colleague who suggested a transhepatic approach. Dr. Rosenblum recalls scanning a very thin patient where the aorta was easily visible and close to the anterior abdominal wall, making the celiac plexus potentially accessible if bowel perforation, liver bleeding, or gallbladder perforation could be avoided. He shares an experience with a patient suffering from severe pancreatitis pain who received temporary relief from a paravertebral thoracic nerve block at T8-T10, noting that paravertebral blocks provide some sympathetic spread. Conclusion and Community Resource ReminderDr. Rosenblum concludes by recommending the article, noting its well-written analysis and graphs showing morphine consumption dropping over months following the procedure. He suggests neurolytic procedures are underutilized because they sound intimidating. He again encourages listeners to check out the community he created with separate chat rooms for regenerative medicine, regional anesthesia, and pain boards, where users can share keywords but not specific board questions. Dr. Rosenblum reminds listeners about upcoming courses and his website resources, mentions an upcoming PRP lecture, and asks for five-star reviews if listeners enjoy the podcast. The episode ends with a standard medical disclaimer. Reference https://www.painphysicianjournal.com/current/pdf?article=NTQwOA%3D%3D&journal=113 | |||
| PRP Epidural Injections for Radicular Pain | 28 May 2025 | 00:15:31 | |
PRP in the Epidural Space for Radiculopathy Brooklyn Based Pain Physician, David Rosenblum, MD known for his work publishing and teaching Regenerative Pain Medicine and Ultrasound Guided Pain Procedures hosts this podcast covering the latest and most advanced concepts in Pain Medicine. SummaryDr. David Rosenblum delivered a comprehensive lecture covering several key topics in pain management. He discussed his upcoming speaking engagements at PainWeek, ASPN and great upcoming meetings like the Latin American Pain Society, and other conferences. Dr. Rosenblum shared his extensive experience with PRP (Platelet-Rich Plasma) epidural injections, reviewing multiple research studies that support their efficacy. He highlighted three significant studies: a randomized control trial comparing PRP epidural injections to traditional treatments, a CT-guided epidural PRP study, and a 2025 meta-analysis comparing PRP to steroids. Dr. Rosenblum emphasized that PRP treatments are showing comparable or better results than traditional steroid injections, with potentially fewer required treatments and longer-lasting relief. He noted that while PRP is currently not covered by insurance, it represents a growing trend in 'natural' treatment approaches that patients increasingly prefer. Chapters Introduction and Upcoming EventsDr. Rosenblum announced his upcoming lectures at Pain Week focusing on ultrasound and regenerative medicine, followed by presentations at the Latin American Pain Society in Chile and the New York, New Jersey Pain Conference. He mentioned the SoMeDocs online pain conference accessible through nrappain.org, and upcoming ultrasound training sessions in New York City. PRP Epidural Research ReviewDr. Rosenblum discussed a randomized control trial involving 30 patients receiving transforaminal epidural injections. The study showed that PRP patients demonstrated significant improvements in leg pain scores at 6, 12, and 24 weeks. He noted that while the study didn't use contrast, he personally prefers using contrast diluted with saline for better visualization. CT-Guided Epidural Study AnalysisDr. Rosenblum reviewed a study comparing CT-guided epidural PRP versus steroid injections, questioning the necessity of CT guidance. The study included 60 patients and showed similar results between PRP and steroid groups at six weeks, though he criticized the short follow-up period, noting that PRP typically takes months to show full effects. Meta-Analysis DiscussionDr. Rosenblum presented a 2025 meta-analysis comparing PRP to steroids in epidural injections. The analysis included 310 patients across five RCTs, demonstrating comparable efficacy between PRP and steroid injections without increased adverse events. He emphasized that his clinical experience shows patients typically require fewer PRP injections compared to steroid treatments.
Register for Next Weeks SoMeDocs Pain Conference References Wongjarupong, Asarn, et al. ""Platelet-Rich Plasma" epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial." BMC Musculoskeletal Disorders 24.1 (2023): 335. Bise, Sylvain, et al. "Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain." European radiology 30 (2020): 3152-3160. Muthu S, Viswanathan VK, Gangadaran P. Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials. Exp Biol Med (Maywood). 2025 Feb 4;250:10390. doi: 10.3389/ebm.2025.10390. PMID: 39968415; PMCID: PMC11832311. | |||
| Opiates and the role of Gender- For the Boards! | 19 May 2025 | 00:19:53 | |
Summary Dr. David Rosenblum delivered a comprehensive lecture on gender differences in opiate effects and prescribing practices. He discussed several key studies examining how opiates affect males and females differently, both in animal models and humans. Dr. Rosenblum shared findings showing that morphine has stronger analgesic effects in males, while females experience longer-lasting effects. He also addressed racial disparities in opiate prescribing, noting that white patients are more likely to receive opiates. From his personal clinical experience in Brooklyn, Dr. Rosenblum observed that certain populations tend to be at higher risk for opiate abuse. The lecture covered gender-specific risk factors for opiate misuse, with women tending toward emotional/psychological factors and men showing more behavioral issues. Pain Management Board Prep Ultrasound TrainingChapters Introduction and Upcoming Conferences Dr. Rosenblum introduced himself as the host of the Pain Exam Podcast and announced several upcoming conferences including ASPN in July, PainWeek in September, and other events where he will be teaching ultrasound and regenerative medicine. Board Preparation and Opiate TopicsDr. Rosenblum discussed his role in board preparation through painxam.com and nreppain.org. He emphasized that opiates are a frequently tested topic across different board examinations (FIP, ABPM, ABIP, ABA). Gender Differences in Opiate Effects - Animal StudiesDr. Rosenblum presented research showing that in animal studies, morphine exhibited stronger analgesic effects in males, while females showed longer-lasting effects and could tolerate higher doses. He noted that physical dependence was more severe in male rats during spontaneous withdrawal. Racial and Gender Disparities in Opiate PrescribingDr. Rosenblum discussed a 2025 study revealing racial disparities in opiate prescribing, with white patients more likely to receive opiates. He shared his personal clinical experience in Brooklyn, noting that young white males were often higher-risk for abuse. Gender-Specific Risk Factors for Opiate MisuseDr. Rosenblum detailed how women tend to show emotional and psychological risk factors for opiate misuse, while men demonstrate more behavioral risk factors. Women were more likely to report distress and past trauma, while men showed higher rates of criminal behavior and substance abuse history.
