Hydroxyapatite Deposition Disease and Joint Pain

The PMRExam Podcast

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تمت الإضافة منذ قبل three أعوام

المحتوى المقدم من David Rosenblum, MD, David Rosenblum, and MD. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرة بواسطة David Rosenblum, MD, David Rosenblum, and MD أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.

1
The So What from BCG

إلغاء الاشتراك

منذ 4 أياممنذ 4d ago

إلغاء الاشتراك

شهريا+

This podcast from Boston Consulting Group looks around the corner of today’s big business and social issues. The goal–the so what–is to make sense of today and prepare busy leaders and executives for the day after tomorrow. Award-winning British journalist Georgie Frost interviews the leading thinkers and doers at BCG on the trends, developments, and ideas that will shape and disrupt the future. This is not your typical business strategy podcast.

منذ عام واحد 14:01

MP4•منزل الحلقة

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 Events 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

Valerio Sansone, Emanuele Maiorano, Alessandro Galluzzo & Valerio Pascale (2018) Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment, Orthopedic Research and Reviews, 10:, 63-72, DOI: 10.2147/ORR.S138225 Seijas R, Ares O, Alvarez P, Cusco X, Garcia-Balletbo M, Cugat R. Platelet-Rich Plasma for Calcific Tendinitis of the Shoulder: A Case Report. Journal of Orthopaedic Surgery. 2012;20(1):126-130. doi:10.1177/230949901202000128 Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel). 2023 Aug 15;13(16):2678. doi: 10.3390/diagnostics13162678. PMID: 37627938; PMCID: PMC10453434.

99 حلقات

#Fitness #Higher Education #Medicine #David Rosenblum #Physiatry #Physicalmedicineandrehabilitation #Pmrboards #Rehabilitation #Sportsmedicine #Podcasting Education #David Rosenblum MD #Physics #PMR

Hydroxyapatite Deposition Disease and Joint Pain

The PMRExam Podcast

published منذ عام واحد

MP4•منزل الحلقة

For up to date Calendar, Click Here!

References

Valerio Sansone, Emanuele Maiorano, Alessandro Galluzzo & Valerio Pascale (2018) Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment, Orthopedic Research and Reviews, 10:, 63-72, DOI: 10.2147/ORR.S138225 Seijas R, Ares O, Alvarez P, Cusco X, Garcia-Balletbo M, Cugat R. Platelet-Rich Plasma for Calcific Tendinitis of the Shoulder: A Case Report. Journal of Orthopaedic Surgery. 2012;20(1):126-130. doi:10.1177/230949901202000128 Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel). 2023 Aug 15;13(16):2678. doi: 10.3390/diagnostics13162678. PMID: 37627938; PMCID: PMC10453434.

99 حلقات

#Fitness #Higher Education #Medicine #David Rosenblum #Physiatry #Physicalmedicineandrehabilitation #Pmrboards #Rehabilitation #Sportsmedicine #Podcasting Education #David Rosenblum MD #Physics #PMR

كل الحلقات

The PMRExam Podcast

1
Scrambler Therapy for Chronic Pain: An Interview with Dr. Thomas Strouse 36:45

منذ 9 أيام36:45

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…

The PMRExam Podcast

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Phillip Kim, MD and the Federation for Pain Care Access 32:43

منذ 23 يومًا32:43

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: https://www.painfed.org # 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…

The PMRExam Podcast

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Spravato for Depression. A needle-mover for Pain Practices. Sponsored by Big Leap Health 35:35

منذ 5 weeks35:35

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: Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops) 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.…

The PMRExam Podcast

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Ketamine: Pain and Cancer. Plus Upcoming Ultrasound, Pain and Practice Management Webinar Series! 16:17

