Facet Mediated Pain for the Pain Boards

🎙️ PainExam Podcast & Video Show Notes Facet-Mediated Pain, RFA, and Advanced Interventional Strategies 🔥 Episode Overview

In this episode of the PainExam Podcast, David Rosenblum delivers a high-yield, board-focused deep dive into:

• Lumbar, cervical, and thoracic facet-mediated pain
• Medial branch blocks (MBB) and radiofrequency ablation (RFA)
• Key Medicare / LCD criteria for performing procedures
• Advanced therapies including multifidus stimulation and regenerative medicine (PRP)

This episode is essential for pain physicians preparing for the ABA, ABPM, ABIPP, and FIPP board exams — and for those looking to refine their interventional practice.

🧠 Key Topics Covered 🦴 Facet-Mediated Pain (Lumbar, Cervical, Thoracic)

• Axial, non-radicular pain
• Worse with extension and rotation
• Cervical facet pain → often post-whiplash
• Thoracic facet pain → underdiagnosed

🔬 High-Yield Anatomy & Innervation

• Dual innervation of facet joints
• L5–S1 facet → L5 dorsal ramus (board favorite)
• C2–3 facet → third occipital nerve

💉 Diagnosis & Medicare Criteria

• Gold standard: Medial branch blocks (NOT imaging)
• Medicare requires:
  • Chronic pain ≥ 3 months
  • Failed conservative therapy
  • Two diagnostic blocks with ≥80% relief

⚡ Interventional Treatment

• Radiofrequency ablation (RFA)
  • 6–12 month relief
  • Repeatable
• Proper needle placement and stimulation techniques

🚀 Advanced & Emerging Therapies

• Multifidus stimulation
  • Restores spinal stability
  • Treats underlying dysfunction
• PRP / Regenerative Medicine
  • Targets inflammation and tissue healing
  • Growing role in pain management

🎯 Board Prep Takeaways

• Facet pain = axial + extension-based
• Diagnosis = medial branch blocks
• Know cervical vs lumbar differences
• Medicare requires dual blocks before RFA
• L5 dorsal ramus = high-yield exam concept

🎓 Pain Board Prep & CME Resources

If you're preparing for your boards or want to advance your clinical skills:

👉 Start your Pain Board Review:
https://nrappain.org

👉 Access Question Banks, Lectures & Virtual Fellowship:
https://nrappain.org

👉 PainExam Platform:
https://painexam.com

🏆 Why Pain Physicians Choose NRAP Academy

• Comprehensive ABA / ABPM / ABIPP / FIPP board prep
• High-yield lectures + MCQs
• Ultrasound-guided procedure training
• Regenerative medicine education
• Virtual Pain Fellowship curriculum

🎤 Upcoming Live Training & Conferences

Join Dr. Rosenblum at upcoming events:

• ASPN 2026 Annual Meeting — Ultrasound & regenerative medicine labs
• PainWeek 2026 — Lectures on:
  • Image-guided interventions
  • Ultrasound integration
  • Regenerative pain therapies
  • AI in pain management

🔗 Connect & Learn More

• 🌐 NRAP Academy: https://nrappain.org
• 📚 PainExam Board Prep: https://painexam.com
• 🎥 YouTube: NRAP Academy
• 🎓 Courses: Ultrasound & Regenerative Medicine Training

📢 Call to Action

If you're serious about passing your pain boards and mastering interventional pain:

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