The PMRExam Podcast

Sep 12, 2024

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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Traumeel Epidural? The FDA, Spine applications and more about this Homeopathic treatment 0

Dec 11, 2023

PainExam Podcast Show Notes: Exploring Traumeel as an Alternative for Back Pain Relief

Cl aim CME

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Board Prep and Continuing Education

Introduction:

Today, Long Island Based Pain Physician David Rosenblum, MD delves into the latest advancements and alternative treatments for pain management.
In today's episode, we shine a spotlight on Traumeel®, a homeopathic alternative gaining traction for its anti-inflammatory properties, with fewer reported side effects compared to corticosteroids.

Understanding Traumeel:

Traumeel, a fixed combination of diluted plant and mineral extracts, has been available over-the-counter in Europe for over 60 years.
Contrary to corticosteroids, Traumeel's popularity has surged due to its limited side effect profile, with reported contraindications primarily linked to allergies [9].

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Scientific Insights:

A study by Lussignoli et al. demonstrated Traumeel's efficacy in decreasing systemic interleukin-6 production and reducing edema, countering an unregulated inflammatory response [10].
In vitro studies revealed Traumeel's inhibition of pro-inflammatory mediators (IL-1β, TNFα, IL-8) in immune cells, suggesting its potential in stabilizing the immune system [8].
Notably, Traumeel's effectiveness seems to surpass the sum of its individual components, indicating a synergistic interaction [9-10].

Clinical Applications:

Traumeel has shown efficacy comparable to nonsteroidal anti-inflammatory drugs (NSAIDs) in treating various inflammatory conditions.
It is available in oral, topical, and injectable preparations, making it a versatile option for pain relief [8-9].

Research Gaps and Potential:

Despite its established use, current research lacks information on Traumeel's efficacy in epidural injections for short-term back pain relief.
No studies have compared Traumeel to corticosteroid injections, although the TRARO study protocol proposes a potential avenue for comparison in rotator cuff syndrome patients [11].

Pain Management Board Prep

Clinical Cases:

Five patients seeking back pain relief opted for Traumeel injections due to either a contraindication to or a preference against steroids.
This real-world scenario lays the groundwork for further exploration into Traumeel's efficacy in epidural injections, providing additional pain-relieving options for patients unable to tolerate corticosteroid injections.

Conclusion:

Traumeel presents a promising alternative for pain management, particularly in cases where corticosteroids may be unsuitable, however the FDA has yet to approve it and therefore it has failed to gain traction in the US. [14]
As we wrap up, stay tuned for future developments in the research landscape surrounding Traumeel and its potential role in enhancing pain relief options.

Disclaimer:

Consult with a healthcare professional before considering any alternative treatments. The information provided in this podcast is for educational purposes only and does not replace medical advice.

David Rosenblum, MD
President, NRAP Academy
Clinical Assistant Professor
Department of Anesthesiology
SUNY Downstate Medical Center
Director of Pain Management
Maimonides Medical Center

References

1. Cassidy JD, Carroll LJ, Côté P: The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998, 23:1860-66. 10.1097/00007632-199809010-00012

2. Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR: The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007, 131:293-301. 10.1016/j.pain.2007.01.012

3. Fyneface-Ogan S: Anatomy and Clinical Importance of the Epidural Space. Epidural Analgesia - Current Views and Approaches. IntechOpen. IntechOpen (ed): IntechOpen, Internet; 2012. 1-14. 10.5772/39091

4. Waldman SD: Complications of cervical epidural nerve blocks with steroids: a prospective study of 790 consecutive blocks. Reg Anesth. 1989, 14:149-51.

5. McGrath JM, Schaefer MP, Malkamaki DM: Incidence and characteristics of complications from epidural steroid injections. Pain Med. 2011, 12:726-31. 10.1111/j.1526-4637.2011.01077.x

6. Watters WC 3rd, Resnick DK, Eck JC, et al.: Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: injection therapies, low-back pain, and lumbar fusion. J Neurosurg Spine. 2014, 21:79-90. 10.3171/2014.4.SPINE14281

7. Understanding Potential Complications Of Epidural Steroid Injections . (2011). Accessed: October 1, 2019: https://www.practicalpainmanagement.com/treatments/interventional/injections/understanding-potentialcomplications-ep….

