Podcasts about Ganglion

Play Episode Listen Later Jun 24, 2025 27:40

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 for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep Ultrasound Training REGISTER TODAY! Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights 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 Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Post Herpetic Neuralgia- An Update

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Play Episode Listen Later Jun 24, 2025 27:40

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 for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep Ultrasound Training REGISTER TODAY! Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights 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 Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Ep 157 – Ganglion cysts

GPnotebook Podcast

Play Episode Listen Later May 22, 2025 13:44

Ganglion cysts, also sometimes referred to as synovial cysts, are the most common benign soft-tissue masses of the hand and wrist. These cysts arise from the synovial lining of joints or tendon sheaths and are filled with a gelatinous, mucin-rich fluid. Despite their benign nature, ganglion cysts can cause discomfort, restrict motion and cause neurovascular compression (requiring medical intervention in some cases). In this episode, Dr Roger Henderson looks at epidemiology, pathophysiology, clinical presentation, diagnostic modalities, differential diagnoses and treatment options.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/orthopaedics/ep-157-ganglion-cysts.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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Episode 79 Hand Pathology | Osteoarthritis, Ganglion Cysts, And Carpal Tunnel Syndrome

This Medical Life

Play Episode Listen Later Apr 14, 2025 44:27

It is evident from paintings that Leonardo da Vinci and Michelangelo suffered some form of underlying hand pathologies. These have been the focus of discussions and journal articles amongst many academics. Our understanding of different disease processes involving the hand have come a long way. There are a lot of options for patients both medical and surgical that we discuss in this episode. This is the story of hand pathology Our special guest: Dr Paul van Minnen is a plastic and reconstructive surgeon who runs his own private practice in Adelaide called ‘Grip surgery’. Help support us on our donation page.See omnystudio.com/listener for privacy information.

EMCrit 395 - Stellate Ganglion Block - Not Whether, but When?

EMCrit FOAM Feed

Play Episode Listen Later Feb 23, 2025 29:42

ganglion emcrit

Scrambler Therapy: An Interview with Dr. Thomas Strouse

Play Episode Listen Later Feb 21, 2025 36:45

Episode Summary: In this episode of NRAP's PainExam Podcast, host David Rosenblum, MD, interviews Dr. Thomas Strouse about his extensive experience with Scrambler Therapy and the evidence supporting its use in treating chronic pain. They delve into the intricacies of this innovative therapy, discussing treatment protocols, patient responses, and the overall effectiveness of Scrambler Therapy for various pain conditions. Key Topics Discussed: - Overview of Scrambler Therapy and its analgesic response. - The importance of adjusting treatment intensity based on patient feedback. - Sensations experienced by patients during therapy (from burning to tapping). - Safety considerations for patients with pacemakers during treatment. - Insights into the effectiveness of Scrambler Therapy for conditions such as discogenic back pain and peripheral neuropathy. - Discussion on treatment costs for patients and providers. - Experiences with patients who have experienced pain recurrence after treatment. - The role of booster sessions in maintaining pain relief. - Challenges faced by failed back surgery patients and the potential benefits of Scrambler Therapy. Resources Mentioned: - Contact information for Stefan Erickson at stefan@mail.scramblertherapy.com to integrate Scrambler therapy into your practice. Links to additional resources and research on Scrambler Therapy. Info] Additional Information: - For more information about upcoming webinars, including the next session on cervical ultrasound, visit www.NRAPpain.org Thank you for tuning in to NRAP's PainExam Podcast! We hope you find the insights shared in this episode valuable in your journey toward understanding and managing chronic pain. NY based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Creators Biography: David Rosenblum, MD, currently treats patients in Garden City and Brooklyn. He 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. Dr. Rosenblum 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 working closely with the American Society of Interventional Pain Physicians (ASIPP), Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, and various state societies, 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 is a co-founder of the International Pain Academy and 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. Office based Pain Physicians, Physiatrists, Emergency Room Physicians, Anesthesiologists, Neurologists and Orthopedics who treat pain, utilize Neuromodulation and use PRP, Bone Marrow Aspirate or any other Biologics will benefit from this course. #longislandpaindoctor #interventionalpain #paindoctor #scrambler #scramblertherapy

