🎙️ PainExam Podcast Show Notes Phantom Limb Pain & Sacroiliac Joint Dysfunction — High-Yield Pain Board Review 🔥 Episode Overview

In this episode of the PainExam Podcast, David Rosenblum delivers a high-yield review of two must-know topics for the ABA Pain Medicine Board Certification exam:

• Phantom Limb Pain — mechanisms, risk factors, and advanced treatment strategies
• Sacroiliac (SI) Joint Dysfunction — diagnosis, provocative testing, and interventional management

Whether you're preparing for the ABA, ABPM, ABIPP, or FIPP boards, or looking to sharpen your clinical practice, this episode focuses on testable concepts, real-world applications, and interventional pearls.

👉 Explore full board prep and CME: PainExam.com

🧠 Topic 1: Phantom Limb Pain — Key Points

Phantom limb pain is a neuropathic pain syndrome following amputation, driven by both peripheral and central mechanisms.

High-Yield Pearls

• Caused by cortical reorganization + central sensitization
• Strongly associated with pre-amputation pain
• Distinct from:
  • Phantom sensation (non-painful)
  • Stump pain (localized)

Clinical Features

• Burning, cramping, or electric pain
• Perceived in the missing limb
• May be triggered by stress or environmental factors

Treatment Strategies

• First-line: gabapentinoids, TCAs
• Advanced: ketamine, neuromodulation
• Key non-pharmacologic therapy: mirror therapy

🚨 Board Pearl

Preemptive analgesia reduces the risk of phantom limb pain

🦴 Topic 2: Sacroiliac Joint Dysfunction — Key Points

SI joint dysfunction is a major cause of axial low back pain, accounting for up to 25% of cases.

High-Yield Pearls

• Pain is typically:
  • Unilateral
  • Buttock-dominant
  • Radiates to posterior thigh (rarely below knee)

Physical Exam

• Positive provocative tests:
  • FABER
  • Gaenslen
  • Thigh thrust
  • Compression

👉 3 or more positive tests = high diagnostic accuracy

Diagnosis

• Confirmed with image-guided intra-articular injection
• Imaging alone is NOT diagnostic

Treatment

• Physical therapy
• SI joint injections
• Lateral branch RFA
• SI joint fusion (refractory cases)

🚨 Board Pearl

Diagnostic SI joint injection is the gold standard

🎯 Board Prep Takeaways

• Always distinguish central vs peripheral mechanisms in neuropathic pain
• Know diagnostic confirmation strategies (blocks vs imaging)
• Focus on first-line vs interventional escalation pathways
• Understand procedure indications for boards

🎓 Upcoming Events & Live Training 🏆 ASPN 2026 Annual Meeting

Join Dr. Rosenblum for:

• Ultrasound-guided peripheral nerve blocks
• Spine interventions
• Regenerative medicine techniques (PRP, biologics)
• Hands-on procedural training

💉 Ultrasound-Guided Regenerative Medicine Course

Learn:

• PRP injection techniques
• Ultrasound-guided joint and nerve procedures
• Real-world workflows for integrating regenerative medicine into your practice

👉 Hosted through NRAP Academy

🎤 PainWeek 2026 Lectures

Dr. Rosenblum will be presenting on:

• Precision image-guided pain procedures
• Ultrasound integration in clinical practice
• Regenerative medicine in interventional pain
• Future directions: AI and neuromodulation

🔗 Resources

• 🌐 Pain Board Review: PainExam.com
• 🎓 Courses & CME: NRAPPain.org
• 📺 YouTube: NRAP Academy
• 🧠 Question Bank + Virtual Fellowship: Available now

📢 Call to Action

If you're preparing for the pain boards or want to elevate your clinical skillset:

✅ Subscribe to the PainExam Podcast ✅ Join our Virtual Pain Fellowship ✅ Attend a live ultrasound or regenerative medicine course

PainExam Podcast Show Notes Red Light Therapy (Photobiomodulation) for Pain Evidence, Mechanisms, and Clinical Applications

Host: Dr. David Rosenblum

Red light therapy, also known as photobiomodulation (PBM) or low-level laser therapy (LLLT), is an emerging non-invasive treatment modality increasingly used in pain medicine, rehabilitation, and regenerative medicine practices.

In this episode of the PainExam Podcast, Dr. Rosenblum reviews the mechanisms, clinical evidence, indications, and safety considerations surrounding photobiomodulation therapy for pain.

Red and near-infrared wavelengths stimulate mitochondrial activity, increase ATP production, reduce inflammatory mediators, and promote tissue healing. These physiologic effects may translate into analgesic benefits for a variety of musculoskeletal and neuropathic pain conditions.

Clinical research suggests potential benefit in temporomandibular disorders, chronic neck pain, and inflammatory oral conditions, though results vary due to differences in dosing parameters and treatment protocols.

Despite these limitations, PBM has a favorable safety profile and is increasingly being integrated into multimodal pain management strategies.

Key Topics Covered

• What is photobiomodulation therapy (PBM) • How red and near-infrared light interact with mitochondria • Mechanisms of analgesia and tissue repair • Evidence from clinical trials in TMD, neck pain, and oral inflammatory pain • The biphasic dose response (Arndt-Schulz law) • Safety profile and contraindications • How PBM may integrate with regenerative pain medicine

Mechanism of Action

Photobiomodulation works primarily through stimulation of mitochondrial chromophores, particularly cytochrome c oxidase.

