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