Scrambler Therapy for Neuropathic Pain: An Interview with Dr. Thomas Strouse

Play Episode Listen Later Feb 21, 2025 36:45

Episode Summary: In this episode of NRAP's PainExam Podcast, host David Rosenblum, MD, interviews Dr. Thomas Strouse about his extensive experience with Scrambler Therapy and the evidence supporting its use in treating chronic pain. They delve into the intricacies of this innovative therapy, discussing treatment protocols, patient responses, and the overall effectiveness of Scrambler Therapy for various pain conditions. Key Topics Discussed: - Overview of Scrambler Therapy and its analgesic response. - The importance of adjusting treatment intensity based on patient feedback. - Sensations experienced by patients during therapy (from burning to tapping). - Safety considerations for patients with pacemakers during treatment. - Insights into the effectiveness of Scrambler Therapy for conditions such as discogenic back pain and peripheral neuropathy. - Discussion on treatment costs for patients and providers. - Experiences with patients who have experienced pain recurrence after treatment. - The role of booster sessions in maintaining pain relief. - Challenges faced by failed back surgery patients and the potential benefits of Scrambler Therapy. Resources Mentioned: - Contact information for Stefan Erickson at stefan@mail.scramblertherapy.com to integrate Scrambler therapy into your practice. Links to additional resources and research on Scrambler Therapy. Info] Additional Information: - For more information about upcoming webinars, including the next session on cervical ultrasound, visit www.NRAPpain.org Thank you for tuning in to NRAP's PainExam Podcast! We hope you find the insights shared in this episode valuable in your journey toward understanding and managing chronic pain. NY based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Creators Biography: David Rosenblum, MD, currently treats patients in Garden City and Brooklyn. He 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. Dr. Rosenblum 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 working closely with the American Society of Interventional Pain Physicians (ASIPP), Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, and various state societies, 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 is a co-founder of the International Pain Academy and 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. Office based Pain Physicians, Physiatrists, Emergency Room Physicians, Anesthesiologists, Neurologists and Orthopedics who treat pain, utilize Neuromodulation and use PRP, Bone Marrow Aspirate or any other Biologics will benefit from this course. #longislandpaindoctor #interventionalpain #paindoctor #scrambler #scramblertherapy

Scrambler Therapy for Chronic Pain: An Interview with Dr. Thomas Strouse

Fix Your Sciatica Podcast

Play Episode Listen Later Feb 21, 2025 36:45

Episode Summary: In this episode of NRAP's PainExam Podcast, host David Rosenblum, MD, interviews Dr. Thomas Strouse about his extensive experience with Scrambler Therapy and the evidence supporting its use in treating chronic pain. They delve into the intricacies of this innovative therapy, discussing treatment protocols, patient responses, and the overall effectiveness of Scrambler Therapy for various pain conditions. Key Topics Discussed: - Overview of Scrambler Therapy and its analgesic response. - The importance of adjusting treatment intensity based on patient feedback. - Sensations experienced by patients during therapy (from burning to tapping). - Safety considerations for patients with pacemakers during treatment. - Insights into the effectiveness of Scrambler Therapy for conditions such as discogenic back pain and peripheral neuropathy. - Discussion on treatment costs for patients and providers. - Experiences with patients who have experienced pain recurrence after treatment. - The role of booster sessions in maintaining pain relief. - Challenges faced by failed back surgery patients and the potential benefits of Scrambler Therapy. Resources Mentioned: - Contact information for Stefan Erickson at stefan@mail.scramblertherapy.com to integrate Scrambler therapy into your practice. Links to additional resources and research on Scrambler Therapy. Info] Additional Information: - For more information about upcoming webinars, including the next session on cervical ultrasound, visit www.NRAPpain.org Thank you for tuning in to NRAP's PainExam Podcast! We hope you find the insights shared in this episode valuable in your journey toward understanding and managing chronic pain. NY based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Creators Biography: David Rosenblum, MD, currently treats patients in Garden City and Brooklyn. He 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. Dr. Rosenblum 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 working closely with the American Society of Interventional Pain Physicians (ASIPP), Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, and various state societies, 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 is a co-founder of the International Pain Academy and 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. Office based Pain Physicians, Physiatrists, Emergency Room Physicians, Anesthesiologists, Neurologists and Orthopedics who treat pain, utilize Neuromodulation and use PRP, Bone Marrow Aspirate or any other Biologics will benefit from this course. #longislandpaindoctor #interventionalpain #paindoctor #scrambler #scramblertherapy

Unlocking Pain Relief: The Power of Stellate Ganglion Blocks

Play Episode Listen Later Feb 3, 2025 31:19

In this conversation, Dr. Ashley interviews Dr. Arun Kalava, MD about the use of stellate ganglion blocks in managing pain and other medical conditions. They discuss these various conditions that can be treated with this intervention, the role of the nervous system in pain perception, and the procedure itself. Dr. Kalava explains the importance of patient selection and the potential side effects of the treatment, emphasizing that it is often a last resort for patients who have not found relief through other means. The discussion highlights the significance of understanding pain pathways and the innovative approaches to managing chronic pain.Chapters00:00 Exploring Pain Management Modalities02:43 Understanding the Stellate Ganglion06:44 Conditions Treated by Stellate Ganglion Blocks12:23 The Role of Stellate Ganglion in PTSD15:25 Balancing the Autonomic Nervous System18:39 Patient Selection for Stellate Ganglion Blocks22:19 The Procedure: What to Expect24:50 Post-Procedure Care and Side Effects28:42 Finding Help: Tampa Pain MDhttps://www.tampapainmd.com/Did you know that our YouTube channel has a growing number of videos including this podcast? Give us a follow here- https://youtube.com/@fixyoursciatica?si=1svrz6M7RsnFaswNAre you looking for a more affordable way to manage your pain? Check out the patient advocate program here: ptpatientadvocate.comHere's the self cheat sheet for symptom management: https://ifixyoursciatica.gymleadmachine.co/self-treatment-cheat-sheet-8707Book a free strategy call: https://msgsndr.com/widget/appointment/ifixyoursciatica/strategy-callSupport this podcast at — https://redcircle.com/fix-your-sciatica-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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258: Ganglion Cyst, Sauna & Periods, Serrapeptase, Nut Limits