This leads to:

• Increased ATP production • Modulation of inflammatory cytokines • Increased angiogenesis and tissue repair • Reduced oxidative stress

These effects may improve pain, inflammation, and healing in certain musculoskeletal conditions.

Evidence Discussed in This Episode Temporomandibular Disorders

Randomized trial demonstrating improvements in pain and mandibular function with red light therapy.

De Carvalho et al., Pain Research and Treatment (2019) https://onlinelibrary.wiley.com/doi/full/10.1155/2019/8578703

Chronic Neck Pain

Clinical trial demonstrating improvements in pain scores and pressure pain thresholds after photobiomodulation therapy.

Chen et al., Lasers in Medical Science (2022) https://link.springer.com/article/10.1007/s10103-022-03540-0

Oral Pain and Dental Inflammation

Randomized study demonstrating reduced pain and improved healing following PBM treatment.

Almeida et al., BMC Oral Health (2023) https://link.springer.com/article/10.1186/s12903-023-02784-8

Who May Benefit From Photobiomodulation?

Red light therapy may be considered as an adjunct treatment for:

• myofascial pain • cervical spine pain • temporomandibular disorder • tendinopathy • peripheral neuropathy • musculoskeletal injury recovery

Safety and Contraindications

Photobiomodulation has a very favorable safety profile.

Reported adverse effects are rare and usually mild:

• transient erythema • warmth at treatment site • headache • eye irritation without proper protection

Precautions include:

• avoiding direct retinal exposure • avoiding treatment over malignancy • avoiding application over the uterus during pregnancy • caution in photosensitive disorders

Resources For Patients Seeking Treatment

Learn more about integrative and regenerative pain treatments including PRP, ultrasound-guided injections, and advanced pain therapies:

AABP Integrative Pain Care & Wellness https://www.AABPpain.com

For Pain Physicians and Advanced Practice Providers

Training in ultrasound, interventional pain procedures, and pain board preparation:

NRAP Academy CME Education https://www.NRAPpain.org

Dr. Rosenblum from NRAP Academy presented a webinar on the integration of regenerative medicine into pain practices, highlighting its benefits and applications. He discussed the evolution of treating pain, emphasizing the shift from neural blockade to addressing tissue health. Dave explained the use of PRP and BMAC in treating conditions like knee pain, and shared patient success stories. He addressed common misconceptions about regenerative medicine, including its cost and effectiveness. Dave also mentioned upcoming events and training opportunities in regenerative medicine.

Regenerative Medicine Pain Management Events

Dr. Rosenblum announced his upcoming involvement in two significant events: a webinar on regenerative medicine for ASIPP and co-directing the ASPN Ultrasound and Regenerative Medicine Pain Workshop in Miami with Dr. Ali Valimoed. He encouraged attendees to register for these events, emphasizing their importance in the field of pain management. He also mentioned a previous lecture he gave on the integration of regenerative medicine into pain practices, though the recording was not successful.

Regenerative Medicine in Pain Practices

Dr. Rosenblum discussed the integration of regenerative medicine into pain practices, emphasizing its importance in 2026 and beyond. He explained that traditional approaches like steroids and RFA only manage pain without addressing tissue health, using the knee as an example. He suggested combining visco supplements with regenerative techniques like PRP or BMAC to preserve joints in patients seeking alternatives to knee replacement. He noted that while other stem cell products are promising, more research is needed for wider adoption, and he plans to focus on PRP and BMAC for now.

Regenerative Medicine Patient Education

Dr. Rosenblum discussed the importance of educating patients about regenerative medicine and pain treatment options. He explained that while regenerative treatments cannot fully reverse severe issues like meniscus damage, they can help heal and repair tissues, reduce inflammation, and improve function. He highlighted the growing demand for non-surgical, opiate-sparing solutions and mentioned the role of government and physician-led campaigns in addressing the opiate crisis.

PRP's Role in Chronic Pain Management

Dr. Rosenblum discussed the growing demand for alternative treatments to opioids and surgeries, highlighting the role of Platelet-Rich Plasma (PRP) in addressing chronic pain by modulating inflammation and stimulating tissue repair. He emphasized the importance of using high-quality PRP preparation methods, such as a double-spin kit, to achieve optimal results, and criticized studies claiming PRP's ineffectiveness, often due to poor preparation techniques. David also noted that effective PRP treatments can improve pain and function better than corticosteroids, and he expressed hope that patients would refer others, leading to business growth.

PRP Therapy: A Promising Alternative

Dr. Rosenblum discussed the effectiveness of PRP (platelet-rich plasma) therapy compared to steroids and viscosupplements in treating various musculoskeletal conditions. He cited a meta-analysis showing that PRP provided better relief than steroid and viscosupplement treatments for patients with moderate arthritis after one year. David also shared a recent case where he used PRP to treat coccydynia, a condition involving pain in the coccyx, and mentioned its potential use in treating other conditions such as radiculopathy and foraminal stenosis.