References Djurendic-Brenesel, Maja, et al. "Gender-related differences in the pharmacokinetics of opiates." Forensic science international 194.1-3 (2010): 28-33. Kosten, Thomas R., Bruce J. Rounsaville, and Herbert D. Kleber. "Ethnic and gender differences among opiate addicts." International Journal of the Addictions 20.8 (1985): 1143-1162.Cicero, Theodore J., Shawn C. Aylward, and Edward R. Meyer. "Gender differences in the intravenous self-administration of mu opiate agonists." Pharmacology Biochemistry and Behavior 74.3 (2003): 541-549. Jamison, Robert N., et al. "Gender differences in risk factors for aberrant prescription opioid use." The Journal of Pain 11.4 (2010): 312-320.
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| PVD for the Physiatry and Pain Boards | 06 May 2025 | 00:22:08 | |
Podcast Show Notes: Peripheral Vascular Disease in PainManagement Episode Highlights: Download the App Key Topics Covered: 2. Diagnostic Considerations ABI Interpretation: 3. Pain Characteristics 4. Pain Management Strategies Non-Pharmacological Interventions: Upcoming Conferences Mentioned: Additional Resources: Disclaimer: Always consult with a healthcare professional for personalized medical advice. Reference Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi, Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 Maier, J.A.; Andrés, V.; Castiglioni, S.; Giudici, A.; Lau, E.S.; Nemcsik, J.; Seta, F.; Zaninotto, P.; Catalano, M.; Hamburg, N.M. Aging and Vascular Disease: A Multidisciplinary Overview. J. Clin. Med. 2023, 12, 5512. https://doi.org/10.3390/jcm12175512 | |||
| WIll JOURNAVX™ (Suzetrigine) appear on the PM&R Boards? | 17 Apr 2025 | 00:16:42 | |
Summary At some point this medication may show its face on the Physiatry boards. Whether or not Suzetrigine will appear on the Physical Medicine and Rehabilitation boards, all of us need to know about this new class of analgesic. Brought to you by NRAP Academy, home of the PMRExam Board Prep Here, Dr. David Rosenblum delivered a comprehensive lecture about a new pain medication called Journavx (Suzetrigine). He discussed its mechanism of action as a NAV 1.8 receptor inhibitor, its clinical applications, contraindications, and dosing guidelines. Dr. Rosenblum emphasized that this non-opioid medication represents a new class of pain management drugs with no addiction potential. He also shared information about upcoming educational events, including ultrasound courses and various pain management conferences. The lecture included detailed information about drug interactions, safety considerations, and clinical trial results comparing Journavx to placebo and hydrocodone-acetaminophen combinations. Key findings from clinical trials showed that Jornavix achieved pain relief in 119 minutes compared to 480 minutes for placebo in abdominoplasty trials, and 240 minutes versus 480 minutes in bunionectomy trials. The recommended dosing is 50mg tablets twice daily, with an initial loading dose of 100mg. While the drug showed promising results for moderate to severe acute pain management, it did not demonstrate superiority over hydrocodone in clinical trials. Important contraindications include CYP3A inhibitors, and special considerations are needed for patients with hepatic impairment or those taking hormonal contraceptives. The medication should be taken on an empty stomach, either one hour before or two hours after food, and patients should avoid grapefruit juice while on this medication. Chapters Introduction and Upcoming EventsDr. Rosenblum announced several upcoming events, including an ultrasound course in New York City on May 17th, 2025. He mentioned offering ultrasound and IV training for healthcare professionals, particularly nurses, ICUs, PAs, and hospital doctors. He also highlighted upcoming conferences including ASPN, Pain Week, Latin American Pain Society, New York, New Jersey Pain Congress, ASIPP, and EPA. Introduction to Journavx (Suzetrigine)Dr. Rosenblum introduced Suzetrigine (Journavx), a new 50mg tablet medication. He emphasized that this discussion was not sponsored by any pharmaceutical company but rather focused on educating about a new class of pain medication. He noted its potential importance as a future board examination topic. Mechanism of ActionDr. Rosenblum explained that Jornavx works by inhibiting the NAV 1.8 receptor. He detailed how the drug blocks sodium ions from entering pain-sensing neurons, disrupting action potential initiation and propagation. He emphasized that the drug is highly selective, binding over 31,000 times more selectively to NAV 1.8 than other NAV subtypes. Contraindications and Drug InteractionsDr. Rosenblum outlined various contraindications, particularly focusing on CYP3A inhibitors and inducers. He listed specific medications in each category and emphasized the importance of careful monitoring when prescribing Journavx alongside these medications. Clinical Trial Results and Dosing GuidelinesDr. Rosenblum presented clinical trial results showing Journavx's effectiveness in treating moderate to severe acute pain. He detailed the dosing guidelines: 50mg tablets twice daily, with an initial loading dose of 100mg. He emphasized the importance of taking the medication on an empty stomach and avoiding grapefruit juice. Q&ANo Q&A session in this lecture | |||
| Hamed Sadeghipour, MD on Pain: Board Prep, Jobs and more! | 31 Mar 2025 | 00:25:36 | |
Summary The video covers a conversation between Dr. David Rosenblum and Dr. Hamed Sadeghipour, discussing board preparation experiences and the current state of pain management practice. Dr. Rosenblum begins by announcing upcoming events, including a May 17th ultrasound course in New York City and his lectures at various conferences. He also mentions shadowing opportunities at his office. Dr. Sadeghipour shares his board preparation experience, discussing three main resources he used: Huntoon book (800 questions), Board Vitals (700 questions), and Pain Exam. He achieved notably high scores using these resources. Regarding his current practice, Dr. Sadeghipour describes working both in academic anesthesia (40-50% time) and private pain practice, managing four offices with four nurse practitioners. The discussion then shifts to the changing landscape of pain management, with both doctors noting concerning trends: increasing focus on surgery center procedures over office-based ones due to reimbursement differences, the challenge of maintaining competency in advanced procedures, and competition from non-specialists entering the field. They also discuss the future of the specialty, suggesting it's moving toward becoming a hybrid of neurosurgery and orthopedic surgery with traditional pain management procedures.