The Health Formula Show

Play Episode Listen Later Aug 9, 2024 13:06

Happy Friday! We're diving deep into some surprising topics today. Ever wondered about the hidden dangers of plastics? We uncover those, along with the surprising link between menstruation and dehydration. We also introduce you to serrapeptase—a powerful enzyme that's a game-changer for pain management. And don't miss our chat about the nutrient-packed world of nuts and seeds; we've got some top picks you won't want to miss! Tune in to hear: Cysts on left foot: next steps (1:36) Can you sauna when menstruating? (4:11) Serrapeptase explained (6:42) If nuts are healthy, why is there a limit? (9:17) Head to www.paulabenedi.com/episode258 for the show notes Join our newsletter: www.synergised.info/newsletter Follow Synergised on Instagram: @synergiseduk Follow Paula on Instagram: @paulabenedi . P.S. This podcast and website represent the opinions of Paula Benedi. The content here should not be taken as medical advice and is for informational purposes only, and is not intended to diagnose, treat, cure, or prevent any disease. Please consult your healthcare professional for any medical questions.

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Ganglion

Radio 1 - Sprechstunde

Play Episode Listen Later Jul 17, 2024 2:28

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3061: Semaglutide & MCAS, Stellate Ganglion Block, PEMF & Increased Stress, CREST & EMFs, Reoccurring Stye (HouseCall)

The Cabral Concept

Play Episode Listen Later Jun 23, 2024 15:48

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Jack: Dr Cabral you are the man! Extremely intelligent and respected. It's an honor to ask I have MCAS and high blood sugar eating very healthy and working out plant based no fats. Pancreas is not producing insulin. Can you speak more about semaglutide on how it could help MCAS. Also French lilacs main ingredient in metformin. I've tried Berberine 500mg ten capsules a day and it just doesn't work. Any suggestions for any herbs? Semaglutide or metformin. Thank you I feel stuck I know the blood sugar is directly connect to MCAS. Justin: What are your thoughts on using the stellate ganglion block as an alternative for prescription medication? Jim: Hi Dr. Cabral. I hope you and your family are doing well. I'd love your thoughts on a weird thing I've observed when using a PEMF mat and my Oura ring. I've used two different PEMF mats (Higher Dose and Therasage) at night and have noticed that my Stress level on my Oura ring goes up while sitting on it. I'm only using the heat function without PEMF. Why is this happening and would it negatively affect my sleep? Thanks so much! Mike: Hi Dr Cabral, I've worked with you and your team members over the past two yrs on my journey to heal CREST, I'm grateful for everything you do. I am doing a protocol you built for me at the end of last yr, I'm actually almost done the CBO protocol and looking forward to doing my retesting. Although I generally feel great, I am still suffering from CREST symptoms. Reason I'm writing in is because I'm curious if EMF exposure could be a primary cause of my symptoms. Ive read that EMF's can cause calcification (which I suffer from badly), and when I think back to when my CREST symptoms started, it was around the time I started using a cell phone in my teenage yrs. Also how can I limit EMF exposure while WFH without disrupting WIFI for work? Andrea: Hi Dr. Cabral , My husband gets reoccurring stye. He is then put on a combination of oral pills called cephalexin and an ointment called erythromycin. It gets better then randomly comes back several weeks later. Is there something else he can do to stop this cycle? Please advise. Your content and advice has been life changing for me, I am so grateful. Thank you! Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3061 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!

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Understanding the Stellate Ganglion Block with John Vogel DO

justASK!