PRP Injection Treatment Flexibility

Dr. Rosenblum discussed a medical procedure involving PRP and lidocaine injections in various areas of the body, including the coccygeal ligaments, caudal space, and transforaminal spaces, to address pain and inflammation. He emphasized the importance of tailoring treatment to individual patients rather than adhering to insurance company guidelines, which can limit the number of injections given in a single session. David highlighted that when patients pay out-of-pocket, practitioners have more flexibility to effectively treat their conditions, potentially avoiding surgery or improving post-surgical outcomes.

PRP in Orthopedic Practice

Dr. Rosenblum shared his experience treating a patient with PRP for post-operative knee surgery, despite the orthopedic surgeon's skepticism. He discussed how regenerative medicine can enhance a practice by positioning it as innovative and attracting younger patients who prefer non-surgical treatments. David noted that while some orthopedic surgeons may refer patients for PRP, others might be hesitant due to potential decreases in surgical procedures. He also mentioned that primary care doctors may not be aware of the growing evidence supporting PRP's effectiveness and safety.

PRP: A Cost-Effective Alternative

Dr. Rosenblum discussed regenerative medicine, particularly PRP, highlighting its potential to avoid surgeries and improve patient satisfaction with an estimated 70% success rate. He emphasized the financial benefits for physicians, as it provides a cash stream with no need for prior authorizations or denials. David also addressed patient responsibility in healthcare costs, comparing the cost of regenerative treatments to other lifestyle expenses. He noted that while training is necessary, most interventional pain physicians possess the skills to administer PRP treatments.

PRP Treatment Success Stories

Dr. Rosenblum shared patient testimonials highlighting successful outcomes from PRP (platelet-rich plasma) treatments for various pain conditions, including shoulder, back, and neck issues. Patients reported significant improvements in pain relief and mobility, with some noting long-lasting effects beyond cortisone shots or surgery. David emphasized the importance of individualized treatment approaches and quality care, encouraging both patients and physicians to reach out for training and consultations. He concluded by inviting listeners to share the content with colleagues and patients, emphasizing the value of PRP treatments when done correctly.

Peptides in Pain Management: BPC-157, Risks, Reality, and the Business of Regenerative Medicine

Episode Length: ~12–15 minutes Target Audience: Pain physicians, anesthesiologists, PM&R, sports medicine, and regenerative medicine clinicians Hosted by: Dr. David Rosenblum, MD Produced by: PainExam | NRAP Academy

🧠 Episode Overview

Peptides like BPC-157 have exploded in popularity across regenerative medicine, sports medicine, and cash-based pain practices — but does the science support the hype?

In this episode of PainExam, Dr. David Rosenblum takes a critical, evidence-based look at BPC-157 and other peptidesin pain management, examining:

• The biological rationale behind peptide therapy

• Preclinical and early human evidence for pain and tissue healing

• Regulatory status and safety concerns

• Ethical, legal, and marketing risks for physicians

• How peptides are currently being incorporated — and monetized — in pain practices

This episode is designed to help clinicians separate science from marketing, and to approach peptide therapies with appropriate caution and professionalism.

⏱️ Episode Breakdown 🔹 00:00–01:30 — Introduction

• Why peptides are trending in pain and regenerative medicine

• What patients are asking — and what physicians need to know

🔹 01:30–04:30 — What Is BPC-157?

• Origins of Body Protection Compound-157

• Mechanisms: angiogenesis, inflammation modulation, tissue repair

• Summary of preclinical data and animal pain models

🔹 04:30–07:00 — Evidence for Pain Relief & Healing

• Early inflammatory and non-inflammatory pain studies

• Intra-articular BPC-157 for knee pain: what the case series showed

• Why current human data are hypothesis-generating, not definitive

🔹 07:00–09:30 — Risks, Unknowns & Regulatory Issues

• FDA status and investigational use

• Quality, purity, and dosing variability

• Theoretical biologic risks and drug interactions

🔹 09:30–12:30 — The Business of Peptides in Pain Practice

• How peptides are marketed in regenerative clinics

• Cash-based models and patient demand

• Ethical marketing, informed consent, and medicolegal exposure

🔹 12:30–End — Clinical Takeaways

• Where peptides fit — and don't fit — in current pain practice

• Why evidence still matters in regenerative medicine

⚠️ Key Clinical Takeaways

• BPC-157 shows promising preclinical data, but human evidence remains limited

• Current studies lack randomization, controls, and long-term outcomes

• Peptides are not FDA-approved for pain or musculoskeletal indications

• Marketing peptides without transparency poses ethical and legal risk

• Physicians must clearly distinguish experimental therapies from standard of care

📚 Key References Discussed

• Józwiak et al. Multifunctionality and Possible Medical Application of BPC-157 — MDPI Pharmaceuticals (2025)

• McGuire et al. Regeneration or Risk? A Narrative Review of BPC-157 — Current Reviews in Musculoskeletal Medicine (2025)

• Sikirić et al. Effects of BPC-157 on Inflammatory and Non-Inflammatory Pain — Inflammopharmacology (1993)

• Lee & Padgett. Intra-Articular Injection of BPC-157 for Knee Pain — Alternative Therapies in Health and Medicine (2021)

📢 Sponsored Message / Advertisement 🔔 Ready to Master Evidence-Based Pain Medicine?