For pain medicine Board Prep go to NRAPpain.org For ultraound training go to NRAP Academy Highlights Introduction and Upcoming EventsDr. Rosenblum introduces the podcast and announces several upcoming events, including an ultrasound course in New York City on May 17th, appearances at ASPN and Pain Week conferences, and opportunities for shadowing at his practice. Board Preparation Experience DiscussionDr. Sadeghipour details his board preparation strategy using three main resources: Huntoon book (800 questions), Board Vitals (700 questions), and Pain Exam(700 questions videos, lectures, ultrasound training, regenerative medicine training and more). He explains the strengths and limitations of each resource and mentions achieving exceptionally high scores. Current Practice StructureDr. Sadeghipour describes his dual practice model: Evolution of Pain Management PracticeBoth doctors discuss the shifting landscape of pain management, noting increased focus on surgery center procedures, reimbursement challenges, and competition from non-specialists. They address concerns about fellowship training adequacy and the financial pressures affecting new practitioners. Future of Pain Management SpecialtyThe discussion concludes with perspectives on the specialty's future, suggesting it's evolving toward a combination of minimally invasive spine surgery and traditional pain management, with concerns about maintaining specialty integrity and the need for stronger regulatory oversight. | |||
| PRP Q&A plus Ultrasound Guided Cervical Injections- Best Practice? | 12 Mar 2025 | 00:18:15 | |
Dr. Rosenblum Reviews Questions from my previous lecture, he gave at the trigeminal academy in Indonesia. Dr. Rosenblum explores techniques for rich plasma injection and preparation. He discusses centrifuge settings with plasma volume and concentration as well as the addition of hyaluronic acid to platelet rich plasma. Dr. Rosenb;um also received multiple comments on the recent video that he filmed on performing a cervical selective nerve root block under ultrasound. For more informatin go to NRAPpain.org
Disclaimer: This Podcast,video, website and any content from NRAP Academy otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. | |||
| Scrambler Therapy for Chronic Pain: An Interview with Dr. Thomas Strouse | 21 Feb 2025 | 00:36:45 | |
Episode Summary: In this episode of NRAP's PainExam Podcast, host David Rosenblum, MD, interviews Dr. Thomas Strouse about his extensive experience with Scrambler Therapy and the evidence supporting its use in treating chronic pain. They delve into the intricacies of this innovative therapy, discussing treatment protocols, patient responses, and the overall effectiveness of Scrambler Therapy for various pain conditions. Key Topics Discussed: - Overview of Scrambler Therapy and its analgesic response. - The importance of adjusting treatment intensity based on patient feedback. - Sensations experienced by patients during therapy (from burning to tapping). - Safety considerations for patients with pacemakers during treatment. - Insights into the effectiveness of Scrambler Therapy for conditions such as discogenic back pain and peripheral neuropathy. - Discussion on treatment costs for patients and providers. - Experiences with patients who have experienced pain recurrence after treatment. - The role of booster sessions in maintaining pain relief. - Challenges faced by failed back surgery patients and the potential benefits of Scrambler Therapy. Resources Mentioned: - Contact information for Stefan Erickson at stefan@mail.scramblertherapy.com to integrate Scrambler therapy into your practice. Links to additional resources and research on Scrambler Therapy. Info] Additional Information: - For more information about upcoming webinars, including the next session on cervical ultrasound, visit www.NRAPpain.org Thank you for tuning in to NRAP's PainExam Podcast! We hope you find the insights shared in this episode valuable in your journey toward understanding and managing chronic pain. NY based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Creators Biography: David Rosenblum, MD, currently treats patients in Garden City and Brooklyn. He serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn , NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures. Dr. Rosenblum has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is working closely with the American Society of Interventional Pain Physicians (ASIPP), Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, and various state societies, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more! Doctor Rosenblum is a co-founder of the International Pain Academy and created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Office based Pain Physicians, Physiatrists, Emergency Room Physicians, Anesthesiologists, Neurologists and Orthopedics who treat pain, utilize Neuromodulation and use PRP, Bone Marrow Aspirate or any other Biologics will benefit from this course. #longislandpaindoctor #interventionalpain #paindoctor #scrambler #scramblertherapy | |||
| Phillip Kim, MD and the Federation for Pain Care Access | 07 Feb 2025 | 00:32:43 | |
Host: David Rosenblum, MD Guest: Phillip Kim, MD Date: January 24, 2025 Time: 6:30 AM Episode Summary: In this episode of the PainExam Podcast, Dr. David Rosenblum engages with Dr. Phillip Kim to discuss the Federation Pain Care Access, a newly formed organization advocating for improved access to interventional pain treatments. The episode delves into the challenges posed by restrictive insurance coverage policies and the collaborative efforts needed to address these issues effectively. Key Discussion Points: -Introduction to Federation Pain Care Access: A new entity focused on advocating for emergent and standard care in interventional pain treatments, aiming to enhance access through advocacy and legislative solutions. - Impact of Restrictive Policies: Dr. Kim highlights how insurance carriers like Evicor, AIM, and Optum impose restrictive coverage policies that harm patients and practitioners, particularly amid the ongoing opioid epidemic. AIM, Optum and Evicore are not insurance carriers. these are separate entities which oversee utilization management and prior auth requests for insurance carriers (HMO, TPA's etc) e g. BCBS plans, UHS etc. Prior Authorization Challenges: Discussion on the AMA 2022 Prior Authorization Physician Survey, which indicates significant negative impacts on patient care due to prior authorization processes. - Case Studies: Dr. Kim shares specific cases where patients faced harm due to denied claims, including issues related to medical cannabis and necessary medical equipment.