Play Episode Play 60 sec Highlight Listen Later Jun 18, 2024 33:23

Stellate Ganglion Block for PTSDIndividuals may develop PTSD (also called Post Traumatic Stress Injury) from a single or repeated traumatic events. When trauma causes a persistent injury pattern to the nervous system, it can become locked into a permanent protective mode, even in the absence of on-going threat. This can cause a variety of symptoms including:Being "on-guard" all the timeConstant anxiety and fearIntolerance of being around groups of peopleNightmaresIsolation from others physically and emotionallyDifficulty progressing in therapy because talking about the trauma makes you too anxiousWhat is a stellate ganglion block?The sympathetic nervous system (the "fight or flight" part of the nervous system) is organized in front of the spinal column. Along the spine there are nerve bundles referred to as ganglion. Several ganglia are located in the neck, including one in the lower neck called the stellate ganglion. These nerves are special for their connection to brain regions which store and control emotional memories. Injection of local anesthetic around these nerve bundles interrupts the nervous system's constant exaggerated response to emotional trauma. You can think of it like rebooting your computer.How is a stellate ganglion block done?For decades, the procedure was done by feeling for a particular bone in the front of the spine, pushing the carotid artery toward the middle with one hand, and inserting a needle until it contacted bone prior to injection. Later, the procedure was improved by the use of x-ray to verify the correct level of the spine. However, use of x-ray does not allow visualization of important nerves and arteries in the neck.Ultrasound imaging and needle guidance is the gold standard for accuracy and safety, and the only technique Dr. Vogel has used over the last 7 years. The procedure is 1-2 minimally painful injections done in an outpatient setting that takes about 15 minutes.Dr. John Vogel, DODr. John Vogel is an independent pain specialist providing personalized treatment for a wide spectrum of pain conditions. He completed his pain fellowship at Brooke Army Medical Center and his residency at Emory University. Dr. Vogel is board-certified in pain medicine, headache medicine and family medicine.Dr. Vogel served in the Army Medical Department for 39 years. Upon retirement, he established a private direct pay practice in Marietta, GA. He provides the expertise, time and education needed for comprehensive individualized care. He offers the most recent advances in pain management, tailored to each person's concerns and goals. Dr. Vogel collaborates with other medical professionals to achieve multidisciplinary care.Dr. Vogel sees patients by medical professional referral or self-referral. He does not prescribe chronic opiate (DEA schedule II) medicationsDr. Vogel's information https://www.drjohnvogel.com/To Follow US check out: Heather- www.theshowcenter.comJackie- https://www.mymonarchhealthco.comThe podcast- @justaskhiveHeather- @showcenterdrqJackie- @jackiep_gynnpThe course is live and available at:the-hive8.teachable.com

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Fingersjukdomar-franska namn

Radio Tyresö

Play Episode Listen Later Apr 28, 2024 30:00

Dupuytren, de Quervain, Karpaltunnel och Ganglion handlar dr Lenas hörna om den här gången. Det är konstiga franska namn på vanliga åkommor i fingrarna. Programmakare Lena Hjelmérus och Leif Bratt skrattar tillsammans åt sina franska uttal, tur att man kan läsa mer på 11.77 och viss.nu

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Interventional Psych and Pain? The Stellate Ganglion, Scope of Practice, Ketamine & Magnesium and more!

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Play Episode Listen Later Mar 13, 2024 17:26

Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions. Other Announcements from NRAP Academy: PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full References Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik M, Kawka M, Grzegorzewska A. Magnesium in Ketamine Administration in Treatment-Resistant Depression. Pharmaceuticals (Basel). 2021 May 3;14(5):430. doi: 10.3390/ph14050430. PMID: 34063604; PMCID: PMC8147622. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.513068/full https://www.sutterhealth.org/services/behavioral-health/interventional-psychiatry Hanling SR, Hickey A, Lesnik I, et al Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial Regional Anesthesia & Pain Medicine 2016;41:494-500. https://www.psychiatrist.com/jcp/oral-ketamine-for-depression/

Stellate Ganglion, Ketamine Infusions and Interventional Psychiatry

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Play Episode Listen Later Mar 13, 2024 17:26

Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions. Other Announcements from NRAP Academy: PainExam App almost ready Pain Management Board Prep migrated to NRAPpain.org AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org Live Workshop Calendar Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full References Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik M, Kawka M, Grzegorzewska A. Magnesium in Ketamine Administration in Treatment-Resistant Depression. Pharmaceuticals (Basel). 2021 May 3;14(5):430. doi: 10.3390/ph14050430. PMID: 34063604; PMCID: PMC8147622. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.513068/full https://www.sutterhealth.org/services/behavioral-health/interventional-psychiatry Hanling SR, Hickey A, Lesnik I, et al Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial Regional Anesthesia & Pain Medicine 2016;41:494-500. https://www.psychiatrist.com/jcp/oral-ketamine-for-depression/

Rudy Malayil, MD WVSIPP President, Stellate Ganglion for Hot Flashes and more!

Play Episode Listen Later Feb 28, 2024 23:00

Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course. Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City. After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360. https://pain360.org https://www.malayilmd.com Ultrasound Interventional Pain Course Registration For Pain Management Board Prep Go to: References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full

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Stellate Ganglion Block and Hot Flashes- Rudy Malayil, MD of WVSIPP

Play Episode Listen Later Feb 28, 2024 23:00

Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course. Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City. After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360. https://pain360.org https://www.malayilmd.com Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full

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Rudy Malayil, MD PM&R, Pain, WVSIPP President discusses the Stellate Ganglion Block for Hot Flashes, the Appalachian Regional Spine and Pain Meeting and more!

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Play Episode Listen Later Feb 28, 2024 31:45

Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course. Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City. After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360. https://pain360.org https://www.malayilmd.com Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep Click Here! References https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full

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DO NOT TRY THIS AT HOME: Scott had a ganglion cyst...it's gone now. Hour 4 2/26/2024

The Dana & Parks Podcast

Play Episode Listen Later Feb 26, 2024 35:58

Episode 47: What are Ganglion Cysts?

Performance Health for Musicians

Play Episode Listen Later Jan 23, 2024 6:44

In this episode, Amanda talks about ganglion cysts, their symptoms, diagnosis, and treatment. Also, be sure to visit www.magicmind.com/JANformusicians AND use the code ASAGE20 for a total of 75% off your first subscription to Magic Mind!