If you're preparing for Pain Medicine boards or looking to strengthen your foundation in interventional and regenerative pain management, check out the educational resources at:

👉 https://www.nrappain.org

🎓 Offered through NRAP Academy:

• ✅ PainExam® Pain Management Board Review

• ✅ ABA, ABPM, FIPP, and ABIPP exam preparation

• ✅ Ultrasound-guided pain procedure training

• ✅ Regenerative pain medicine education — grounded in evidence, not hype

• ✅ Virtual Pain Fellowship curriculum

All content is designed by practicing pain physicians, for practicing pain physicians.

🎯 Why Learn with NRAP Academy?

• Evidence-driven, board-relevant education

• Practical clinical insights you can apply immediately

• Trusted by physicians nationwide

• Focused on ethical, safe, and effective pain care

👉 Explore courses and upcoming programs at https://www.nrappain.org

🎧 Subscribe & Stay Sharp

If you found this episode helpful:

• Subscribe to the PainExam Podcast

• Share it with a colleague

• Leave a review to help other pain physicians find evidence-based content

Disclaimer: This podcast is for educational purposes only. Discussion of investigational therapies does not constitute endorsement or clinical recommendation. Physicians should follow applicable laws, regulations, and professional guidelines when considering experimental treatments.

References

Lee, Edwin, and Blake Padgett. "Intra-Articular Injection of BPC 157 for Multiple Types of Knee Pain." Alternative Therapies in Health & Medicine 27.4 (2021).

Józwiak, Michalina, et al. "Multifunctionality and Possible Medical Application of the BPC 157 Peptide—Literature and Patent Review." Pharmaceuticals 18.2 (2025): 185.

McGuire, F. P., Martinez, R., Lenz, A., Skinner, L., & Cushman, D. M. (2025). Regeneration or risk? A narrative review of BPC-157 for musculoskeletal healing. Current Reviews in Musculoskeletal Medicine, 18(12), 611-619.

Meralgia Paresthetica Education and the Pain Boards

This podcast episode from the NRAP Academy features Dr. David Rosenblum discussing Meralgia Paresthetica, a mononeuropathy affecting the lateral femoral cutaneous nerve. The condition involves entrapment or compression of this purely sensory nerve as it passes under the inguinal ligament near the anterior superior iliac spine, causing burning pain, tingling, and numbness in the anterior lateral thigh.

Key clinical points covered include the nerve's L2-3 origin from the lumbar plexus, common causes such as obesity, tight clothing, pregnancy, and diabetes, and the absence of motor weakness or reflex changes. Diagnosis is primarily clinical, though ultrasound can visualize nerve entrapment effectively.

Treatment approaches range from conservative management including weight loss, avoiding tight clothing, physical therapy, and neuropathic pain medications (gabapentinoids, duloxetine, tricyclics) to interventional procedures. Dr. Rosenblu strongly advocates for ultrasound-guided nerve blocks over fluoroscopic or blind approaches, citing better visualization and reduced risk of nerve trauma. Advanced treatments mentioned include peripheral neuromodulation and cryoablation for refractory cases.

The episode emphasizes that this condition is commonly tested on pain management board examinations (ABA, ABPM, FIPP, osteopathic boards) and can be significantly more painful and disabling than typically appreciated.

Upcoming Courses and Training Opportunities:

• Ultrasound training available at nrappain.org
• Regenerative medicine training courses
• Comprehensive Question Bank for Pain Management board preparation covering ABA, ABPM, FIPP, and osteopathic examinations
• CME credits available through the platform
• Clinical consultation services available at Dr. Rosenblu's Brooklyn office for patients seeking treatment

Meralgia Paresthetica Education and Clinical Guidance

• Overview:
• Focused on definition, anatomy, diagnosis, management, and board exam relevance for meralgia paresthetica.
• Anatomy and Pathophysiology:
• Nerve: lateral femoral cutaneous nerve (sensory only), typically arising from L2–L3.
• Course: traverses across the iliacus, passes under or through the inguinal ligament just medial to the ASIS, then enters the thigh.
• Sensory distribution: anterolateral thigh; anterior cutaneous division extends toward the knee.
• Etiology and Risk Factors:
• Common contributors: obesity, tight belts or clothing, pregnancy, prolonged sitting, diabetes, prior pelvic or hip surgery.
• Entrapment site: under the inguinal ligament near the ASIS (most frequent).
• Clinical Presentation:
• Symptoms: burning pain, tingling, numbness, dysesthesia localized to the anterolateral thigh.
• Provocation/relief: worse with standing or walking; relief with sitting or hip flexion.
• Neurologic exam: no motor weakness; no reflex changes.
• Diagnosis:
• Primarily clinical; Tinel's sign over the inguinal ligament may reproduce symptoms.
• EMG and nerve conduction studies are typically normal.
• Ultrasound: superficial nerve, generally easy to visualize, including in obese patients; can identify entrapment.
• Management Recommendations:
• First-line conservative care: weight loss; avoidance of tight belts/clothing; physical therapy; NSAIDs for inflammation.
• Pharmacologic options: gabapentin, pregabalin, duloxetine, tricyclic antidepressants; consider topical analgesic creams (e.g., lidocaine or anti-inflammatory combinations).
• Interventional approach:
• Ultrasound-guided nerve block is strongly recommended; the nerve lies lateral to the sartorius; real-time visualization enables precise, safe injection.
• Avoid fluoroscopic and blind approaches due to risk of further nerve trauma and post-procedure pain.
• Advanced interventions:
• Peripheral neuromodulation may provide benefit in select cases.
• Cryoablation has shown beneficial outcomes for the lateral femoral cutaneous nerve.
• Surgery is rarely required; options include neurolysis, decompression, or neurectomy as a last resort.
• Board Exam Preparation Emphasis:
• Key facts commonly tested:
• Involved nerve: lateral femoral cutaneous nerve.
• Nerve roots: L2–L3 (with population variants).
• Sensory-only nerve; absence of motor deficits.
• Compression site: under the inguinal ligament near the ASIS.
• First-line therapy: conservative measures; refractory cases: ultrasound-guided nerve block.
• Keywords to study: meralgia paresthetica; lateral femoral cutaneous nerve (also called lateral cutaneous nerve of the thigh).
• Practice Considerations:
• Severity: can be profoundly painful and disabling; often underappreciated.
• Referral: clinicians not trained in interventional techniques should refer patients to an interventionalist for diagnosis and treatment.

