The PMRExam Podcast

Author: David Rosenblum, MD

PMR Board Review instructor, David Rosenblum, MD brings his unique insight into this podcast where he discusses issues relevant to physiatrists and pain physicians. Dr. Rosenblum is the author of PMRExam.com For more information go to PMRExam.com for board review and CME credits
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SI Joint Dysfunction and Phantom Limb Pain for the Physiatry Boards
Wednesday, 25 March, 2026

🎙️ 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