- Collaboration with Medical Societies: The Federation works alongside various pain societies and stakeholders to address common concerns and push for better coverage policies. - Future Goals Plans for meetings with CMS and Medicare Administrative Contractors (MACs) regarding specific treatments like SI joint radiofrequency ablation, aiming to improve coverage and access.
Fundraising and Outreach: The Federation seeks to grow its membership and funding through outreach to allied health professionals and patient care groups while launching a media campaign to raise awareness of patient struggles Legal and Advocacy Efforts: Emphasis on the need for legal considerations in advocacy efforts and the importance of public support in achieving the Federation's goals. - The No Pain Act: Discussion on recent legislation aimed at expanding access to non-opioid treatments and alternatives for chronic pain management. Guest Bio: Phillip Kim, MD is a leading advocate for pain care access and a founding member of the Federation Pain Care Access. He brings extensive experience in managing chronic pain patients and navigating healthcare policies. Resources Federation Pain Care Access Website: # board Listeners are encouraged to support the Federation Pain Care Access by visiting their website to learn more about their initiatives and consider contributing to help advance their mission. Join Dr. Rosenblum and Dr. Kim in this vital conversation about the ongoing efforts to improve pain care access and the importance of collaboration in overcoming the challenges faced by patients and healthcare providers.
Long island based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Garden City Office 516 482 7246 | |||
| Spravato for Depression. A needle-mover for Pain Practices. Sponsored by Big Leap Health | 24 Jan 2025 | 00:35:35 | |
Unlock new, well-reimbursed services: Spravato, a needle-mover for pain practices. Discover how Spravato, an FDA-approved esketamine treatment for depression, can drive significant financial reimbursement for your practice while improving patient outcomes. Join me as I meet with Yakov Kagan, CEO and co-founder of Big Leap Health, as he highlights the clinical efficacy of Spravato, its comparison to ketamine, and its financial impact. Learn key considerations for launching—whether independently or via an MSO—and actionable steps to get started, from staff training to billing essentials. Yakov will also share insights into future developments like monotherapy developments, helping your practice stay ahead in this rapidly evolving field. For more information and to integrate Spravato into your Pain Practice go to https://www.bigleaphealth.com Host David Rosenblum, MD Long island based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Garden City Office 516 482 7246 NRAP Academy also offers:
Regional Anesthesia & Pain Ultrasound Course
Private Training Available Email Info@NRAPpain.org **Disclaimer:** The information presented in this podcast is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional for medical concerns. | |||
| Ketamine: Pain and Cancer. Plus Upcoming Ultrasound, Pain and Practice Management Webinar Series! | 10 Jan 2025 | 00:16:17 | |
Episode Title: Ketamine for Cancer and Pain Management - Journal Club Host: David Rosenblum, MD Upcoming Free Webinars: 2. Understanding Scrambler Therapy 3. Cervical Ultrasound: Anatomy and Interventional Pain Targets Sign up for the webinars and check out our full calendar of events. Join us for this insightful episode as we explore the potential of ketamine in transforming pain management practices! Summary In today's episode, we delve into the emerging role of ketamine in managing cancer and chronic pain. Our discussion is anchored around a comprehensive review article titled "Ketamine Use for Cancer and Chronic Pain Management," published in Frontiers in Pharmacology on February 1, 2021. This review, authored by Clayton Culp, Hee Kee Kim, and Salahadin Abdi, explores ketamine's potential as an analgesic in chronic pain conditions, particularly cancer-related neuropathic pain. Key Points from the Review Article: Reference | |||
| An Interview with Guilherme Ferreira Dos Santos, MD CIPS. Regenerative Pain Medicine and more! | 02 Jan 2025 | 00:33:44 | |
Episode Title: Evidence-Based Regenerative Pain Medicine with Guilherme Ferreira Dos Santos, MD CIPS Host: David Rosenblum Episode Overview:
Key Topics Discussed: - Evidence-Based Regenerative Pain Medicine: An exploration of current research and practices that inform effective pain management strategies. - PRP Quality and Standardization: Discussion on the importance of PRP quality in treatment outcomes and the need for standardized protocols. - Ultrasound-Guided Spine Interventions: Insights into the benefits and techniques of ultrasound guidance in performing spinal interventions, including a conversation on avoiding cervical epidurals. - Access to Pain Care: A comparative analysis of the differences in access to pain care across Portugal, Spain, the USA, and Canada, highlighting challenges and opportunities in each region. - Pain Expo Dubai: An overview of the upcoming Pain Expo in Dubai, where both Dr. Rosenblum and Dr. Ferreira Dos Santos will be presenting, sharing their expertise with a global audience. Guest Biography: Dr. Ferreira dos Santos further advanced his expertise with a Clinical Fellowship in Chronic Pain Medicine at the University of Toronto in 2022, training under esteemed mentors such as Dr. Anuj Bhatia, Dr. Paul Tumber, and Dr. Philip Peng. In this role, he was instrumental in advancing education on ultrasound-guided techniques nationally and internationally, which deepened his clinical skills and passion for mentorship. Currently based in Barcelona, Dr. Ferreira Dos Santos serves as the Senior Specialist and Responsible Clinical