Decisions and Recommendations

• Ultrasound guidance is the preferred modality for lateral femoral cutaneous nerve interventions, superseding fluoroscopic or blind approaches.
• Rationale: superior visualization, real-time feedback, and reduced risk of nerve trauma and post-procedural pain.

Outreach and Resources

• NRAP Academy resources:
• Ultrasound training, regenerative medicine training, CME credits, and a comprehensive pain board question bank (ABA, ABPM, FIPP, osteopathic, and related exams).
• Clinical availability:
• Patient consultations for meralgia paresthetica offered in Brooklyn at www.AABPpain.com 718 436 7246 .

🎙️ 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

• Kratom's primary alkaloids are mitragynine and 7-hydroxymitragynine.

• They act as partial mu-opioid receptor agonists and demonstrate G-protein biased signaling, which may reduce β-arrestin–mediated respiratory depression seen with full opioids.

• No FDA-approved medical use; pharmacokinetics and dose-response remain inconsistent.

2. Reported Effects

Potential Benefits (mostly anecdotal or preclinical):

• Analgesia for chronic pain

• Mood elevation and increased energy

• Reduction of opioid withdrawal symptoms

Major Limitations:

• No high-quality randomized controlled trials

• Not a recommended analgesic for evidence-based pain practice

3. Adverse Effects & Safety Concerns

Commonly reported:

• Nausea, vomiting, constipation

• Tachycardia, palpitations

• Hepatotoxicity in some users

• Dependence and withdrawal syndrome similar to mild-moderate opioid withdrawal

Serious risks:

• Product variability and contamination

• Potential interactions with CNS depressants

• Unpredictable potency of alkaloids

4. Regulatory Status

• Kratom is unregulated, with significant variability in purity and composition.

• FDA and multiple public-health agencies caution against its use due to safety concerns.

• Not recommended as a first-line or adjunct pain therapy.

5. What Boards Like to Test

Expect questions on:

• Mechanism: partial MOR agonist, G-protein bias

• Differences from classical opioids

• Adverse effects and withdrawal

• Toxicology and contamination risks

• Counseling patients who self-medicate

• Lack of clinical trial data and regulatory approval

🎓 Board Prep Resources

Prepare for the ABA, ABPM, ABIPP, FIPP, and AOBPM exams with the PainExam Board Review and full curriculum at the NRAP Academy: 👉 https://www.NRAPpain.org

🫁 Hands-On Ultrasound Training for Pain Physicians

Boost your procedural skills with live ultrasound-guided interventional pain and regional anesthesia workshops: 👉 https://www.nrappain.org/pages/ultrasound-training

📚 References (Condensed)

• Kruegel AC, Grundmann O. Neuropharmacology of kratom alkaloids. Neuropharmacology.

• Eastlack SC et al. Kratom: Pharmacology & clinical implications. Phytother Res.

• Striley CW et al. Health effects of kratom. Front Pharmacol.

• FDA Public Health Advisory on Kratom.

Educational Offerings & Learning Opportunities

PainExam / NRAP Academy Training & Programs:

• Neuromodulation & Regional Anesthesia Workshops

• Ultrasound-Guided Pain Procedures

• Regenerative Pain Medicine Training

• Virtual Pain Fellowship

• Pain Management Board Review & Question Banks

Learn More / Register: 🔹 https://PainExam.com 🔹 https://NRAPpain.org

Board Prep & Certification Support

Prepare for:

• ABA Pain Boards

• ABPM

• ABIPP

• Pain Management Board Certification Exams

• (No reference to FIPP included, per request)

Access Board Prep Courses & Q-Banks: ➡️ https://PainExam.com ➡️ https://NRAPpain.org

Clinical Practice

AABP Integrative Pain Care (Brooklyn & Great Neck, NY) To schedule a consultation or referral: 🌐 https://AABPpain.com 📞 Brooklyn: 718-436-7246

About the Host – David Rosenblum, MD

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:

• Developed regional anesthesia training programs

• Published widely in pain medicine literature

• Lectured nationally and internationally through ASIPP, ASPN, NANS, IASP, and more

• Helped over 3000 physicians pass pain board exams

• Hosted the PainExam, AnesthesiaExam, and PMRExam podcasts

Awards (Selected):

• New York Magazine Top Doctors: 2016–2025

• Top Doctors NY Metro Area: 2016–2025

• Schneps Media Honors: Multiple Years

Connect with Dr. Rosenblum

• LinkedIn: https://www.linkedin.com/in/davidrosenblummd/

• Instagram: https://www.instagram.com/painexam/

• Facebook: https://www.facebook.com/david.rosenblum.16

• X (Twitter): https://x.com/AlgoSonic

Episode Call-to-Action

✅ Join the NRAP Community ✅ Register for an Upcoming Workshop ✅ Access Pain Board Review Training

Start here → https://NRAPpain.org | https://PainExam.com

Caudal Epidural Steroid Injection with PRP

Case Reports and a Testimonial!

