The PMRExam Podcast

Regenerative Medicine Journal Club Dr. Rosenblum reviews a case report discussing Platelet Rich Plasma Intra-discal Injection using ultrasound and fluoroscopy. The author mentions use of ultrasound to avoid the Internal jugular vein, carotid artery, phrenic nerve, esophagus and neural structures. The author mentions mixing lidocaine with PRP and Dr. Rosenblum comments on his experience and knowledge of the technique. Dr. Rosenblum mentions the risk of disci tis. Course Calendar Practice Management Webinar: The End of the Public Health Emergency. What's Changed and what Opportunities Remain! Register to our Free Upcoming Practice Management Webinar on April 24th Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 For up to date Calendar, Click Here! Claim CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wpE4BfThe CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wpE4Bf References Ultrasound-Guided Lumbar Intradiscal Injection for Discogenic Pain: Technical Innovation and Presentation of Two Cases Tsung-Ju Wu et al. Journal of Pain Research Published online: 16 Nov 2022

CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/W8x3jd Journal Club. Minimally Invasive Lumbar Decompression (mild® Procedure) with Conventional Medical Management vs. Conventional Medical Management Alone. Descripton of Procedure, Safety, Technique, study outcome, personal experience with this minimally invasive technique that interventional pain physicians are using to treat neurogenic claudication related to ligamentum flavum hypertrophy. Dr. Rosenblum discusses spinal stenosis pathophysiology and neurogenic claudication. Dr. Rosenblum also mentions upcoming courses and webinars: Upcoming Courses and Workshops! Course Calendar Practice Management Webinar: The End of the Public Health Emergency. What's Changed and what Opportunities Remain! Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 For up to date Calendar, Click Here!

References

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

Biologics and the Peripheral Nerve. Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TgB18M Dr. Rosenblum discuss his upcoming talk at the Appalachian Region Spine and Pain Meeting: Incorporating Ultrasound into a Spine and Pain Practice on April 14-16 2023 and the topics he plans to include: Ultrasound Guided Knee therapies, cluneal nerve, caudal, brachial plexus and more! Today's podcast (inspired by TOBI and Dr. Sudhir Diwan, Dr. Sheldon Jordon and Dr. Rikin Patel's ASIPP Lectures) focuses on the risk and benefits of performing PRP injection onto a nerve. Dr. Rosenblum discusses: Possible fibrosis of the ulna nerve after using PRP for partial ulnar collateral ligament tears Best Time for PRP Injection after Nerve Regeneration Alpha 2-macroglobulin (what is it?) PRP for moderate to severe carpal tunnel syndrome Featured Courses! May 25, 2023 Private Pain Group Ultrasound Course- NYC (Sold out) Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 see the full schedule for our July and August US IPM Courses! References Robert G. Thompson, Kendall Bradley, Gary M. Lourie, Ulnar nerve dysfunction at the elbow after platelet-rich plasma treatment for partial ulnar collateral ligament injuries,JSES Reviews, Reports, and Techniques,Volume 1, Issue 1,2021,Pages 41-44,ISSN 2666-6391, Si-Ru Chen, Yu-Ping Shen, Tsung-Yen Ho, Tsung-Ying Li, Yu-Chi Su, Yu-Ching Chou, Liang-Cheng Chen, Yung-Tsan Wu,One-Year Efficacy of Platelet-Rich Plasma for Moderate-to-Severe Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial,Archives of Physical Medicine and RehabilitationVolume 102, Issue 5,2021, Pages 951-958,ISSN 0003-9993,https://doi.org/10.1016/j.apmr.2020.12.025. Rehman, A.A., Ahsan, H. and Khan, F.H. (2013), Alpha-2-macroglobulin: A physiological guardian. J. Cell. Physiol., 228: 1665-1675. https://doi.org/10.1002/jcp.24266 Muhammad Pandunugrahadi, Komang Agung Irianto, Oen Sindrawati, "The Optimal Timing of Platelet-Rich Plasma (PRP) Injection for Nerve Lesion Recovery: A Preliminary Study", International Journal of Biomaterials, vol. 2022, Article ID 9601547, 7 pages, 2022. https://doi.org/10.1155/2022/9601547

Knee Osteoarthritis and Regenerative Pain Medicine Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/TJXGw0 Dr. Rosenblum reviews the latest evidence comparing Bone Marrow Aspirate and Platelet Rich Plasma for knee pain. He also reviews the latest publication by Di Martino et al's study which compared Leukocyte-rich PRP vs. Leukocyte-poor PRP in the treatment of knee osteoarthritis. Upcoming Courses

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

Regenerative Pain Medicine Course NYC- May 13

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

References

El-Kadiry, A.EH., Lumbao, C., Salame, N. et al. Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study. BMC Musculoskelet Disord 23, 23 (2022). https://doi.org/10.1186/s12891-021-04910-5

Hede, Kris, et al. "Combined bone marrow aspirate and platelet-rich plasma for cartilage repair: two-year clinical results." Cartilage 13.1_suppl (2021): 937S-947S. Anz AW, Plummer HA, Cohen A, Everts PA, Andrews JR, Hackel JG. Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 2 Years: A Prospective Randomized Trial. The American Journal of Sports Medicine. 2022;50(3):618-629. doi:10.1177/03635465211072554 Di Martino A, Boffa A, Andriolo L, et al. Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial. The American Journal of Sports Medicine. 2022;50(3):609-617. doi:10.1177/03635465211064303

Carpal Tunnel Syndrome

Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/JiPKnm Diagnosis, Pathophysiology, Clinical Findings and Management of the Carpal Tunnel Syndrome

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

Discussion on Carpal Tunnel Syndrome: Carpal Tunnel Syndrome is a condition that occurs when the median nerve, which runs from the forearm to the hand, becomes compressed or squeezed at the wrist. This compression can lead to pain, numbness, and tingling in the hand and arm, which can be debilitating. There are many causes of Carpal Tunnel Syndrome, including repetitive hand movements, wrist injuries, pregnancy, and medical conditions such as diabetes and thyroid disorders. Treatment options for Carpal Tunnel Syndrome range from non-invasive approaches like rest, ice, and wrist splints to more invasive treatments like surgery. It's important to diagnose and treat Carpal Tunnel Syndrome early to prevent long-term damage to the median nerve. A proper diagnosis can be made through a physical exam and imaging tests like an electromyography (EMG) or nerve conduction study (NCS). Don't forget to check out the NRAP Academy CME courses offered on our website, www.painexam.com/events page, to continue your medical education and enhance your patient care. 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.

Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/tn70Yk 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

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!

Claim CME Credit!

This Podcast is not worth any CME Credit, but Credit can be Claimed for reflecting on content: The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/9AX9LN

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!

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

The CE experience for this Webinar is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/p1nfCi

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

[email protected]

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

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. Claim CME Credit 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. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/QzrQ19 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 ...

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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 Claim CME Credit The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/FOIuSR 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.