منذ 7 weeks16:17

16:17

Episode Title: Ketamine for Cancer and Pain Management - Journal Club Host: David Rosenblum, MD Upcoming Free Webinars: 1. Exploring Innovative Mental Health Treatments which are well reimbursed Discussing Spravato, Transmagnetic Stimulation, and Ketamine Infusion, sponsored by Big Leap Health. Register! 2. Understanding Scrambler Therapy Learn about this revolutionary approach to pain management. Register! 3. Cervical Ultrasound: Anatomy and Interventional Pain Targets Sponsored by Clarius, this session will explore advanced imaging techniques. Register! Sign up for the webinars and check out our f ull 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: - Mechanism of Action: Ketamine functions as an N-methyl-D-aspartate receptor antagonist, providing analgesic effects at sub-anesthetic doses. Its ability to counteract central nervous system sensitization makes it effective in opioid-induced hyperalgesia. - Clinical Efficacy: Recent studies highlight ketamine's potential to reduce pain scores and opioid consumption, offering a promising alternative for patients with refractory pain. - Safety Profile: At lower doses used for analgesia, ketamine's safety and adverse event profile are significantly improved compared to its use as an anesthetic. - Pharmacogenomics and Interactions: The article discusses how genetic variations can affect ketamine metabolism and highlights potential drug interactions that clinicians should be aware of. Reference Culp, Clayton, Hee Kee Kim, and Salahadin Abdi. "Ketamine use for cancer and chronic pain management." Frontiers in Pharmacology 11 (2021): 599721.…

The PMRExam Podcast

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An Interview with Guilherme Ferreira Dos Santos, MD CIPS. Regenerative Pain Medicine and more! 33:44

منذ 8 weeks33:44

33:44

Episode Title: Evidence-Based Regenerative Pain Medicine with Guilherme Ferreira Dos Santos, MD CIPS Host: David Rosenblum Guest: Guilherme Ferreira Dos Santos, MD CIPS Episode Overview: In this insightful episode of the PainExam Podcast, Dr. David Rosenblum sits down with Dr. Guilherme Ferreira Dos Santos, a distinguished expert in pain medicine who is well known for his research, educational endeavors and expertise in Regenerative Pain Medicine and Ultrasound-Guided interventions. Together, they delve into the evolving landscape of regenerative pain medicine, focusing on evidence-based practices and the standardization of Platelet-Rich Plasma (PRP) quality. 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. Guilherme Ferreira Dos Santos is an Interventional Pain Medicine Specialist and Clinical Scientist with a career spanning Portugal, the United States, Canada, and Spain. He began his journey at the University of Lisbon, earning his Medical Degree in 2014, followed by a five-year residency program in Physical Medicine and Rehabilitation, which he completed in 2020. His fascination with Interventional Pain Medicine led him to the Department of Pain Medicine at Mayo Clinic, where he served as an Invited Clinical Research Scholar in 2018 and 2021 under the mentorship of Dr. Mark Friedrich Hurdle. At Mayo Clinic, he contributed to refining ultrasound-guided techniques for chronic spinal pain. 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: Tune in to gain valuable insights from Dr. Ferreira Dos Santos and learn more about the future of pain medicine. Available on all major podcast platforms. Links and Resources: - NRAP Academy - Follow Dr. David Rosenblum on X and LinkedIn - Follow Dr. Guilherme Ferreira Dos Santos on LinkedIn Join the Conversation: We encourage our listeners to reach out with their thoughts and questions! Use the hashtag #PainExamPodcast on social media to engage with us. S ubscribe and Review: If you enjoyed this episode, please subscribe and leave a review on your favorite podcast platform. Your feedback helps us improve and reach more listeners! Next Episode Preview: Stay tuned for our next episode, where we will continue to explore the latest advancements in pain management and treatment options.…

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An Interview with a Naturopathic Pain Physician 22:01