8. Schneider C: Traumeel - an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med. 2011, 4:225-34. 10.2147/IJGM.S16709 9. Grech D, Velagala J, Dembek DJ, Tabaac B: Critical literature review of the homeopathic compound Traumeel for treatment of inflammation. Pharmacology & Pharmacy. 2018, 9:67-83. 10. Lussignoli S, Bertani S, Metelmann H, Bellavite P, Conforti A: Effect of Traumeel S®, a homeopathic formulation, on blood-induced inflammation in rats. Complement Ther Med. 1999, 7:225-30.

10.1016/S0965-2299(99)80006-5

11. Vanden Bossche L, Vanderstraeten G: A multi-center, double-blind, randomized, placebo-controlled trial protocol to assess Traumeel injection vs dexamethasone injection in rotator cuff syndrome: the TRAumeel in ROtator cuff syndrome (TRARO) study protocol. BMC Musculoskelet Disord. 2015, 16:8. 10.1186/s12891- 015-0471-z

12. Birnesser H, Oberbaum M, Klein P, Weiser M: The homeopathic preparation Traumeel® S compared with NSAIDS for symptomatic treatment of epicondylitis

13. Ehlert, Dianna, and Ariel Majjhoo. "Traumeel® Epidural Injection: A Viable Alternative to Corticosteroids-A Five-Patient Case Study." Cureus 11.11 (2019)

14. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/medinatura-inc-596269-06112020

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Hydroxyapatite Deposition Disease and Joint Pain 0

Nov 13, 2023

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

Ultrasound Guided Interventional Pain and Regenerative Medicine Course Feb 10, 2024

	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.

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Peptides: A Brief Overview 0

Oct 12, 2023

Dr. Rosenblum explores Peptides, the various types, usess and applications for health and wellness.

Upcoming Pain Management Conferences

Upcoming Workshops and Events

	NYC Regional Anesthesia and Pain Ultrasound CME Workshop	Saturday, October 28, 2023 8:00 AM
	Charleston, SC Regional Anesthesia and Pain Ultrasound CME Workshop	Sunday, October 29, 2023 9:00 AM
	NRAP Academy: Regenerative Pain Medicine Course NYC	Saturday, November 11, 2023 8:00 AM
	NYC Regional Anesthesia and Pain Ultrasound CME Workshop	Saturday, December 16, 2023 7:30 AM
	NYC Regional Anesthesia and Pain Ultrasound CME Workshop	Saturday, January 6, 2024 7:30 AM

For up to date Calendar, Click Here!

References

https://healthgains.com/wellness/peptide-therapy/#Selank

https://www.nature.com/articles/s41392-022-00904-4

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Ketamine for Chronic Pain 0

Jun 14, 2023

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David Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, Board Review and NRAP Academy’s Continuing Medical Education Programs, discusses Ketamine infusions, optimal infusion protocols and the evidence or lack of to support them.

Ketamine infusions have been used for chronic neuropathic pain, CRPS and depression. Dr. Rosenblum is accepting new patients and consultations could be scheduled by visiting www.AABPPain.com or calling 718 436 7246 or 516 482 7246.

Pain Management Board Prep

Physiatry Board Prep

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR

For up to date Calendar, Click Here!

References

Maher, Dermot P MD, MS; Chen, Lucy MD; Mao, Jianren MD, PhD. Intravenous Ketamine Infusions for Neuropathic Pain Management: A Promising Therapy in Need of Optimization. Anesthesia & Analgesia 124(2):p 661-674, February 2017. | DOI: 10.1213/ANE.0000000000001787

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The Sacroiliac Joint- 2023 CMS Update 0

May 2, 2023

2023 Update to the Sacroiliac Joint

CMS Covered Indications for SI Joint Injection

Long Island Based Interventional Pain Physician, David Rosenblum, MD discusses Sacroiliac Joint Dysfunction, and CMS’s Covered Indications for Sacroiliac Joint Injection and Diagnostic Nerve Block

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For PM&R Board Review, Click Here!