Lead for the Education and Training Excellence Center in Pain Medicine at Hospital Clínic de Barcelona. He is also the Director of the Clinical Fellowship Program in Interventional Pain Medicine. Throughout his career, he has lectured at international conferences in over 25 countries and authored more than 35 peer-reviewed Q1 articles. His contributions have earned him several accolades, including the 2018 Grant for Young Clinical Researcher of the Year in Pain Medicine from the Grünenthal Foundation, the 2020 Gofeld Academic Scholarship Award, and the 2022 Nikolai Bogduk Young Investigator Grant. His journey across four countries has shaped his approach to clinical care, research, and mentorship, fueling his mission to improve pain management globally. Listen to the Episode: Links and Resources: Join the Conversation: S ubscribe and Review: Next Episode Preview: | |||
| An Interview with a Naturopathic Pain Physician | 17 Dec 2024 | 00:22:01 | |
Painexam Podcast Episode Show Notes Episode Title: Exploring Naturopathy in Pain Medicine with Dr. Sarah Trahan Host: David Rosenblum, MD Guest: Dr. Sarah Trahan Episode Summary: Key Discussion Points: - ntroduction to Naturopathy: - The Role of Naturopathy in Pain Management: - Regenerative Therapies: - Patient-Centered Care: - Success Stories - NRAP Academy Online Courses and Workshops: Resources Pain Management CME Workshop Calendar Pain Medicine CME Board Prep and Online Courses
Tune in to this insightful conversation to learn more about how naturopathy and regenerative therapies can play a vital role in managing pain and improving patient outcomes.
--- This episode promises to provide valuable insights for healthcare professionals and patients alike, highlighting the importance of a holistic approach to pain management. | |||
| PRP vs BMAC Revisited | 27 Nov 2024 | 00:21:54 | |
PainExam Podcast Show Episode Title: Exploring PRP and BMAC in Pain Managemen Host: David Rosenblum, MD Episode Overview: 1. A Comparison of Functional Outcomes in Rotator Cuff Repairs Using Adjunctive Bone Marrow Aspirate Concentrate vs. Bone Marrow Aspirate Concentrate With Platelet-Rich Plasma: A Systematic Review and Meta-Analysis** 2. Bone Marrow Aspirate Concentrate Versus Platelet-Rich Plasma for Treating Knee Osteoarthritis: A One-Year Non-Randomized Retrospective Comparative Study 3. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis** 4. Platelet-Rich Plasma vs Bone Marrow Aspirate Concentrate: An Overview of Mechanisms of Action and Orthobiologic Synergistic Effects 5. PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers* Key Takeaways: Upcoming Events: Listen to the Episode: Connect with Us: Disclaimer | |||
| Phenol Genicular Nerve Ablations & Optimizing Outcomes- Journal Club | 14 Nov 2024 | 00:18:21 | |
Podcast Show Notes Episode Title: Optimizing Genicular Nerve Chemical Ablation: Insights from Dr. David Rosenblum Episode Summary: In this episode, we are joined by Dr. David Rosenblum, a New York-based interventional pain physician, who discusses optimizing genicular nerve chemical ablation. Dr. Rosenblum shares insights as well as his upcoming ultrasound course schedyke in New York City, focusing on regional anesthesia, interventional pain, and IV ultrasound placement. He emphasizes the significance of ultrasound in enhancing pain management procedures and the latest advancements in the field. For PM&R Board Prep, go to NRAPpain.org Key Topics Discussed:
For Anesthesia Board Prep go to AnesthesiaExam at NRAPpain.org Featured Article:Dr. Rosenblum references an article from The Korean Journal of Pain discussing the optimization of genicular nerve chemical ablation. Key takeaways include:
Dr. David Rosenblum, MD is an interventional pain physician based in New York City. With extensive experience in pain management techniques, Dr. Rosenblum is dedicated to advancing the field through education and innovative practices. He is particularly focused on the integration of ultrasound technology into pain management procedures. Course Information:Dr. Rosenblum's upcoming ultrasound courses are CME supported, monthly hands on workshops to give clinicians experience with ultrasound imaging to identify targets for nerve block joint injection, soft tissue injection and more.. • Monthly IV Ultrasound Course in Manhattan: • Ultrasound Courses: • Presentation Invitation at Pain Expo in Dubai: April 26-27. • • Next LAPS conference in September in Chile. Call to Action:
Upcoming Opportunities and Closing Remarks
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| Multifidus Atrophy, Spinal Stenosis, PNS and PRP Injections! | 25 Oct 2024 | 00:25:04 | |
Exploring the Efficacy of Autologous Platelet Leukocyte Rich Plasma Injections in Chronic Low Back Pain & Understanding Degenerative Lumbar Spinal Stenosis Host David Rosenblum, MD Episode Date: October 25, 2024 In this episode, Dr. David Rosenblum discusses two significant studies related to chronic low back pain and degenerative lumbar conditions. The first study focuses on the use of autologous platelet leukocyte rich plasma (PLRP) injections for treating atrophied lumbar multifidus muscles, while the second study investigates the correlation between muscle atrophy and the severity of degenerative lumbar spinal stenosis (DLSS). Featured Article 1: Key Points Discussed Featured Article 2: Key Points Discussed Discussion: Closing Remarks:
**Follow Us:** NRAP Academy also offers:
Regional Anesthesia & Pain Ultrasound Course
Private Training Available Email Info@NRAPpain.org **Disclaimer:** The information presented in this podcast is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional for medical concerns. References | |||
| Scrambler Therapy for Pain | 09 Oct 2024 | 00:16:40 | |
Dr. Rosenblum reviews the benefits of Scrambler Therapy for CRPS and Neuropathic Pain State.
