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Caudal Epidurals with PRP, Ultrasound Guidance & more!

The PMRExam Podcast

Release Date: 11/25/2025

From Chronic Pain to Zero: Nora Rodden on the Biopsychosocial Model and the Nervana App show art From Chronic Pain to Zero: Nora Rodden on the Biopsychosocial Model and the Nervana App

The PMRExam Podcast

Dr. David Rosenblum sits down with Nora Rabah Rodden, founder and CEO of Nervana, a digital health app for people living with chronic pain and other persistent symptoms. During her senior year at Cornell, Nora was hit by a car, which led to five years of mid and low back pain. She tried radiofrequency ablation, PRP, steroid injections, chiropractic care, physical therapy and acupuncture, and none of them gave her lasting relief. While earning her MBA and MS in Biotechnology at Harvard, Nora enrolled as a participant in a clinical study of Psychophysiologic Symptom Relief Therapy (PSRT), led by...

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PM&R Board Prep: Need to Know Pain Keywords! show art PM&R Board Prep: Need to Know Pain Keywords!

The PMRExam Podcast

It's the day before the pain boards, so Dr. David Rosenblum skipped the Zoom and recorded a rapid-fire, last-minute review of the high-yield keywords and "board traps" most likely to show up on the ABA Pain Medicine exam. Listen on your commute or at the gym. High-yield topics covered Neonatal pain: A-delta and C fibers and ascending pathways work before birth, but descending inhibition is immature, so neonatal pain may be exaggerated or prolonged. Board trap: incomplete myelination does not mean neonates can't feel pain. Dorsal horn anatomy: Rexed laminae I, II and V. Lamina II is the...

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Artificial Intelligence,  PM&R and Pain Medicine show art Artificial Intelligence, PM&R and Pain Medicine

The PMRExam Podcast

Artificial intelligence is moving fast from buzzword to clinical tool — and pain medicine is no exception. In this episode, Dr. David Rosenblum breaks down how AI is already touching the field, drawing on "Artificial Intelligence and Pain Medicine: An Introduction" by Hagedorn, George, Aiyer, Schmidt, Halamka, and D'Souza (Journal of Pain Research, 2024;17:509–518). Topics covered: Why AI is expected to be a genuine turning point for healthcare, not just another tech trend Using machine learning to optimize clinical trial design and patient selection in pain research Natural language...

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Low Dose Ketamine for Pain show art Low Dose Ketamine for Pain

The PMRExam Podcast

Ketamine clinics have exploded worldwide, offering low-dose intravenous infusions for chronic pain patients who've run out of options. But is this practice actually backed by evidence, or has off-label use outpaced the science? In this episode of the PainExam Podcast, Dr. David Rosenblum reviews the current literature on subanaesthetic-dose ketamine infusions (SDKIs) for chronic pain, drawing on the 2023 British Journal of Pain review by Harry M. Griffiths, "Low-dose ketamine infusions for chronic pain management: Does this qualify as evidence-based practice?" Topics covered: Why conventional...

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NAD+ Supplementation for Pain, Health and Wellness show art NAD+ Supplementation for Pain, Health and Wellness

The PMRExam Podcast

    PainExam Podcast Show Notes NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science? Hosted by: Presented by: Host: David Rosenblum, MD Episode Overview In this episode of the PainExam Podcast, we explore the growing interest in NAD+ (Nicotinamide Adenine Dinucleotide) supplementation and its potential role in pain management, inflammation reduction, cellular recovery, and healthy aging. NAD+ is a naturally occurring coenzyme found in every living cell and is essential for energy production, mitochondrial function, DNA repair,...

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Vertebrplasty, Kyphoplasty and Occipital Neuralgia for the PM&R Boards show art Vertebrplasty, Kyphoplasty and Occipital Neuralgia for the PM&R Boards

The PMRExam Podcast

PainExam Podcast Show Notes Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the ABA Pain Medicine Boards In this episode of the PainExam Podcast, Dr. David Rosenblum reviews two frequently tested topics on the ABA Pain Medicine Board Examination: Occipital Neuralgia and Vertebral Compression Fractures, including the indications, techniques, complications, and evidence surrounding vertebroplasty and kyphoplasty. Whether you are preparing for the ABA Pain Medicine Boards, ABPM, ABIPP, FIPP, or simply looking to strengthen your interventional pain knowledge, this...

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CRPS and Pain Pumps for the PM&R Boards! show art CRPS and Pain Pumps for the PM&R Boards!

The PMRExam Podcast

🎙️ PainExam Podcast Show Notes CRPS & Intrathecal Pain Pumps — High-Yield ABA Pain Board Review 🔥 Episode Overview In this episode of the PainExam Podcast, David Rosenblum reviews two essential ABA Pain Medicine Board topics: Complex Regional Pain Syndrome (CRPS) Intrathecal Drug Delivery Systems (Pain Pumps) This episode focuses on: High-yield board pearls Clinical decision-making Interventional treatment strategies Common exam pitfalls Whether you are preparing for the: ABA Pain Medicine Boards ABPM ABIPP FIPP —or looking to sharpen your interventional pain...