منذ 11 weeks22:01

22:01

Painexam Podcast Episode Show Notes Episode Title: Exploring Naturopathy in Pain Medicine with Dr. Sarah Trahan Host: David Rosenblum, MD David Rosenblum is a dedicated pain management specialist with extensive experience in treating chronic pain conditions. He is passionate about integrating various approaches to improve patient outcomes and enhance quality of life. His expertise and commitment to patient-centered care make him a trusted voice in the field of pain medicine. His NY Practice is located in Brooklyn and Garden City and through his international educaitonal platform he has attracted physicians and pateints from all over the world to seek out consultation on the latest breakthroughs in interventional pain management. Guest: Dr. Sarah Trahan Dr. Sarah Trahan is a licensed naturopathic physician with a focus on holistic approaches to pain management and regenerative therapies. With a background in both conventional and alternative medicine, Dr. Trahan is committed to empowering patients through education and personalized treatment plans that address the root causes of pain. Episode Summary: In this episode, David Rosenblum, MD, interviews Dr. Sarah Trahan to explore the role of naturopathy in pain medicine and the potential of regenerative therapies. Dr. Trahan shares her insights on how naturopathic principles can complement traditional pain management approaches, offering a comprehensive view of patient care. Key Discussion Points: - ntroduction to Naturopathy: Dr. Trahan explains the philosophy of naturopathic medicine and its emphasis on treating the whole person rather than just symptoms. - The Role of Naturopathy in Pain Management: The conversation delves into how naturopathy can be integrated into pain management strategies, including dietary changes, lifestyle modifications, and natural supplements. - Regenerative Therapies: Dr. Trahan discusses the latest advancements in regenerative therapies, focusing on how these approaches can be applied in the context of pain management without delving into stem cell treatments. - Patient-Centered Care: Emphasizing the importance of a collaborative approach, Dr. Trahan shares strategies for working with patients to develop tailored treatment plans that align with their individual needs and preferences. - Success Stories Dr. Trahan recounts some of her most impactful approaches and success stories, illustrating the benefits of combining naturopathic and conventional approaches to pain relief. - NRAP Academy Online Courses and Workshops: Dr. Trahan highlights the educational opportunities available through the NRAP Academy, which offers online courses and workshops aimed at healthcare professionals interested in enhancing their understanding of naturopathic principles in pain management. Private ultrasound training is also available for those seeking hands-on experience. For more information, visit NRAPpain.org 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. Stay connected with Painexam for more episodes on pain management and treatment innovations. Don't forget to subscribe and leave a review! For questions or feedback, reach out to us at info@nrappain.org --- This episode promises to provide valuable insights for healthcare professionals and patients alike, highlighting the importance of a holistic approach to pain management.…