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Stellate Ganglion Block For Long COVID In Los Altos: Get Relief From Symptoms

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Play Episode Listen Later Oct 24, 2023 2:39

If you suffer from symptoms of Long COVID in the greater San Francisco Bay Area, Soft Reboot Wellness (+1 650-419-3330) now offers the ground-breaking stellate ganglion block therapy. Go to https://www.softrebootwellness.com/stellate-ganglion-block-treatments for more information. Soft Reboot Wellness City: Menlo Park Address: 825 Oak Grove Ave Website https://www.softrebootwellness.com/ Phone +1-650-419-3330 Email hello@softrebootwellness.com

Ep. #308. Dr. Eugene Lipov, Stellate Ganglion Block and Ketamine.

Operation Tango Romeo, the Trauma Recovery Podcast

Play Episode Listen Later Oct 5, 2023 98:49

It's PTSI (itsptsi.com) Biological PTSD Treatment | SGB injection for PTSD | Stella (stellacenter.com) PTSD is an injury that can be treated. In psychology, Post-Traumatic Stress Disorder (PTSD) is defined as a response to experiencing traumatic or stressful events that create feelings of horror or helplessness. A neuroscience-informed view suggests that what has been called PTSD is in fact a biological injury that can be seen through brain scans. Though PTSD is a common term mental healthcare professionals use, Stella and others have suggested a new term – Post Traumatic Stress Injury (PSTI) – instead of Post Traumatic Stress Disorder. By talking about Post-Traumatic Stress as an injury, we can reduce stigmas around healing. At Stella, we have a range of proven treatments for the symptoms and conditions associated with trauma exposure. While many mental healthcare resources highlight the 17 most common PTSD symptoms, there are actually more. Operation Tango Romeo was voted Top 10 Trauma Podcasts in Canada by Feedspot. https://blog.feedspot.com/canada_trauma_podcasts/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/tango-romeo/message Support this podcast: https://podcasters.spotify.com/pod/show/tango-romeo/support

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Ultrasound of Ganglion Cyst & Wrist Anatomy Review

Radiologist Headquarters Video Podcasts

Play Episode Listen Later Sep 28, 2023 12:44

In this radiology lecture, we review the ultrasound appearance of ganglion cysts while highlighting relevant wrist ultrasound anatomy! Key teaching The post Ultrasound of Ganglion Cyst & Wrist Anatomy Review appeared first on Radquarters.

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Hand⎪Ganglion Cysts

The Orthobullets Podcast

Play Episode Listen Later Aug 11, 2023 12:20

In this episode, we review the high-yield topic of Ganglion Cysts ⁠⁠⁠⁠from the Hand section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

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Top San Francisco Stellate Ganglion Block Therapy For Long Covid Depression

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Play Episode Listen Later Aug 2, 2023 2:51

Long COVID is now associated with several mental health difficulties. If you're experiencing such symptoms in the sider San Francisco Bay Area, the SGB therapy from Soft Reboot Wellness (+1 650-419-3330) could help. Learn more at https://softrebootwellness.com/stellate-ganglion-block-treatments/ Soft Reboot Wellness 825 Oak Grove Ave # A101, Menlo Park, California 94025, United States Website https://www.softrebootwellness.com/ Email prc.pressagency@gmail.com

Stellate Ganglion Block Therapy In Bellevue, WA: Reduce Long Covid Symptoms

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Play Episode Listen Later Jul 28, 2023 2:17

Are you looking for a non-pharmaceutical option for treating the symptoms of long Covid? Interventional Orthopedics Of Washington (425-326-1665) offers Stellate Ganglion Block treatment to help you minimize your symptoms! Visit https://iowmed.com/stellate-ganglion-block-sgb/ for more information. Interventional Orthopedics of Washington 1515 116th Ave NE Suite 202, Bellevue, WA 98004, United States Website https://iowmed.com Phone +1-425-326-1665 Email info@iowmed.com

How I Do It: Gasserian Ganglion Block for Trigeminal Neuralgia

ASRA News

Play Episode Listen Later Jul 19, 2023 13:48

"Exosomes: The Good, The Bad, and The Ugly" by Drs. Apoorv Chaturvedi and Fabian Camilo Dorado Velasco, from St. Michael's Hospital, Dr. Harsha Shanthanna, from McMaster University, Dr. Xiang Qian, from Stanford University, and Dr. Akash Goel, from the University of Toronto. From ASRA Pain Medicine News, May 2023. See original article at www.asra.com/may23news for figures and references. This material is copyrighted.