Sacroiliac Joint Injections are considered necessary and reasonable when all of the following criteria are met:

Moderate to severe low back pain primarily experienced over the anatomical location of the SI joints between the upper level of the iliac crests and the gluteal fold, AND
Low back pain duration of at least three (3) months, AND
Low back pain below L5 without radiculopathy, AND
Clinical findings and/or imaging studies do not suggest any other diagnosed or obvious cause of the lumbosacral pain (such as central spinal stenosis with neurogenic claudication/myelopathy, foraminal stenosis or disc herniation with concordant radicular pain/radiculopathy, infection, tumor, fracture, pseudoarthrosis, or pain related to spinal instrumentation), AND
At least three positive findings with provocative maneuvers: FABER, Gaenslen, Thigh Thrust or Posterior Shear, SI Compression, SI Distraction and Yeoman Tests,3,4 AND
Low back pain persists despite a minimum of four weeks of conservative therapies.5

Workshop and Calendar

Regenerative Pain Medicine Course NYC- May 13

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR

For up to date Calendar, Click Here!

References

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39383&ver=9

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The MOTION Study:Treating Spinal Stenosis 0

Mar 29, 2023

CME Credit

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Journal Club. Minimally Invasive Lumbar Decompression (mild® Procedure) with Conventional Medical Management vs. Conventional Medical Management Alone.

Descripton of Procedure, Safety, Technique, study outcome, personal experience with this minimally invasive technique that interventional pain physicians are using to treat neurogenic claudication related to ligamentum flavum hypertrophy.

Dr. Rosenblum discusses spinal stenosis pathophysiology and neurogenic claudication. Dr. Rosenblum also mentions upcoming courses and webinars:

Upcoming Courses and Workshops!

Course Calendar

Practice Management Webinar: The End of the Public Health Emergency. What’s Changed and what Opportunities Remain!

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Regenerative Pain Medicine Course NYC- May 13

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023

For up to date Calendar, Click Here!

References

Timothy R Deer, MD, Shrif J Costandi, MD, Edward Washabaugh, MD, Timothy B Chafin, MD, Sayed E Wahezi, MD, Navdeep Jassal, MD, Dawood Sayed, MD, The MOTION Study: A Randomized Controlled Trial with Objective Real-World Outcomes for Lumbar Spinal Stenosis Patients Treated with the mild® Procedure: One-Year Results, Pain Medicine, Volume 23, Issue 4, April 2022, Pages 625–634, https://doi.org/10.1093/pm/pnac028

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Platelet Rich Plasma, the Peripheral Nerve, A2M and more! 0

Mar 21, 2023

Biologics and the Peripheral Nerve.

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Dr. Rosenblum discuss his upcoming talk at the Appalachian Region Spine and Pain Meeting: Incorporating Ultrasound into a Spine and Pain Practice on April 14-16 2023 and the topics he plans to include: Ultrasound Guided Knee therapies, cluneal nerve, caudal, brachial plexus and more!

Today’s podcast (inspired by TOBI and Dr. Sudhir Diwan, Dr. Sheldon Jordon and Dr. Rikin Patel's ASIPP Lectures) focuses on the risk and benefits of performing PRP injection onto a nerve. Dr. Rosenblum discusses:

Possible fibrosis of the ulna nerve after using PRP for partial ulnar collateral ligament tears

Best Time for PRP Injection after Nerve Regeneration

Alpha 2-macroglobulin (what is it?)

PRP for moderate to severe carpal tunnel syndrome

Featured Courses!

May 25, 2023 Private Pain Group Ultrasound Course- NYC (Sold out)

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Regenerative Pain Medicine Course NYC- May 13

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

see the full schedule for our July and August US IPM Courses!

References

Robert G. Thompson, Kendall Bradley, Gary M. Lourie,

Ulnar nerve dysfunction at the elbow after platelet-rich plasma treatment for partial ulnar collateral ligament injuries,JSES Reviews, Reports, and Techniques,Volume 1, Issue 1,2021,Pages 41-44,ISSN 2666-6391,

Si-Ru Chen, Yu-Ping Shen, Tsung-Yen Ho, Tsung-Ying Li, Yu-Chi Su, Yu-Ching Chou, Liang-Cheng Chen, Yung-Tsan Wu,One-Year Efficacy of Platelet-Rich Plasma for Moderate-to-Severe Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial,Archives of Physical Medicine and RehabilitationVolume 102, Issue 5,2021,

Pages 951-958,ISSN 0003-9993,https://doi.org/10.1016/j.apmr.2020.12.025.

