🎙️ 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