Upcoming Training Courses and Services

• Regional Anesthesia and IV Vascular Access Courses:
• New York and Detroit locations scheduled
• Pain Management Board Preparation

Private Coaching Services:

• Ultrasound guidance Preceptorship

• Board preparation coaching

• Contact available via email [email protected] for interested physicians

PRP Caudal Epidural Research Review

• Study Overview: Randomized double-blind controlled pilot study comparing leukocyte-rich PRP versus corticosteroids in caudal epidural space

• 50 patients randomly assigned to two groups

• Treatment options: triamcinolone 60mg or leukocyte-rich PRP from 60ml autologous blood

• Follow-up assessments at 1, 3, and 6 months using VAS and SF-36 surveys

• Key Findings:

• Both treatments showed significant pain reduction compared to baseline

• Steroid group had lower VAS scores at one month

• PRP group demonstrated superior results at 3 and 6 months

• PRP group showed significant improvement across all SF-36 domains at 6 months

• No complications or adverse effects in either group during 6-month follow-up

Personal Treatment Experience

• Dr. Rosenblum received transforaminal PRP injection 9-10 weeks ago

• Gradual improvement noted from weeks 4-8, with more noticeable benefits from weeks 8-10

• Current status: minimal pain (0.5/10) only during weather changes

Clinical Practice Philosophy

• Treatment Approach: Minimalist philosophy focusing on turmeric, PRP, and Pilates

• Medication Strategy: Low-dose naltrexone as go-to medication, avoiding long-term drugs with side effects

• Surgical Avoidance: Prioritizing conservative treatments over unnecessary surgical interventions

Emergency Department PRP Implementation

• Case Study Results: Ultrasound-guided caudal epidural steroid injection in ER setting

• 100% pain resolution achieved

• Patient discharged directly from ER

• Cost savings: reduced from $33,000 to $4,800 (approximately $28,000 savings)

• Training Opportunities: Private training sessions available for ER physicians interested in ultrasound-guided procedures

Patient Testimonial Highlights

• Case Background: Nurse with herniated disc from March, previously considering $30,000 surgery

• Treatment Outcome: PRP injection completed two months ago with nearly complete pain relief

• Reduced from multiple pain medications to one Advil daily

• Eliminated antalgic posture and muscle spasms

• Returned to full 12-hour hospital shifts without difficulty

• Overall quality of life restored to normal levels

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

Irvan J. Bubic, Jessica Oswald, Ultrasound-Guided Caudal Epidural Steroid Injection for Back Pain: A Case Report of Successful Emergency Department Management of Radicular Low Back Pain Symptoms, The Journal of Emergency Medicine,Volume 61, Issue 3,2021,Pages 293-297,ISSN 0736-4679

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

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

• Evidence and clinical rationale for select supplements in chronic pain management

• The role of ultrasound guidance in improving accuracy and safety in interventional pain procedures

• How regenerative medicine techniques such as PRP and BMAC are shaping personalized pain care

• Practical considerations when combining supplements with neuromodulation, RFA, or injections

• Patient case applications and real-world treatment planning

Educational Offerings & Learning Opportunities

PainExam / NRAP Academy Training & Programs:

• Neuromodulation & Regional Anesthesia Workshops

• Ultrasound-Guided Pain Procedures

• Regenerative Pain Medicine Training

• Virtual Pain Fellowship

• Pain Management Board Review & Question Banks

Learn More / Register:

www.AABPpain.com 🔹 https://PainExam.com 🔹 https://NRAPpain.org

Board Prep & Certification Support

Prepare for:

• ABA Pain Boards

• ABPM

• ABIPP

• Pain Management Board Certification Exams

• (No reference to FIPP included, per request)

Access Board Prep Courses & Q-Banks: ➡️ https://PainExam.com ➡️ https://NRAPpain.org

Clinical Practice

AABP Integrative Pain Care (Brooklyn & Great Neck, NY) To schedule a consultation or referral: 🌐 https://AABPpain.com 📞 Brooklyn: 718-436-7246

About the Host – David Rosenblum, MD

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:

• Developed regional anesthesia training programs

• Published widely in pain medicine literature

• Lectured nationally and internationally through ASIPP, ASPN, NANS, IASP, and more

• Helped over 3000 physicians pass pain board exams

• Hosted the PainExam, AnesthesiaExam, and PMRExam podcasts

Awards (Selected):

• New York Magazine Top Doctors: 2016–2025

• Top Doctors NY Metro Area: 2016–2025

• Schneps Media Honors: Multiple Years

Connect with Dr. Rosenblum

• LinkedIn: https://www.linkedin.com/in/davidrosenblummd/

• Instagram: https://www.instagram.com/painexam/

• X (Twitter): https://x.com/AlgoSonic

Practical Takeaways

• Evidence strength varies widely; preclinical support is more robust than human RCT data for most supplements.