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Bellevue Clinic Offers Stellate Ganglion Block Injections For Long Covid Relief

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Play Episode Listen Later Jul 19, 2023 2:11

Long Covid got you down? There is hope right here in Bellevue, Washington, with a Stellate Ganglion Block (SGB) treatment from Interventional Orthopedics of Washington (425-326-1665). Learn more at https://iowmed.com/stellate-ganglion-block-sgb/ Interventional Orthopedics of Washington 1515 116th Ave NE Suite 202, Bellevue, WA 98004, United States Website https://iowmed.com Phone +1-425-326-1665 Email info@iowmed.com

EP #1216: STELLATE GANGLION BLOCK (aka "The Magic Shot") for PTSD, Anxiety, Depression

Naturally Savvy

Play Episode Listen Later Jul 18, 2023 73:08

Lisa is joined by Eugene Lipov and Jamie Mustard, the authors of The Invisible Machine: The Startling Truth About Trauma and the Scientific Breakthrough That Can Transform Your Life. Lisa here. I have done thousands and thousands of interviews in my 25 year career in television, radio and podcasting in the health realm and THIS BOOK and the TREATMENT it offers for POST TRAUMATIC STRESS INJURY (injury is more accurate than disorder) is mind blowing. If you know ANYONE with the following issues, please have them listen to this interview: PTSI (also known as PTSD) Anxiety Depression Trouble Sleeping Stress Impulsivity Sexual Dysfunction Suicidal Ideation Issues Concentrating Hypervigilance Substance Abuse Numbness Book description. The world has long misunderstood trauma. Now, leading experts in the field have a radical new understanding of post-traumatic stress . . . and a surprising new treatment to reverse it could have profound implications for medicine, mental health, and society. Despite its prevalence, post-traumatic stress, PTSD, is often seen as an unbeatable lifelong mental disorder. However, top trauma doctors and neuroscientists now understand that the result of trauma is not a disorder, but rather a physical injury—and while invisible to the naked eye, the posttraumatic stress injury (PTSI) can now be seen on a scan. Most importantly, the effects of PTSI are reversible. Meet Dr. Eugene Lipov. His research and partnerships have led to an amazing discovery that all trauma has at its root a single piece of human hardware: the sympathetic nervous system, controlling the fight-or-flight response. Anyone who has endured trauma, including long-term microdoses of emotional stress, can have this injury. Dr. Lipov has pioneered a safe, 15-minute procedure that reverses the injury, relieving mild to extreme symptoms of PTSI—irritability, hypervigilance, anxiety, insomnia, and more—for survivors to combat soldiers to the everyday person. Weaving hard science with moving human stories, The Invisible Machine reveals how this treatment was developed. It also tells the incredible story of the unlikely team, including the doctor, an artist, Special Forces leadership, and a sheriff, who are working together to change our understanding of post-traumatic stress and why it matters to society. Coauthored by artist and innovator Jamie Mustard and in collaboration with writer Holly Lorincz, The Invisible Machine weaves hard science with moving stories of warriors, prisoners, and ordinary people to provide a stark new understanding of the human condition. The implications for a better, pain-free world are astounding—and that world could be nearer than we think.

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What are Stellate Ganglion Blocks? A look inside the treatment that has helped long COVID-19 patients

Minnesota Now

Play Episode Listen Later Apr 17, 2023 11:50

The U.S. national emergency to respond to the COVID-19 pandemic ended a last week as President Joe Biden signed a bipartisan congressional resolution to bring it to a close after three years. COVID-19, though, is still lurking, still making people sick and still killing many others. After three years, there are many people still experiencing symptoms from an early infection. There's still so much we don't know about what is causing long COVID and how to treat it. Remember hearing how many people lost their sense of taste and smell? There are those who still haven't recovered those vital sense. A growing number of providers around the country are using injections from the world of pain treatment to help long COVID patients regain taste and smell. Andy Johnson is in that group. He's a certified registered nurse anesthetist at Olivia Hospital and has given what are called Stellate Ganglion Blocks to about two dozen long COVID patients. Dr. Matthew Tyler is an Assistant Professor at the University of Minnesota medical school who specializes in nose and sinus issues, including the loss of smell. Both Andy Johnson and Dr. Matthew Tyler joined MPR News host Cathy Wurzer to talk about the use of Stellate Ganglion Blocks.

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37. Ketamine & Stellate Ganglion Blockade for Depression & Anxiety w/ Dr. Armen Haroutunian

No Supervision

Play Episode Listen Later Apr 12, 2023 46:07

Dr. Armen Haroutunian is an anesthesiologist that stops by the podcast to talk about some of the treatments that he performs that are very effective for treating depression and anxiety: Stellate Ganglion Blockade and Ketamine administration. SGB has an 80% + success rate, so this episode is definite worth a listen. Dr. Thomas Hughes is hosting. IG: @chronicpaindoc @cubepsych @seenpsychiatry Website: paininjuryrelief.com cubepsych.com seenpsychiatry.com

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76 - Dr Robert Groysman - Stellate Ganglion Block

Long Covid Podcast

Play Episode Play 32 sec Highlight Listen Later Mar 22, 2023 55:09 Transcription Available

Episode 76 of the Long Covid Podcast is a chat with Dr Robert Groysman about the work he has been doing treating Long Covid with the Stellate Ganglion Block. We discuss what the block is and how it can be really successful in helping people. Facebook Treatment GroupYouTube ChannelDr Groysman's websiteDr Groysman in NewsMaxDr Groysman in a Houston Magazine Support the show~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costs.Share the podcast, website & blog: www.LongCovidPodcast.comFacebook @LongCovidPodcastInstagram & Twitter @LongCovidPodFacebook Support GroupSubscribe to mailing listPlease get in touch with feedback and suggestions or just how you're doing - I'd love to hear from you! You can get in touch via the social media links or at LongCovidPodcast@gmail.com

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Ultrasound Guided Spine and Interventions- Cluneal Nerve, Stellate Ganglion, Facet, Caudal and more!