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PRP vs BMAC Revisited 21:54

منذ 14 weeks21:54

21:54

PainExam Podcast Show Episode Title: Exploring PRP and BMAC in Pain Managemen Host: David Rosenblum, MD Release Date: November 27, 2024 Episode Overview: In this episode of the PainExam Podcast, Dr. David Rosenblum, a New York-based pain physician, examines the latest research surrounding Platelet-Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) in pain management for the knee, shoulder, and spine. Dr. Rosenblum reviews several key studies, providing insights into the efficacy of these regenerative treatments and their implications for clinical practice. Featured Studies: 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** - Authors: Seth J. Spicer, Sara Soliman, Robert Malek, Mitchell Kaplan, Jensen Clark, Nicholas Averell, Brandon Goodwin, Richard Jermyn - Published in: Cureus. 2024 Aug 23;16(8):e67594. doi: 10.7759/cureus.67594 - Summary: This systematic review evaluates the outcomes of rotator cuff repairs (RCR) using BMAC alone versus BMAC combined with PRP. The analysis included three studies and found no significant difference in functional outcomes between the two groups, suggesting that BMAC alone may be adequate, potentially reducing costs and resource use. 2. Bone Marrow Aspirate Concentrate Versus Platelet-Rich Plasma for Treating Knee Osteoarthritis: A One-Year Non-Randomized Retrospective Comparative Study - Authors: Abed El-Hakim El-Kadiry, Carlos Lumbao, Natasha Salame, Moutih Rafei, Riam Shammaa - Published in: BMC Musculoskeletal Disorders, 2022. - Summary: This study compared the effectiveness of intra-articular BMAC and PRP injections in patients with knee osteoarthritis (OA). Results indicated that patients receiving BMAC experienced significant improvements in pain and functionality scores over 12 months, while the PRP group showed nonsignificant improvements. BMAC was found to be more effective than PRP in managing knee OA symptoms. 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** - Authors: John W. Belk, Joseph J. Lim, Carson Keeter, Patrick C. McCulloch, Darby A. Houck, Eric C. McCarty, Rachel M. Frank, Matthew J. Kraeutler - Published in: World Journal of Stem Cells, 2021. - Summary: This systematic review assessed the efficacy of PRP and BMAC compared to hyaluronic acid (HA) injections for knee OA. The findings demonstrated that both PRP and BMAC led to significantly better patient-reported outcomes (PROs) compared to HA, with no significant differences between PRP and BMAC in terms of effectiveness. 4. Platelet-Rich Plasma vs Bone Marrow Aspirate Concentrate: An Overview of Mechanisms of Action and Orthobiologic Synergistic Effects - Authors: José Fábio Santos Duarte Lana, Lucas Furtado da Fonseca, Rafael da Rocha Macedo, Tomas Mosaner, William Murrell, Ashok Kumar, Joseph Purita, Marco Antonio Percope de Andrade - Published in: World Journal of Stem Cells, 2021. - **Summary:** This overview discusses the mechanisms of action for PRP and BMAC and their potential synergistic effects in musculoskeletal healing. The authors highlight that while both therapies show promise, further research is needed to standardize treatment protocols and fully understand their combined effects on healing processes. 5. PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers* - Authors: Fabio S. M. Yamaguchi, Shahin Shams, Eduardo A. Silva, Roberta S. Stilhano - Published in:** International Journal of Molecular Sciences, 2019. - Summary: This review focuses on the use of biomaterial carriers in conjunction with PRP and BMAC to enhance regenerative processes for musculoskeletal injuries. The authors emphasize the growing interest in these therapies as alternatives for treating cartilage, muscle, and bone injuries, and discuss the various biomaterials used in clinical trials. Key Takeaways: - The efficacy of BMAC compared to PRP in various orthopedic applications. - Insights into the mechanisms of action and potential synergistic effects of PRP and BMAC. - The importance of research in optimizing treatment protocols for knee osteoarthritis and other musculoskeletal conditions. Upcoming Events: Visit NRAPpain.org to learn about the virtual pain fellowship and other educational resources. Additionally, check out our live courses designed for healthcare professionals looking to enhance their skills in pain management and regenerative therapies. Listen to the Episode: Join Dr. Rosenblum as he provides expert analysis on these studies and discusses the implications for pain management and regenerative medicine. Connect with Us: For more information, resources, and to access past episodes, visit our website or follow us on social media. Your feedback and questions are always welcome! Disclaimer The content of this podcast is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for any medical concerns.…

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Phenol Genicular Nerve Ablations & Optimizing Outcomes- Journal Club 18:21

منذ 15 weeks18:21

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: Overview of Dr. Rosenblum's upcoming ultrasound courses in NYC, including regional anesthesia and IV ultrasound placement. More information can be found here or at NRAPpain.org. The role of ultrasound in interventional pain management, specifically in optimizing genicular nerve chemical ablation. Discussion on the recent study comparing genicular nerve phenol neurolysis and radiofrequency ablation. Importance of updating anatomical targets for pain management. Recommendations for expanding the number of targets in pain interventions. Insights on the safety and efficacy of chemical neurolysis versus radiofrequency procedures. Challenges and considerations in performing neurolytic blocks. Future directions in personalized treatment for chronic pain patients. 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: The evolution of anatomical understanding related to genicular nerves. The recommendation to consider multiple targets for pain management instead of the traditional three. The need for careful patient examination to map pain effectively before intervention. Discussion on Knee Pain Management • ArticlebyAndresRochaRomero: • Discussion on knee pain targeting genicular nerve ablation. • Co-authored by Tony Ng and King K Stanley Lam. • Published in Korean Journal of Pain. • Highlights differences in pain management practices outside the U.S. Other Points on Genicular Nerve Chemical Ablation discussed Phenol ablation being used more internationally vs. radiofrequency ablations. Considerations for more extensive targeting of genicular nerves: • Importance of the median branch of the nerve to the vastus intermedius. • Expansion of targeting to include 6 nerves, not just 3. • Anatomical variations require different approaches. Recommendations and Observations • Importance of considering patient-specific anatomy and pain. • Repeat procedures and rehabilitation: • Concerns about bio intensity and fascia integrity. • Emphasizes muscle strengthening exercises to support knee. • CRPS Considerations: • Elderly patients may develop CRPS post-knee replacement. • Importance of lumbar sympathetic block in diagnosis and treatment. Host Bio: 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: • Ideal for nurses, PAs, anesthesiologists, ER docs. • Provides practice with phantoms, short lecture on IV ultrasound. • Offers CME credits. • Ultrasound Courses: • Held one Saturday a month, mostly in New York, but travels if needed. • Upcoming dates: December 21st, January 11th in Manhattan. • Presentation Invitation at Pain Expo in Dubai: April 26-27. • • Next LAPS conference in September in Chile. Call to Action: Subscribe to our podcast for more episodes on advancements in pain management. Follow us on social media for updates on upcoming courses and events. Share this episode with colleagues who may benefit from learning about ultrasound techniques in pain management. Upcoming Opportunities and Closing Remarks Dr. Rosenblum encourages attending his ultrasound courses and conferences. Mention of upcoming conferences in ASPN inMiami, Pain Expo in Dubai, and LAPS inChile. Recommendations to subscribe to newsletters for updates and free info. The podcast aims to support pain management professionals.…