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Contrast Agents and Corticosteroid Selection for Pain Management Injections show art Contrast Agents and Corticosteroid Selection for Pain Management Injections

The PMRExam Podcast

🎙️ PainExam Podcast Show Notes Corticosteroids & Contrast Agents in Pain Management + Evidence-Based Steroid Selection 🔥 Episode Overview In this high-yield episode of the PainExam Podcast, David Rosenblum breaks down a must-know board topic: 👉 Injectable corticosteroids vs contrast agents in interventional pain procedures This episode goes beyond basics and dives into: Particulate vs non-particulate steroids Comparative profiles of dexamethasone, betamethasone, triamcinolone, and methylprednisolone Contrast agent selection and safety Critical complications including...

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Facet Mediated Pain for the PM&R Boards show art Facet Mediated Pain for the PM&R Boards

The PMRExam Podcast

🎙️ AnesthesiaExam Podcast & Video Show Notes Spine Pain, Facet Syndromes, and Interventional Concepts for the Anesthesia Boards 🔥 Episode Overview In this episode of the AnesthesiaExam Podcast, David Rosenblum delivers a high-yield, board-focused review of spine pain concepts every anesthesiologist must know: Lumbar, cervical, and thoracic facet-mediated pain Key anatomy and spinal innervation patterns Medial branch blocks and radiofrequency ablation (RFA) Important clinical correlations for anesthesia and pain boards This episode bridges the gap between anesthesiology board...

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SI Joint Dysfunction and Phantom Limb Pain for the Physiatry Boards show art SI Joint Dysfunction and Phantom Limb Pain for the Physiatry Boards

The PMRExam Podcast

🎙️ 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...

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More Episodes

Caudal Epidural Steroid Injection with PRP

Case Reports and a Testimonial!

Upcoming Training Courses and Services

 

Private Coaching Services:

  • Ultrasound guidance Preceptorship
  • Board preparation coaching

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 leukocyte-rich PRP from 60ml autologous blood
  • Follow-up assessments at 1, 3, and 6 months using VAS and SF-36 surveys
  • Key Findings:
  • Both treatments showed significant pain reduction compared to baseline
  • Steroid group had lower VAS scores at one month
  • PRP group demonstrated superior results at 3 and 6 months
  • PRP group showed significant improvement across all SF-36 domains at 6 months
  • No complications or adverse effects in either group during 6-month follow-up

Personal Treatment Experience

  • Dr. Rosenblum received transforaminal PRP injection 9-10 weeks ago
  • Gradual improvement noted from weeks 4-8, with more noticeable benefits from weeks 8-10
  • Current status: minimal pain (0.5/10) only during weather changes

Clinical Practice Philosophy

  • Treatment Approach: Minimalist philosophy focusing on turmeric, PRP, and Pilates
  • Medication Strategy: Low-dose naltrexone as go-to medication, avoiding long-term drugs with side effects
  • Surgical Avoidance: Prioritizing conservative treatments over unnecessary surgical interventions

Emergency Department PRP Implementation

  • Case Study Results: Ultrasound-guided caudal epidural steroid injection in ER setting
  • 100% pain resolution achieved
  • Patient discharged directly from ER
  • Cost savings: reduced from $33,000 to $4,800 (approximately $28,000 savings)
  • Training Opportunities: Private training sessions available for ER physicians interested in ultrasound-guided procedures

Patient Testimonial Highlights

  • Case Background: Nurse with herniated disc from March, previously considering $30,000 surgery
  • Treatment Outcome: PRP injection completed two months ago with nearly complete pain relief
  • Reduced from multiple pain medications to one Advil daily
  • Eliminated antalgic posture and muscle spasms
  • Returned to full 12-hour hospital shifts without difficulty
  • Overall quality of life restored to normal levels

David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.

 

Awards

New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025

Schneps Media: 2015, 2016, 2017, 2019, 2020

Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025

Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023

 

Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County’s Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!

 

Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  

 Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators.

He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call

Brooklyn     718 436 7246

Reference

Irvan J. Bubic, Jessica Oswald,
Ultrasound-Guided Caudal Epidural Steroid Injection for Back Pain: A Case Report of Successful Emergency Department Management of Radicular Low Back Pain Symptoms,
The Journal of Emergency Medicine,Volume 61, Issue 3,2021,Pages 293-297,ISSN 0736-4679

Ruiz‐Lopez, Ricardo, and Yu‐Chuan Tsai. "A randomized double‐blind controlled pilot study comparing leucocyte‐rich platelet‐rich plasma and corticosteroid in caudal epidural injection for complex chronic degenerative spinal pain." Pain Practice 20.6 (2020): 639-646.

#prppain #paincme #sciatia #ultrasoundmsk #ultrasoundprp #epidural #nypaindoctor #prppainwindsor