ST was introduced as a chronic pain relief method in 2003. That same year, Giuseppe Marineo published findings from a small clinical trial involving 11 terminal cancer patients suffering from drug-resistant chronic visceral pain, with all participants showing positive responses and significant reductions in pain scores. In a subsequent trial involving 226 patients with neuropathic pain, 80% reported a 50% reduction in pain. Since then, numerous case reports and studies have documented the use of ST for various pain types. Evidence from these reports suggests that ST is effective for managing both acute and chronic pain from different causes. For instance, a child with acute mixed pain, resistant to pharmacological treatment, experienced significant relief after four ST sessions, with pain levels dropping from 5/10 to 0/10. Additionally, a 52-year-old woman with burning pain from her foot to knee, stemming from a right medullary acute hemorrhage and suffering for 12 years, reported immediate relief after ST. Her pain score decreased from 9/10 to 3/10 on the first day, and to 0/10 by the second day, remaining below 1 on the Visual Analog Scale (VAS) throughout the 10-day treatment period. In terms of chronic pain, literature includes a case where a patient with shoulder joint pain and limited range of motion saw significant pain reduction and increased mobility after 10 sessions of ST. ST has shown considerable promise in treating severe pain conditions that are typically difficult to manage, such as complex regional pain syndrome and pain related to HIV. Despite the encouraging results from these case studies, higher-quality evidence is necessary to establish the efficacy of ST, which could be obtained through extensive clinical trials, particularly focusing on chronic pain. Besides the aforementioned studies by Marineo and Sabato et al, additional trials have indicated that ST is an effective treatment for various chronic pain conditions, including low back pain, postherpetic pain, and neuropathic pain. For instance, a prospective study on chronic low back pain patients showed a significant decrease in VAS scores from 8.12 to 3.63 after six treatment days. Another trial involving 10 patients with postherpetic pain reported a drop in the average Numeric Rating Scale (NRS-11) score from 7.64 to 1.46 at baseline and 0.42 to 0.89 after one month, with benefits persisting at two and three months. ST has also demonstrated significant potential in treating neuropathic pain. In a prospective study of 45 patients with neuropathic pain lasting over three months, 28 experienced a decrease in Douleur Neuropathique en 4 questions (DN4) pain scores, with four patients stopping treatment early due to complete pain resolution. The mean baseline DN4 score dropped from 5.67 to 2.82 by the end of treatment. A pilot randomized trial involving 52 patients found that 21 out of 26 in the intervention group achieved complete pain relief. While the findings from these studies, along with others that have been systematically analyzed, suggest strong evidence for the efficacy of ST, a definitive conclusion regarding its effectiveness has not yet been reached. A systematic review by Majithia et al concluded that while studies generally indicate ST results in pain reduction with lasting benefits, there are still gaps in the evidence. This article aims to evaluate the research needs surrounding ST for cancer pain management. While Majithia et al focused on chronic pain across various conditions and noted specific evidence limitations, this study will concentrate on the effectiveness of ST for cancer-related pain. The objective is to identify gaps in the existing literature and provide recommendations for future research through a systematic review. We will specifically analyze the types and levels of evidence supporting the use of ST in managing cancer pain and determine what studies are necessary to enhance the evidence base. References Majithia, N., Smith, T.J., Coyne, P.J. et al. Scrambler Therapy for the management of chronic pain. Support Care Cancer 24, 2807–2814 (2016). https://doi.org/10.1007/s00520-016-3177-3 Mohamed, Mohamed S. I.1; Alkahlout, Lama1; Elgamal, Salma1; Mohiuddin, Amna1; Al-sayed, Talal1; Al-Marri, Hamad1; Zahid, Fatima1; Martínez-Magallanes, Daniela2; Fregni, Felipe2; Doi, Suhail A. R.1; Abdallah, Abdallah M.3; Musa, Omran A.H.1,4; Khan, Muhammad Naseem1; Babu, Giridhara R.1,*. Efficacy of scrambler therapy in chronic neuropathic pain: pairwise and dose-response meta-analysis. Brain Network and Modulation 3(3):p 63-70, Jul–Sep 2024. | DOI: 10.4103/BNM.BNM_20_24 Kashyap, Komal, and Sushma Bhatnagar. "Evidence for the efficacy of scrambler therapy for cancer pain: a systematic review." Pain Physician 23.4 (2020): 349. | |||
| Hydrogen Therapy for Pain? | 12 Sep 2024 | 00:11:17 | |