The PMRExam Podcast

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Multifidus Atrophy, Spinal Stenosis, PNS and PRP Injections! 25:04

منذ 18 weeks25:04

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: - Effect of Autologous Platelet Leukocyte Rich Plasma Injections on Atrophied Lumbar Multifidus Muscle in Low Back Pain Patients with Monosegmental Degenerative Disc Disease - **Authors:** Mohamed Hussein, Tamer Hussein Key Points Discussed 1. Background: Correlation between lumbar multifidus muscle dysfunction and chronic low back pain. 2. Study Overview: 115 patients treated with weekly PLRP injections for six weeks, followed for 24 months. 3. Outcome Measures: Significant improvements in NRS and ODI scores, with high patient satisfaction. 4. Conclusions: PLRP injections into the atrophied multifidus muscle are safe and effective for managing chronic low back pain. Featured Article 2: - Degenerative Lumbar Spinal Stenosis Authors:* Gen Xia, Xueru Li, Yanbing Shang, Bin Fu, Feng Jiang, Huan Liu, Yongdong Qiao Key Points Discussed 1. Background: DLSS is a common condition in older adults, often leading to muscle atrophy and disability. 2. Study Overview: A retrospective analysis involving 232 patients to investigate the correlation between muscle atrophy and spinal stenosis severity. 3. Results: - Significant differences in the ratio of fat-free multifidus muscle cross-sectional area between stenotic and non-stenotic segments. - A strong positive correlation was found between multifidus atrophy and the severity of spinal stenosis. - The atrophy was more pronounced on symptomatic sides of the spine compared to contralateral sides. 4. Conclusions: The findings suggest that more severe spinal stenosis is associated with greater muscle atrophy, emphasizing the importance of addressing muscle health in DLSS patients. Discussion: Dr. Rosenblum provides insights into how these studies inform clinical practices for treating chronic low back pain and managing degenerative conditions. He emphasizes the need for comprehensive treatment strategies that consider both muscle health and spinal integrity which may be achieved via peripheral nerve stimulation of the medial branch nerve and multifidus muscle or PRP injection in to the multifidus muscle. Closing Remarks: Listeners are encouraged to stay informed about innovative treatment options and the importance of muscle assessment in managing spinal disorders. **Follow Us:** - Subscribe to the Painexam Podcast for more episodes discussing the latest in pain management research and treatments. - Connect with us on social media [insert social media links]. NRAP Academy also offers: Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops) 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 Xia, G., Li, X., Shang, Y. et al. Correlation between severity of spinal stenosis and multifidus atrophy in degenerative lumbar spinal stenosis. BMC Musculoskelet Disord 22, 536 (2021). https://doi.org/10.1186/s12891-021-04411-5 Hussein M, Hussein T. Effect of autologous platelet leukocyte rich plasma injections on atrophied lumbar multifidus muscle in low back pain patients with monosegmental degenerative disc disease. SICOT J. 2016 Mar 22;2:12. doi: 10.1051/sicotj/2016002. PMID: 27163101; PMCID: PMC4849261.…

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Scrambler Therapy for Pain 16:40