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Play Episode Listen Later Jan 10, 2023 32:33

David Rosenblum, MD, creator of PainExam.com, AnesthesiaExam.com, PMRExam.com, NRAP Academy and International Pain Academy Co-Founder presents an excerpt from Grand Rounds Given on January 2, 2023 to the Metropolitan Hospital Physical Medicine and Rehabilitation Department. Reflect on Ultrasound Guided Interventional Spine Procedures and Claim CME Credit Agenda: Ultrasound Guided Cluneal Nerve Blocks Ultrasound Guided Stellate Ganglion Block Ultrasound Guided Facet Joint Injection Ultrasound Guided Medial Branch Blocjks Ultrasound Guided Sacroiliac Joint Inejction Ultrasound Guided Caudal Epidural Injections Dr. Rosenblum offers live regional anesthesia, regenerative medicine, board review and interventional pain management CME courses in NY and around the world. For more information, go to www.NRAPpain.org or PainExam.com/events Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Great Neck Office 516 482 7246 Upcoming Courses and Workshops! Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- Dec 3, 2022 Regenerative Interventional Pain Course NYC- Jan, 28, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 NRAP: NYC Regional Anesthesia and Pain Ultrasound CME Workshop Registration, Sat, Dec 3, 2022 at 7:30 AM | Eventbrite For up to date Calendar, Click Here!

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How I Do It: Stellate Ganglion Blocks for Refractory Ventricular Electrical Storm

ASRA News

Play Episode Listen Later Jan 5, 2023 10:28

"How I Do It: Stellate Ganglion Blocks for Refractory Ventricular Electrical Storm," by Jackson M. Condrey, MD, Assistant Professor; Renuka George, MD, Associate Professor; and Sylvia H. Wilson, MD, Professor; all of the Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina. From ASRA Pain Medicine News, November 2022. See original article at www.asra.com/nov22news for figures and references. This material is copyrighted.

From Leading Global R&D Teams to Funding Startups

OIS Podcast

Play Episode Listen Later Nov 23, 2022 51:04

Scott Brun, MD, began his long career in pharma R&D leadership in the late 1990s, holding key roles at Abbott and AbbVie. Had he picked up a pencil with his right hand, his career may have taken a completely different turn.Dr. Brun earned his medical degree at Johns Hopkins University School of Medicine and completed a residency in ophthalmology at the Massachusetts Eye and Ear Infirmary. A leftie, Dr. Brun ultimately decided not to become ambidextrous. Instead, he joined Abbott as a pharmaceutical physician and began a fruitful career leading development across multiple therapeutic areas.With OIS Podcast host Sophia Pathai, MD, PhD, Dr. Brun looks both forward and ahead, sharing stories from his time at Abbott and AbbVie as well as his insights on promising developments in ophthalmology. At venture capital firm Abingworth, Dr. Brun currently helps young biopharma leaders turn their visions into reality. He's also running his own consulting company and helping Horizon Therapeutics build its internal pipeline.Listen to the podcast today to hear Dr. Pathai and Dr. Brun talk about:Dr. Brun's background, from medicine to industry to consulting and VC work. Pivotal events across therapeutic areas during his tenures at Abbott and AbbVie. How Dr. Brun fostered teamwork, motivation, and engagement among large teams within large pharmaceutical companies, especially in times of failure. The differences between managing a team of six and leading an organization of 2,000 people across 40-plus countries.The success of Opthea and how it illustrates the need for VCs to think globally. How the current bear market will test early-stage biopharma and biotech, and how these startups can survive current economic challenges. The road ahead. What areas of development look most promising? Gene therapy for dry age-related macular degeneration? Ganglion cell regeneration? Something else?Click “play” to listen.

Hand⎪Ganglion Cysts

The Orthobullets Podcast

Play Episode Listen Later Oct 30, 2022 12:20

In this episode, we review the high-yield topic of Ganglion Cysts from the Hand section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

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Stellate Ganglion Block for Trauma and PTSD - Interview with Dr. James Lynch

The Taproot Therapy Podcast - https://www.GetTherapyBirmingham.com

Play Episode Listen Later Oct 24, 2022 29:41

Stellate Ganglion Block (SGB)—a medical procedure that effectively treats symptoms associated with posttraumatic stress disorder (PTSD)—is an injection of local anesthetic in the neck to temporarily block the cervical sympathetic chain which controls the body's fight-or-flight response. SGB has been safely used for over 80 years for many other reasons but was discovered ten years ago to provide relief of PTSD symptoms as well. Since that time, along with a handful of other physicians, I have pioneered the use of SGB for treating posttraumatic stress within the US Army. Due to its safety, success rate, and rapid onset of relief, SGB has gained wide acceptance in several locations at US military hospitals where it has been available. https://www.drjameslynch.com/ Check Out More Info and Resources on Trauma