Rehman, A.A., Ahsan, H. and Khan, F.H. (2013), Alpha-2-macroglobulin: A physiological guardian. J. Cell. Physiol., 228: 1665-1675. https://doi.org/10.1002/jcp.24266

Muhammad Pandunugrahadi, Komang Agung Irianto, Oen Sindrawati, "The Optimal Timing of Platelet-Rich Plasma (PRP) Injection for Nerve Lesion Recovery: A Preliminary Study", International Journal of Biomaterials, vol. 2022, Article ID 9601547, 7 pages, 2022. https://doi.org/10.1155/2022/9601547

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Carpal Tunnel Syndrome for the PM&R Boards 0

Feb 25, 2023

Carpal Tunnel Syndrome

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Diagnosis, Pathophysiology, Clinical Findings and Management of the Carpal Tunnel Syndrome

In this episode, we will be discussing Carpal Tunnel Syndrome, a common condition that affects millions of people worldwide. But before we dive into the topic, we want to tell you about a great opportunity to advance your medical knowledge through the NRAP Academy CME courses offered on our website.

Discussion on Carpal Tunnel Syndrome:

Carpal Tunnel Syndrome is a condition that occurs when the median nerve, which runs from the forearm to the hand, becomes compressed or squeezed at the wrist. This compression can lead to pain, numbness, and tingling in the hand and arm, which can be debilitating.

There are many causes of Carpal Tunnel Syndrome, including repetitive hand movements, wrist injuries, pregnancy, and medical conditions such as diabetes and thyroid disorders. Treatment options for Carpal Tunnel Syndrome range from non-invasive approaches like rest, ice, and wrist splints to more invasive treatments like surgery.

It's important to diagnose and treat Carpal Tunnel Syndrome early to prevent long-term damage to the median nerve. A proper diagnosis can be made through a physical exam and imaging tests like an electromyography (EMG) or nerve conduction study (NCS).

Don't forget to check out the NRAP Academy CME courses offered on our website, www.painexam.com/events page, to continue your medical education and enhance your patient care.

For Board Prep go to www.PMRExam.com

NRAP Academy Events

Hands on Training for medical professional looking to enhance your knowledge and skills in pain management? Offering courses are designed to help you stay up-to-date with the latest advances in pain management and to help you improve patient outcomes. Visit our website, www.painexam.com/events page, to learn more about the courses available and to sign up today.

References

Sevy JO, Varacallo M. Carpal Tunnel Syndrome. [Updated 2022 Sep 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448179/

Sevy JO, Varacallo M. Carpal Tunnel Syndrome. 2022 Sep 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 28846321.

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Shingles and Interventional Pain: A look at the evidence. 0

Jan 31, 2023

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Dr. Rosenblum discuss a challenging case and reviews the pathology, treatment and evidence for interventional pain in the the treatment of Post Herpetic Neuralgia.

Discussed in this podcast:

Intrathecal injection of methylprednisolone

Dorsal Root Ganglion

Paraveterbral Nerve Block

Stellate Ganglion Block

Spinal Cord Stimulation

Botulinum Toxin Injection

And more!

Course Calendar

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Puerto Rico- Feb. 10, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Regenerative Pain Medicine Course NYC- May 13

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

References

Lin, Chia-Shiang, et al. "Interventional treatments for postherpetic neuralgia: a systematic review." Pain physician22.3 (2019): 209.

https://www.painphysicianjournal.com/current/pdf?article=NjMwMg%3D%3D&journal=120

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2023 Physician Fee Schedule + New Chronic Pain Management Codes 0

Dec 21, 2022

Rachel Trobman, CEO of Upside Health and David Rosenblum, MD discuss updates to the 2023 Physician Fee Schedule + New Chronic Pain Management Codes, Remote Patient Monitoring and more!

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This Podcast is not worth any CME Credit, but Credit can be Claimed for reflecting on content:
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Upcoming Courses and Workshops!

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- Dec 3, 2022

Regenerative Interventional Pain Course NYC- Jan, 28, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

NRAP: NYC Regional Anesthesia and Pain Ultrasound CME Workshop Registration, Sat, Dec 3, 2022 at 7:30 AM | Eventbrite

For up to date Calendar, Click Here!