منذ 21 weeks16:40

16:40

Dr. Rosenblum reviews the benefits of Scrambler Therapy for CRPS and Neuropathic Pain State. What is Scrambler Therapy? Efficacy of Scrambler Therapy for Neuropathic Pain Mechanism of action of Scrambler Therapy Regenerative Pain Management Course PainExam Board Prep NRAP Academy Private Tutorials for Ultrasound Guidance and Regenerative Medicine 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.…

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Hydrogen Therapy for Pain? 11:17

منذ 24 weeks11:17

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 Overview The 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: Nociceptive Responses: Mechanical allodynia and thermal hyperalgesia. Affective Disorders: Depressive-like behaviors (measured by Tail Suspension Test and Forced Swimming Test) and anxiety-like behaviors (assessed using Elevated Plus Maze and Open Field tests). Biomarker Analysis: Levels of oxidative stress, inflammatory, and apoptotic markers in the paws and amygdala. Key Findings 1. Analgesic Effects: Mechanical Allodynia and Thermal Hyperalgesia: The study found that both intraperitoneal and subplantar administration of HRW significantly reduced mechanical allodynia and thermal hyperalgesia in CFA-injected mice. Remarkably, the local (subplantar) administration showed greater effectiveness, achieving complete inhibition of nociceptive responses with just one day of treatment. 2. Antidepressant and Anxiolytic Effects: Depressive-like Behaviors: HRW treatment normalized the increased immobility times in both the Tail Suspension Test and Forced Swimming Test, indicating potent antidepressant properties. Anxiety-like Behaviors: HRW also reversed the anxiety-like behaviors in the Elevated Plus Maze and Open Field tests, showcasing its anxiolytic effects without impairing motor function. 3. Biochemical Pathways: The study highlighted the significant role of the Nrf2/HO-1-NQO1 pathway in mediating the analgesic effects of HRW. Inhibitors targeting this pathway reversed the pain-relieving actions of HRW, underscoring its pivotal role. Oxidative Stress and Inflammation: HRW treatment reduced the expression of oxidative (4-HNE), inflammatory (p-IKBα), and apoptotic (BAX) markers in both the paw and amygdala tissues, demonstrating its broad-spectrum protective effects. Implications for Clinical Practice 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. Conclusion The 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 : PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References 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.…

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Using Ultrasound for Safe and Accurate Platelet Rich Plasma Injections 19:13

منذ 28 weeks19:13

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 Discussed in this lecure: 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 : PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://rapm.bmj.com/content/rapm/early/2024/07/16/rapm-2024-105593.full.pdf 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.…

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Corticosteroid Injections in Chronic Pain Management- New Guidelines 18:55

منذ 31 weeks18:55

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 Use of corticosteroids for adult chronic pain interventions: sympathetic and peripheral nerve blocks, trigger point injections - guidelines from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, the American Society of Interventional Pain Physicians, the International Pain and Spine Intervention Society, and the North American Spine Society 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: Background and Need for Guidelines: Overview of potential adverse events from corticosteroid injections, such as increased blood glucose levels, decreased bone mineral density, and suppression of the hypothalamic–pituitary axis. Importance of using lower doses of corticosteroids, which studies have found to be just as effective as higher doses. Development of the Guidelines: The guidelines were approved by multiple pain societies and structured into three categories: sympathetic and peripheral nerve blocks, joint injections, and neuraxial injections. Extensive literature review and consensus-building through a modified Delphi process. Key Recommendations: The addition of corticosteroids to local anesthetics is recommended for certain nerve blocks, such as the greater occipital nerve block for cluster headaches and ilioinguinal/iliohypogastric nerve blocks for post-herniorrhaphy pain. Corticosteroid addition is not recommended for sympathetic nerve blocks, greater occipital nerve blocks for migraines, and pudendal nerve blocks for pudendal neuralgia. Imaging guidance (ultrasound or fluoroscopy) improves the safety and accuracy of certain procedures. Efficacy and Safety: Detailed analysis of various studies on the effectiveness of corticosteroid injections for different types of chronic pain. Discussion on the minimal benefit of corticosteroids in trigger point injections and the potential risks associated with their use. Clinical Implications: https://form.jotform.com/240446610837052 How these guidelines can assist clinicians in making informed decisions regarding corticosteroid use in chronic pain management. Emphasis on the need for personalized treatment plans based on individual patient characteristics and clinical data. Future Directions: Identification of gaps in the current research and the need for well-designed studies to further assess the benefits and risks of corticosteroid injections. Join us as we explore these comprehensive guidelines and their potential impact on improving chronic pain management practices. Resources: Link to the full guidelines: Journal Online Other Announcements from NRAP Academy : PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://rapm.bmj.com/content/rapm/early/2024/07/16/rapm-2024-105593.full.pdf 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.…