PainExam Podcast Episode: An In-Depth Look at Hydrogen-Rich Water for Chronic Inflammatory Pain In a recent episode of the PainExam podcast, Dr. David Rosenblum delves into an intriguing study published in the journal Antioxidants, exploring the therapeutic potential of hydrogen-rich water (HRW) in alleviating chronic inflammatory pain and associated mood disorders in mice. The study, conducted by Santiago Coral-Pérez and colleagues from the Institut d'Investigació Biomèdica Sant Pau and Universitat Autònoma de Barcelona, presents compelling evidence supporting the analgesic, antidepressant, and anxiolytic effects of HRW. Study OverviewThe study investigates the efficacy of HRW in treating nociceptive responses and affective disorders associated with chronic inflammatory pain. Using a mouse model induced by the subplantar injection of complete Freund's adjuvant (CFA), the researchers evaluated the impact of HRW on several parameters:
1. Analgesic Effects:
2. Antidepressant and Anxiolytic Effects:
3. Biochemical Pathways:
Dr. Rosenblum emphasizes the potential of HRW as a novel therapeutic strategy for chronic inflammatory pain and its associated comorbidities. The study's findings suggest that HRW could offer a multifaceted approach, addressing both pain and mood disorders through its antioxidant, anti-inflammatory, and anti-apoptotic properties. ConclusionThe episode concludes with a discussion on the broader implications of these findings for pain management, particularly in conditions where chronic inflammatory pain is prevalent. Dr. Rosenblum highlights the need for further clinical trials to validate these promising preclinical results and explore the potential of HRW in human subjects. For more detailed insights into this study, including potential applications and future research directions, tune into the PainExam podcast with Dr. David Rosenblum. For more information go to: https://molecularhydrogeninstitute.org/links-mhi/ Other Announcements from NRAP Academy:
Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References Coral-Pérez, S., Martínez-Martel, I., Martínez-Serrat, M., Batallé, G., Bai, X., Leite-Panissi, C. R., & Pol, O. (2022). Treatment with hydrogen-rich water improves the nociceptive and anxio-depressive-like behaviors associated with chronic inflammatory pain in mice. Antioxidants, 11(11), 2153. | |||
| Using Ultrasound for Safe and Accurate Platelet Rich Plasma Injections | 20 Aug 2024 | 00:19:13 | |
Dr. Rosenblum serves at AMETD's 2024 Conference as faculty and discusses the safe and accurate usage of Ultrasound to Guide PRP injecitons Knee, Hip, Shoudler, Ligament and Tendon Targets, the ultrasound technique, the evidence for PRP and controversy. Controversy with respect to the Achilles Tendon! Other Announcements from NRAP Academy:
References Disclaimer Disclaimer: This Podcast, website and any content from NRAP Academy (NRAPpain.org) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. | |||
| Corticosteroid Injections in Chronic Pain Management- New Guidelines | 31 Jul 2024 | 00:18:55 | |
Podcast Show Note Summary: Episode Title: "New Guidelines for Corticosteroid Injections in Chronic Pain Management" This podcast is a discussion about the recent review article In this episode, we dive into the recently published guidelines on the use of corticosteroid injections for managing chronic pain, developed by the American Society of Regional Anesthesia and Pain Medicine, along with several other prominent pain societies. These guidelines address the safety and efficacy of corticosteroid injections for sympathetic and peripheral nerve blocks, as well as trigger point injections. Key Discussion Points:
Join us as we explore these comprehensive guidelines and their potential impact on improving chronic pain management practices. Resources:
Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References Disclaimer Disclaimer: This Podcast, website and any content from NRAP Academy (NRAPpain.org) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. | |||
| The Trigeminal Nerve Block for Facial Pain | 19 Jul 2024 | 00:16:59 | |
PainExam Show Notes: Mandibular Division of the Trigeminal Nerve Block with Dr. David Rosenblum Introduction
These show notes provide a comprehensive overview of the discussion, highlighting key points on the anatomy, technique, and clinical considerations for mandibular nerve blocks in cancer patients. Other Announcements from NRAP Academy:
Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References Nicholas A Telischak, Jeremy J Heit, Lucas W Campos, Omar A Choudhri, Huy M Do, Xiang Qian, Fluoroscopic C-Arm and CT-Guided Selective Radiofrequency Ablation for Trigeminal and Glossopharyngeal Facial Pain Syndromes, Pain Medicine, Volume 19, Issue 1, January 2018, Pages 130–141, https://doi.org/10.1093/pm/pnx088 Allam, Abdallah El-Sayed, et al. "Ultrasound‐Guided Intervention for Treatment of Trigeminal Neuralgia: An Updated Review of Anatomy and Techniques." Pain Research and Management 2018.1 (2018): 5480728.
