๐๏ธ PainExam Podcast Show Notes Phantom Limb Pain & Sacroiliac Joint Dysfunction โ High-Yield Pain Board Review ๐ฅ 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 โ mechanisms, risk factors, and advanced treatment strategies
- Sacroiliac (SI) Joint Dysfunction โ 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.
๐ Explore full board prep and CME: PainExam.com
๐ง Topic 1: Phantom Limb Pain โ 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
๐จ Board Pearl
Preemptive analgesia reduces the risk of phantom limb pain
๐ฆด Topic 2: Sacroiliac Joint Dysfunction โ 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
๐ 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)
๐จ Board Pearl
Diagnostic SI joint injection is the gold standard
๐ฏ 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
๐ Upcoming Events & Live Training ๐ ASPN 2026 Annual Meeting
Join Dr. Rosenblum for:
- Ultrasound-guided peripheral nerve blocks
- Spine interventions
- Regenerative medicine techniques (PRP, biologics)
- Hands-on procedural training
๐ 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
๐ Hosted through NRAP Academy
๐ค 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
๐ Resources
- ๐ Pain Board Review: PainExam.com
- ๐ Courses & CME: NRAPPain.org
- ๐บ YouTube: NRAP Academy
- ๐ง Question Bank + Virtual Fellowship: Available now
๐ข Call to Action
If you're preparing for the pain boards or want to elevate your clinical skillset:
โ
Subscribe to the PainExam Podcast
โ
Join our Virtual Pain Fellowship
โ
Attend a live ultrasound or regenerative medicine course
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