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The Trigeminal Nerve Block for Facial Pain 16:59

منذ 32 weeks16:59

16:59

PainExam Show Notes: Mandibular Division of the Trigeminal Nerve Block with Dr. David Rosenblum Introduction Host: Dr. David Rosenblum Topic: Mandibular Division of the Trigeminal Nerve Block for Cancer Pain Management Techniques: Ultrasound and Fluoroscopic Guidance Overview Purpose: Alleviate chronic facial pain, specifically in cancer patients suffering from trigeminal neuralgia or other related conditions. Focus: Detailed discussion on the anatomy, clinical presentation, and procedural techniques for effective nerve block. Anatomy of the Mandibular Nerve Origin: Mandibular nerve is a branch of the trigeminal nerve (cranial nerve V). Pathway: Exits the middle cranial fossa through the foramen ovale and descends between the lateral and medial pterygoid muscles. Sensory Innervation: Anterior two-thirds of the tongue Teeth and mucosa of the mandible Skin of the chin and lower lip Skin over the mandible (excluding the mandibular angle) Tragus and anterior part of the ear Posterior part of the temporalis muscle up to the scalp Ultrasound-Guided Technique Patient Positioning: Patient lies on their side with the affected side facing upward. Transducer Selection: Curvilinear transducer preferred for deeper structures. Transducer Placement: Place distal and parallel to the zygomatic arch to bridge the coronoid and condylar processes. Anatomical Landmarks: Identify the lateral pterygoid muscle and plate. Use power Doppler to locate the sphenoid palatine artery. Needle Trajectory: Introduce the needle using an out-of-plane approach to target the pterygopalatine fossa (anterior to the lateral pterygoid plate). For the mandibular nerve block, target the area posterior to the lateral pterygoid plate between the medial and lateral pterygoid muscles. Electrostimulation (Optional): Utilize a 22G, 10 cm insulated short beveled needle connected to a peripheral nerve simulator. Position confirmed by motor response from the temporalis and masseter muscles. Fluoroscopic-Guided Technique Patient Positioning: Similar to ultrasound guidance, patient lies on their side with the affected side facing upward. C-arm Positioning: Position the C-arm to visualize the foramen ovale. Needle Insertion: Insert the needle under fluoroscopic guidance towards the foramen ovale. Contrast Injection: Confirm needle placement with contrast injection. Anesthetic Administration: Administer local anesthetic and/or neurolytic agents. Clinical Symptoms and Diagnosis Symptoms: Unilateral sharp, stabbing, or burning pain in the mandibular nerve distribution. Pain triggered by activities such as eating, talking, washing the face, or cleaning the teeth. Diagnostic Imaging: MRI or CT scans to identify causes like vascular compression, mass lesions, or fractures. Complications and Considerations Potential Complications: Bleeding, hematoma, infection, and hypersensitivity reaction to the injectate. Serious complications from neurolytic agents like permanent sensory deficit and tissue necrosis. Alternative Treatments: PNS? Radiofrequency or cryoablation for recalcitrant cases. Conclusion Efficacy: Ultrasound and fluoroscopic guidance provide precise targeting of the affected nerves, minimizing collateral damage. Safety: Routine use of power Doppler imaging to avoid injury to surrounding vessels. Recommendation: Consider these techniques for patients unresponsive to oral medications or unsuitable for surgery. 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 : PainExam App is ready for iphone Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References 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.…

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Pain Fellowship, Research & Exosomes for Pain Management with Christopher Robinson, MD PhD 37:16

منذ 39 weeks37:16

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 : PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here!…

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