Disclaimer: This Podcast, website and any content from NRAP Academy (NRAPpain.org) otherwise known as Qbazaar.com, LLC is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions. | |||
| Pain Fellowship, Research & Exosomes for Pain Management with Christopher Robinson, MD PhD | 04 Jun 2024 | 00:37:16 | |
Join us on this episode of the PainExam Podcast where rising star, Christopher Robinson, MD PhD discusses his upcoming paper on exosomes featuring some of the largest names in pain managment. Dr. Rosenblum also alludes to degenerative disc disease being a partially infectious podcast. Other topics discussed on this podcast: The Anesthesiology Job Market Pain Management Fellowship Duration of Pain Management Fellowships Should Pain Management be an Independent Residency? Other Announcements from NRAP Academy:
Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! | |||
| The role of L-PRP. Is Degenerative Disc Disease an Infectious Disease? A Journal Club | 20 May 2024 | 00:19:45 | |
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:
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 | |||
| Dry Needling the Iliopsoas Muscle with Therapeutic Stretching in the Treatment of Lumbar Radiculitis | 02 May 2024 | 00:17:09 | |
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:
References Reuben S. Ingber, CMS National Coverage Policy | |||
| Managing Refractory Post Op Shoulder Pain with Radiofrequency Ablation | 17 Apr 2024 | 00:14:36 | |
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:
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| Physicians Lobby Capital Hill for more Transparency and Oversight of Independent Review Organizations | 03 Apr 2024 | 00:29:05 | |
Advocating for Transparency and Oversight in Pain Management Introduction:
Summary of Lobbying Effort:
Importance of Transparency:
Purpose of the Lobbying Effort:
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:
Outro:
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| Rudy Malayil, MD PM&R, Pain, WVSIPP President discusses the Stellate Ganglion Block for Hot Flashes, the Appalachian Regional Spine and Pain Meeting and more! | 28 Feb 2024 | 00:31:45 | |
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 https://wvsipp.com/ Ultrasound Interventional Pain Course Registration https://www.eventbrite.com/e/west-virginia-ultrasound-guided-interventional-pain-workshop-wvsipp-registration-725686175887?aff=oddtdtcreator For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full | |||
| Innovative ways of Managing Hip Pain without Surgery | 08 Feb 2024 | 00:17:21 | |
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:
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. | |||
| Ventricular Infusion and Nanoprobes Identify Cerebrospinal Fluid and Glymphatic Circulation in Human Nerves- Journal Club | 24 Jan 2024 | 00:11:42 | |
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:
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. | |||
| Journal Club- Ultrasound Guided Nerve Blocks for Headaches and Facial Pain | 10 Jan 2024 | 00:21:09 | |
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
Summary of Dr. Trescott's Article and Key Points:
Peripheral Triggers and Plastic Surgery:
Ultrasound Advantages:
Exploring Extracranial Causes:
Conclusion:
NRAP Academy also offers:
Private Ultrasound Training Available Email Info@NRAPpain.org Reference:
Publication Details:
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 | |||
| Phenol Injection to Treat Hip Pain | 27 Dec 2023 | 00:20:36 | |
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 https://www.eventbrite.com/cc/ultrasound-guided-regional-anesthesia-pain-med-351559?utm-campaign=social&utm-content=creatorshare&utm-medium=discovery&utm-term=odclsxcollection&utm-source=cp&aff=escb For our Live Course Calendar, https://www.eventbrite.com/cc/ultrasound-guided-regional-anesthesia-pain-med-351559?utm-campaign=social&utm-content=creatorshare&utm-medium=discovery&utm-term=odclsxcollection&utm-source=cp&aff=escb Board Prep for PM&R, Pain and Anesthesiology Boards https://www.nrappain.org 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 | |||
| Traumeel Epidural? The FDA, Spine applications and more about this Homeopathic treatment | 11 Dec 2023 | 00:20:54 | |
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/HoEWFdBoard Prep and Continuing Education
Introduction:
Understanding Traumeel:
Scientific Insights:
Clinical Applications:
Research Gaps and Potential:
Pain Management Board Prep Clinical Cases:
Conclusion:
Disclaimer:
David Rosenblum, MD | |||
| The Iliohypogastric Nerve Entrapment Syndrome | 27 Nov 2023 | 00:12:24 | |
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 | |||
| Hydroxyapatite Deposition Disease and Joint Pain | 13 Nov 2023 | 00:14:01 | |
Hydroxyapatite Deposition Disease Dr. Rosenblum discusses shoulder pain, and the pathophysiology of Hydroxyapatite Deposition Disease. He discusses personal experience with infraspinatous tendon tear, and treatments such as NSAIDs, Lidocaine patch and steroid injections of the infraspinatous tendon. Dr. Rosenblum discusses his experience with a failed suprascapular nerve block as well as evidence to support PRP injections and ethical safe care. Dr. Rosenbum also is the NRAP Academy Course director for Ultrasound, Regenerative Pain Medicine and Regional Anesthesia CME Workshops and developed online PainExam, AnesthesiaExam and PMRExam Board Reviews Pain Management Board Review Upcoming Workshops and Eventshttps://www.eventbrite.com/e/nyc-regional-anesthesia-and-pain-ultrasound-cme-workshop-registration-756302841157?aff=oddtdtcreator 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! References
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| Shoulder Articular Branch Radiofrequency Ablation | 25 Oct 2023 | 00:10:39 | |
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 | |||
| Peptides: A Brief Overview | 12 Oct 2023 | 00:15:57 | |
Dr. Rosenblum explores Peptides, the various types, usess and applications for health and wellness. Upcoming Pain Management Conferences
Upcoming Workshops and Events
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
For up to date Calendar, Click Here! References https://healthgains.com/wellness/peptide-therapy/#Selank https://www.nature.com/articles/s41392-022-00904-4
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| Genicular and Peripheral Nerve Reimubursement Issues, ASPN Pain Board Prep Webinar Oct 4! | 28 Sep 2023 | 00:08:11 | |
Dr. Rosenblum discusses his concerns over: RFA of the Genicular Nerves being a non reimbursed service when the patient already had them in the past with excellent relief. Plus a discussion on CMS policy toward Peripheral Nerve Block reimbursement limitations and documentation! Pain Management, Anesthesiology, PMR Board Review Upcoming Workshops and Events
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
For up to date Calendar, Click Here!
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| The 2024 Physician Fee Schedule: Maximizing Physician Profit | 26 Sep 2023 | 00:37:44 | |
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
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| Pain after Hip Replacement and PNS | 24 Aug 2023 | 00:18:36 | |
Dr. Rosenblum discusses posterior hip pain/buttock pain near scar after Total Hip Arthroplasty. Included in this episode:
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! 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/ | |||
| Neck Pain and Cervical Plexus Blocks | 12 Aug 2023 | 00:14:06 | |
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 :
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! | |||
| Reda Tolba, MD International Society of Pain & Neuroscience Chair- Dubai 2023 | 03 Aug 2023 | 00:29:10 | |
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! | |||
| Passive Income for Physiatrists | 11 Jul 2023 | 00:15:57 | |
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!
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