• Potentially reasonable adjuncts in select contexts

• Vitamin D: plausible benefit in deficiency states, including diabetic neuropathy and chronic pain-related quality-of-life factors; confirm deficiency and monitor.

• Magnesium: consider IV regimens for refractory neuropathic components (e.g., cancer pain, PHN); oral efficacy uncertain.

• Curcumin: consider as adjunct, especially formulated phytosome combinations; monitor for additive effects and tolerability.

• B vitamins: consider B12 in deficiency or neuropathy with suspected demyelination; overall human evidence limited.

• Zinc: mechanistic rationale with preclinical support; limited human data—consider deficiency correction rather than supraphysiologic dosing.

• Cautions and contraindications

• St. John's wort: significant drug–drug interaction potential via CYP/P-gp induction.

• Alpha lipoic acid: may cause hypoglycemia; monitor glucose, especially in diabetes.

• Agent-specific toxicity thresholds should guide safe upper limits; prioritize lab-confirmed deficiencies.

Risks, Limitations, and Research Gaps

• Heterogeneity in study designs, small samples, lack of controls, and multi-ingredient formulations limit causal inference.

• Need for large, well-designed RCTs stratified by neuropathic pain etiology (e.g., CIPN vs. DPN vs. PHN) with standardized outcomes.

• Translational gap between animal models and human clinical efficacy remains significant.

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

Pain Exam Podcast Recent Conference Activities

• London Conference Weekend: Successfully attended and spoke at ISPN and SOMOS care conferences
• Somos Care Conference: Delivered presentation on pain management for primary care physicians
• Presentation consisted of 50+ slides with only one slide dedicated to opiates
• Emphasized shift away from opiate-based treatments in interventional pain management
• Recommended primary care physicians refer patients to pain specialists for comprehensive treatment options
• ISPN Conference: Participated in international pain management conference
• Met with doctors from London, Iraq, and various other countries
• Observed different international approaches to pain treatment including increased phenol use and varying regenerative medicine restrictions

Upcoming Events and Workshops

• New York-New Jersey Pain Conference: November (NRAP Academy booth presence)
• IV Ultrasound Placement Workshops: Monthly sessions in New York
• Regional Anesthesia and Ultrasound-Guided Interventional Pain Medicine Workshops:
• New York: December 13th, January 10th
• Florida (Fort Lauderdale/Hollywood): November 8th
• Detroit: January 18th, February 15th
• Alternative Options: Online ultrasound courses and shadowing opportunities available
  • Board Prep and NRAP Community at PainExam.com or NRAPpain.org
  • ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship

  Educational Offerings and Events

  • Training and Courses:

Research Review: ACL Treatment Study

• Study Focus: Non-surgical treatment of ACL tears using bone marrow concentrate (BMAC) and platelet products versus exercise therapy
• Key Findings:
• BMAC group showed significantly greater improvement in Lower Extremity Function Scale (LEFS) and Single Assessment Numeric Evaluation (SANE) scores at three months
• Sustained improvement in function and decreased pain maintained through two-year follow-up
• Patients reported median subjective improvement of 90% at final follow-up
• No significant improvements observed in exercise-only group during initial three months
• Treatment Protocol:
• Bone marrow harvest from posterior superior iliac crest (60-90ml from 6-8 sites)
• PRP preparation from 60ml whole blood
• Fluoroscopy-guided injection directly into ACL ligament
• Comprehensive 52-week rehabilitation protocol with activity restrictions

Clinical Practice Implications

• Current ACL Treatment Landscape: Over 400,000 ACL reconstruction surgeries performed annually in the US
• Surgical Limitations: Risk of graft failure, persistent instability, cartilage injury, and increased arthritis risk
• Return to Sport Statistics: Post-surgical rates vary significantly (33-92% return to sport, 65% return to pre-injury level)
• Practice Integration Considerations: Potential incorporation of BMAC/PRP protocols for ACL tears, though insurance coverage remains limited

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

Centeno CJ, Berger DR, Pitts J, Markle J, Pelle AJ, Murphy M, Dodson E. Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up. BMC Musculoskelet Disord. 2025 Sep 30;26(1):882. doi: 10.1186/s12891-025-09153-2. PMID: 41029301; PMCID: PMC12486544.

#pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp #aabppain

Project Sync / Status Update Summary Podcast Episode Overview

• The host discussed Transcutaneous Electrical Nerve Stimulation (TENS) as a recurring pain board topic and reviewed mechanisms, efficacy, and clinical considerations.

• Emphasis that TENS appears on pain boards annually and is a foundational topic from early podcast episodes.

• Board Prep and NRAP Community at PainExam.com or NRAPpain.org
• ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship

Educational Offerings and Events

• Training and Courses:

• Monthly ultrasound courses in New York and upcoming courses in Detroit covering ultrasound-guided regional anesthesia and chronic pain.

• Ultrasound Guided Acute and Chronic Pain course in November near Hollywood/Fort Lauderdale with venue pending confirmation.

• Multiple instructors to offer diverse perspectives; registration via the CME calendar at nrappain.org.

• Conferences and Teaching:

• New York–New Jersey Pain Conference in November (hosted by Soudir Duwan).

