Traumeel Epidural? The FDA, Spine applications and more about this Homeopathic treatment
Release Date: 12/11/2023
Does Kratom Relieve Pain? Risks, Benefits and more!
The PMRExam Podcast
🎙️ PainExam Podcast Show Notes Kratom (Mitragyna speciosa): What Pain Physicians Must Know for the Boards In this episode, Dr. David Rosenblum reviews the current science, pharmacology, risks, and clinical relevance of Kratom — an herbal substance widely discussed by pain patients and increasingly appearing on pain-medicine board exams. The discussion focuses on evidence-based mechanisms, safety considerations, and counseling points essential for ABA/ABPM/ABIPP/FIPP board preparation. 🔍 Key Board-Relevant Takeaways 1. Pharmacology & Mechanism Kratom’s primary alkaloids are...
info_outline
Caudal Epidurals with PRP, Ultrasound Guidance & more!
The PMRExam Podcast
Caudal Epidural Steroid Injection with PRP Case Reports and a Testimonial! Upcoming Training Courses and Services and : New York and Detroit locations scheduled Private Coaching Services: Ultrasound guidance Preceptorship Board preparation coaching Contact available via email for interested physicians PRP Caudal Epidural Research Review Study Overview: Randomized double-blind controlled pilot study comparing leukocyte-rich PRP versus corticosteroids in caudal epidural space 50 patients randomly assigned to two groups Treatment options: triamcinolone 60mg or...
info_outline
Supplements for Pain, the Evidence!
The PMRExam Podcast
Episode Overview In this episode, Dr. David Rosenblum discusses the role of supplements and complementary strategies in the management of chronic pain. Drawing from clinical practice at AABP Integrative Pain Care, as well as his teaching and training programs, Dr. Rosenblum reviews how nutraceuticals, regenerative therapies, ultrasound-guided procedures, and neuromodulation can work together to improve patient outcomes and reduce opioid reliance. This episode also highlights educational opportunities and exam-prep resources for pain fellows, residents, anesthesiologists, physiatrists, and APPs...
info_outline
ACL Tear Treatment with BMC and Platelet Products: Journal Club
The PMRExam Podcast
Pain Exam Podcast Recent Conference Activities London Conference Weekend: Successfully attended and spoke at ISPN and SOMOS care conferences Somos Care Conference: Delivered presentation on pain management for primary care physicians Presentation consisted of 50+ slides with only one slide dedicated to opiates Emphasized shift away from opiate-based treatments in interventional pain management Recommended primary care physicians refer patients to pain specialists for comprehensive treatment options ISPN Conference: Participated in international pain management conference Met with...
info_outline
TENS: Mechanism of Action and Evidence
The PMRExam Podcast
Project Sync / Status Update Summary Podcast Episode Overview The host discussed Transcutaneous Electrical Nerve Stimulation (TENS) as a recurring pain board topic and reviewed mechanisms, efficacy, and clinical considerations. Emphasis that TENS appears on pain boards annually and is a foundational topic from early podcast episodes. Board Prep and NRAP Community at or ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship Educational Offerings and Events Training and Courses: Monthly ultrasound courses in New York and upcoming courses in Detroit...
info_outline
ADSC (Adipose Stem Cells) vs BMAC for Knee OA
The PMRExam Podcast
Exploring the Efficacy of BMAC and ADSC Injections in Knee Osteoarthritis Hosts: David Rosenblum,MD Overview: In this episode, we delve into a recent study published in the Indian Journal of Orthopaedics that compares the therapeutic efficacy of Bone Marrow Aspirate Concentrate (BMAC) and Adipose-Derived Stem Cells (ADSCs) for treating knee osteoarthritis (OA). The study aims to provide insights into the effectiveness of these regenerative treatments and their correlation with mesenchymal stem cell (MSC) cellularity. Key Points Discussed: Background on Osteoarthritis:...
info_outline
Steroid vs Ketorolac for Intra-Articular Injections: Journal Club
The PMRExam Podcast
Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and...
info_outline
Post Herpetic Neuralgia- An Update
The PMRExam Podcast
Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors...
info_outline
The Neurolytic Celiac Plexus Block
The PMRExam Podcast
Summary In this Pain Exam Podcast episode, Dr. David Rosenblum discusses a journal club article on low volume neurolytic retrocrural celiac plexus blocks for visceral cancer pain. The study reviewed 507 patients with severe malignancy-related abdominal pain, with data retained for 455 patients at the 5-month mark. Dr. Rosenblum explains that the procedure involves injecting 3-5ml of 6% aqueous phenol at the T12-L1 level under fluoroscopic guidance, with an average procedure time of 16.3 minutes. The study found significant pain relief lasting up to six months, reduced opioid...
info_outline
PRP Epidural Injections for Radicular Pain
The PMRExam Podcast
PRP in the Epidural Space for Radiculopathy Brooklyn Based Pain Physician, David Rosenblum, MD known for his work publishing and teaching Regenerative Pain Medicine and Ultrasound Guided Pain Procedures hosts this podcast covering the latest and most advanced concepts in Pain Medicine. Summary Dr. David Rosenblum delivered a comprehensive lecture covering several key topics in pain management. He discussed his upcoming speaking engagements at PainWeek, ASPN and great upcoming meetings like the Latin American Pain Society, and other conferences. Dr. Rosenblum shared his extensive experience...
info_outlinePainExam Podcast Show Notes: Exploring Traumeel as an Alternative for Back Pain Relief
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].
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