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Healing from trauma & the positive effects of the SGB (Stellate Ganglion Block)

Behind the Service Podcast

Play Episode Listen Later Oct 12, 2022 15:35

Hey BTS listeners! In today's episode, join Libby as she discusses the benefits of healing from trauma and how the SGB (Stellate Ganglion Block) procedure has helped in her healing.Healing is possible!There's no EASY BUTTON!If left untreated, trauma can have long term effects.Faith in Jesus Christ has been the driver in healing.Recovery is hard work!What is trauma?What is the SGB (Stellate Ganglion Block & how can it help?What has it done for her healing. "Healing is hard but it is totally worth it to be able to lean into those uncomfortable parts of your story, move through the pain, change the patterns that your brain has..."patterned for you to survive" and change the ending". ---Libby Bates John 14:27 (Amplified Version) "Peace, I leave with you, My (Perfect) peace I give to you {the Holy Spirit}; not as the world gives do I give to you. Do not let your hearts be troubled, nor let it be afraid. (Let My perfect peace calm you in every circumstance and give you courage and strength for every challenge)."John 10:10 says, "The enemy comes to steal, kill and destroy but I have come to give you a life more abundant, to the fullest, until it overflows". "Thank you to BetterHelp for sponsoring today's episode!Behind the Service listeners can get 10% off by visiting:https://betterhelp.com/behindtheserviceHome » Coming Home WellWe are a 501C3 nonprofit organization.Check out other podcasts: Peace After Combathttps://www.buzzsprout.com/1928334...

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Treating Long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks

Play Episode Listen Later Sep 22, 2022 15:05

Treating Long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks- A new application of an old therapy- Dr. Rosenblum reports his experience with a patient who reported long term relief of anosmia and parosmia with a unilateral stellate ganglion block. Dr. Rosenblum discusses the pathophysiology of the imbalances between the Sympathetic, parasympathetic nervous system, and feedback loops in the Neuro-immune system. For more information see attached texts. For Ultrasound Training to enable safe application of this therapy go to www.PainExam.com/events Links to PDF files- Stellate ganglion block reduces symptoms of Long Covid- A Case Series- Click here to download Regulation of acute reflectory hyperinflammation in viral and other diseases by SGB- Click here to download Upcoming Events... Want to view the complete events agenda? Click Here Now! NRAP's Blocks and Brunch Ultrasound CME Workshop- NYC Oct. 8th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE- Oct. 20th, 2022 NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE! Lock in Your Spot Today! Register Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Podcast Resources: David Rosenblum, M.D. Subscribe to PainExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

Treating long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks

Play Episode Listen Later Sep 22, 2022 15:05

Treating long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks- A new application of an old therapy- Dr. Rosenblum reports his experience with a patient who reported long term relief of anosmia and parosmia with a unilateral stellate ganglion block. Dr. Rosenblum discusses the pathophysiology of the imbalances between the Sympathetic, parasympathetic nervous system, and feedback loops in the Neuro-immune system. For more information see attached texts. For Ultrasound Training to enable safe application of this therapy go to www.PainExam.com/events Links to PDF files- Stellate ganglion block reduces symptoms of Long Covid- A Case Series- Click here to download Regulation of acute reflectory hyperinflammation in viral and other diseases by SGB- Click here to download Upcoming Events... Want to view the complete events agenda? Click Here Now! NRAP's Blocks and Brunch Ultrasound CME Workshop- NYC Oct. 8th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE- Oct. 20th, 2022 NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE! Lock in Your Spot Today! Register Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Podcast Resources: David Rosenblum, M.D. Subscribe to AnesthesiaExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

Treating long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks

Play Episode Listen Later Sep 22, 2022 15:05

Treating long COVID, Parosmia and Anosmia with Stellate Ganglion Blocks- A new application of an old therapy- Dr. Rosenblum reports his experience with a patient who reported long term relief of anosmia and parosmia with a unilateral stellate ganglion block. Dr. Rosenblum discusses the pathophysiology of the imbalances between the Sympathetic, parasympathetic nervous system, and feedback loops in the Neuro-immune system. For more information see attached texts. For Ultrasound Training to enable safe application of this therapy go to www.PainExam.com/events Links to PDF files- Stellate ganglion block reduces symptoms of Long Covid- A Case Series- Click here to download Regulation of acute reflectory hyperinflammation in viral and other diseases by SGB- Click here to download Upcoming Events... Want to view the complete events agenda? Click Here Now! NRAP's Blocks and Brunch Ultrasound CME Workshop- NYC Oct. 8th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE- Oct. 20th, 2022 NSPC's Annual Conference 2022- THE BUSINESS OF PAIN MEDICINE! Lock in Your Spot Today! Register Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Podcast Resources: David Rosenblum, M.D. Subscribe to PMRExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos

Bellevue, WA Orthopedic Practice Offers Stellate Ganglion Block Therapy For PTSD