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Updated CDC Guidelines Explained- Podiatrist Lawrence Kobak DPM, Esq. 0

Dec 14, 2022

1 CME Available

What you need to know: The Updated CDC Clinical Practice Guideline for Prescribing Opioids for Pain

Monday, November 21 at 6:00 pm EDT

NYSPS Legal Briefs

New 2022 CDC Guidelines on

OPIOID USE FOR TREATMENT OF PAIN

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The Guidelines state very clearly: “Nonopioid therapies are preferred for subacute and chronic pain.” If you are using opioids for subacute or chronic pain, which including both terms, means treating pain for 1 month or more, your chart must contain some justification for the use of opioids. This is an extremely important matter. Appropriate reasons, such as a prior treater, attempted various nonopioid treatments of some kind that failed. There must be a very good reason why opioids were tried. It must be documented.

Larry Kobak, Esq.

Senior Counsel

Frier Levitt

ATTORNEYS AT LAW

101 Greenwich Street, Suite 8B

New York, NY 10006

(516) 755-7553 direct

(973) 618-1660 office

lkobak@frierlevitt.com

www.frierlevitt.com

Course Calendar

Regenerative Interventional Pain Course NYC- Jan, 28, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

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Intrathecal Pumps: Complications and Management of Pump Failure 0

Nov 30, 2022

Journal Club where David Rosenblum, MD reviews the possible complications related to an intrathecal pump. Discussed in this podcast:

Intrathecal pump malfunction, disconnect, granuloma, infection, MRI compatibility, related malfunctions, and evaluation of pump failure.

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This CME credit is not for listening to the podcast. No credit is offered for the podcast itself, but reflect on information learned and claim credit.

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Upcoming Workshops

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- Dec 3, 2022

Regenerative Interventional Pain Course NYC- Jan, 28, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

For up to date Calendar, Click Here!

For PM&R and Pain Management board review go to ...

or

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Interosseous Platelet Rich Plasma Injections for Knee Osteoarthritis 0

Nov 16, 2022

Regenerative Pain Medicine in Knee OA- The Interosseous Injection of BMAC and PRP

In anticipation of NRAP Academy’s upcoming Regenerative Medicine Course, Dr. Rosenblum reviews interosseous injections of PRP and Bone Marrow Aspirate in the treatment of Knee Osteoarthritis.

Dr. Rosenblum reviews key points and quotes Delgado et al in the below article.

PMRexam.com for PM&R Board Prep

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Upcoming Courses and Workshops!

Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- Dec 3, 2022

Regenerative Interventional Pain Course NYC- Jan, 28, 2023

Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023

Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023

For up to date Calendar, Click Here!

Reference

Delgado D, Garate A, Vincent H, Bilbao AM, Patel R, Fiz N, Sampson S, Sánchez M. Current concepts in intraosseous Platelet-Rich Plasma injections for knee osteoarthritis. J Clin Orthop Trauma. 2019 Jan-Feb;10(1):36-41. doi: 10.1016/j.jcot.2018.09.017. Epub 2018 Sep 28. Erratum in: J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. PMID: 30705529; PMCID: PMC6349647.

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Should MSCs treat Intervertebral Disc Degeneration? 0

Nov 8, 2022

A review of the evidence

David Rosenblum, MD reviews the description and evidence provided by Loibi et al in the published article referenced below. Dr. Rosenblum discusses personal experiences with treating back pain with regenerative medicine procedures. Discussed in this podcast:

Patient selection

Pathophysiology

Environment of the disc and it’s impact on MSCs

Risks and safety concerns of Intervertebral mesenchymal stem cell transplantation

Pain relief and recommendations for MSC injection into the disc in patients suffering from discogenic pain

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Course Calendar

Pain Management Board Review and Refresher, June 10-12, 2023- NYC Location TBA

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References

Loibl, M, Wuertz-Kozak, K, Vadala, G, Lang, S, Fairbank, J, Urban, JP. Controversies in regenerative medicine: Should intervertebral disc degeneration be treated with mesenchymal stem cells? JOR Spine. 2019; 2:e1043. https://doi.org/10.1002/jsp2.1043

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The Glossopharyngeal Nerve Revisited 0

Oct 27, 2022

The Glossopharyngeal Nerve Revisited-

The CE experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/VOw8zH

Glossopharyngeal Neuralgia, Anatomy, Pathophysiology, Diagnosis, and Treatment-

Dr. Rosenblum reviews Neuralgia and Compression of CN IX pathology, discusses the management, treatment and more. David Rosenblum MD, pain physician in Great Neck, Long Island discusses the different approaches to treating patients with medications and interventional pain procedures such as nerve blocks, neurolysis and radiofrequency lesioning...

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IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022