• ISPN conference in London next week, with ultrasound teaching participation by the host.

• Community and Coaching:

• Private coaching and shadowing opportunities available; contact via newsletter replies.

• Access to the NRAP community forum upon signup at nrappain.org for discussions on neuromodulation, regional anesthesia, and pain.

TENS: Mechanisms and Parameters

• Device and Parameters:

• TENS delivers adjustable pulse frequency and intensity; configurations include low (50–100+ Hz), and mixed frequencies.

• Mechanisms of Analgesia:

• Activation of large-diameter, non-noxious A-beta afferent fibers in the periphery, driving descending inhibitory pathways and reducing hyperalgesia.

• Board-relevant point: selective activation of A-beta fibers is frequently tested.

• Central effects:

• Reduces central excitability and nociceptive dorsal horn neuron activity in uninjured and injured models.

• Frequency-dependent opioid receptor mediation:

• High-frequency analgesia blocked by delta receptor antagonists.

• Low-frequency analgesia blocked by mu receptor antagonists (spinal cord and rostral ventral medulla).

• Additional receptor involvement: muscarinic M1/M3, GABA-A, and cannabinoid (CB1) receptors; blockade reduces or prevents TENS analgesia depending on frequency.

• Peripheral effects:

• High-frequency TENS reduces injury-related increases in substance P in DRG neurons.

• Blockade of peripheral opioid and CB1 receptors can prevent analgesia from both low- and high-frequency TENS.

• Clinical dosing considerations:

• Adequate dosing (timing, frequency of use, intensity achieving strong but non-painful paresthesia) influences efficacy.

• Analgesia has rapid onset/offset and may require repeated administration throughout the day for sustained relief.

Evidence and Efficacy Summary

• Systematic Review Findings:

• Cochrane umbrella review of 9 systematic reviews (51 trials; n=2,895) comparing active TENS with sham/usual care found uncertain efficacy due to:

• Very low-quality evidence (risk of bias, small samples, methodological limitations).

• Inconsistent adverse event reporting.

• Heterogeneity in TENS parameters and comparators.

• Authors note uncertainty may be confounded by inadequate dosing not being an inclusion metric.

• Practical Interpretation:

• TENS is inexpensive, low-risk, self-administered, and titratable; commonly used by patients and physical therapists.

• Clinical experience suggests potential adjunctive benefit for acute pain, but systematic reviews are conflicting; more rigorous studies are needed.

• For board preparation, the critical takeaway is A-beta fiber activation.

Key Takeaways for Board Prep

• TENS targets large-diameter non-noxious A-beta afferents to reduce nociceptive signaling.

• High-frequency TENS: analgesia mediated via delta opioid receptors; blocked by delta antagonists.

• Low-frequency TENS: analgesia mediated via mu opioid receptors; blocked by mu antagonists in spinal cord and RVM.

• Additional receptor systems influencing TENS efficacy include muscarinic (M1/M3), GABA-A, and CB1.

Action Items Review TENS mechanisms with emphasis on A-beta fiber activation for board prep. Verify and publish final venue details for the November Florida ultrasound course. Share registration links and schedules for Detroit and New York ultrasound and chronic pain courses via CME calendar. Prepare teaching materials for ISPN London ultrasound sessions next week. Update board prep resources on painexam.com and nrappain.org with current TENS evidence and dosing guidance. Promote NRAP community forum access and private coaching/shadowing opportunities through the newsletter.

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

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:

1. Background on Osteoarthritis:

   • Definition and impact of OA, particularly in older populations.
   • Overview of traditional treatments and the shift towards regenerative medicine.

2. Study Objectives:

   • To compare the efficacy of BMAC and ADSC injections in symptomatic knee OA patients.
   • To analyze MSC quantity and quality in harvested tissues from both sources.

3. Methodology:

   • Description of the study design involving 60 patients with knee OA.
   • Details on patient demographics, injection protocols, and follow-up assessments (VAS, WOMAC, ROM).

4. Results:

   • Significant improvements in clinical scores for both BMAC and ADSC groups at 6 months.
   • Discussion on the lack of significant correlation between MSC quantity and treatment efficacy.
   • Insights into the success rates of MSC cultures from both bone marrow and adipose tissue.

5. Conclusions:

   • Both treatments demonstrated clinical improvements, with no substantial differences between them.
   • BMAC showed higher MSC counts and faster recovery rates, but further research is needed to understand the underlying factors affecting efficacy.

6. Implications for Clinical Practice:

   • Considerations for clinicians when choosing between BMAC and ADSC treatments.
   • Future directions for research in regenerative therapies for knee OA.

References:

• Vitali, M., Ometti, M., Montalbano, F., et al. (2025). Bone Marrow Aspirate Concentrate (BMAC) Versus Adipose-Derived Stem Cells (ADSCs) Intra-articular Injection Therapeutic Efficacy in Knee OA Correlated to Their Mesenchymal Stem Cell (MSC) Cellularity: An Exploratory Comparative Pilot Study. Indian Journal of Orthopaedics. https://doi.org/10.1007/s43465-025-01525-z

Listener Engagement:

• Join the conversation! Share your thoughts on BMAC and ADSC treatments for knee OA on social media using #JournalClubPodcast.
• Don't forget to subscribe for more discussions on the latest research in orthopaedics and regenerative medicine.