Interventional Pain Management Training

Integrative Pain Management Certification Training for lumbar pathologies, osteoarthritis, joint, and soft tissue injections for Primary Care Physicians and Other Specialties

This is a comprehensive course for physicians to learn and receive their Pain Management Certification onhow to properly test, diagnose, and treat a variety of pain related presentations by your patient. Emphasis is placed on anatomy, pain pathologies, and treatment options available to your patient. Over the 2-Day event, extensive training will be provided on a multitude of interventional pain management techniques with a focus on treating lumbar spinal disorders using the various injection modalities. All protocols for the spinal injections are given including medicines needed for the chemical neurolysis (facet joints), epidurals, and steroid joint injections. Physicians will be trained on and perform the various spinal injections, including facet joint, epidural (lateral foraminal, central, caudal), sympathetic nerve blocks, sacroiliac as well as other joint and specialty injections on human cadavers and other training models throughout the course study.

The use of medical devices for many of the spinal injections are taught for the various large joints and tendon/sheaths including the Platelet Rich Plasma (PRP) injections. Specialty injections using Botulinum Toxin for muscle spasticity and hyaluronic acid for visco-supplementation for shoulders and knees are part of the course study. Chronic pain management is also included within the program study for the management of chronic pain and safe administration of prescriptions within your practice. In addition, physical therapy options are discussed for those patients that need orthopedic rehabilitation after receiving pain management procedures.

Procedures and Topics Covered

We know that with the alarmingly high numbers of patients suffering with Sexual Dysfunction is an equally high demand for treatment and return to a pleasurable, intimate lifestyle. It is also important, however, to treat ED promptly to prevent further deterioration and disuse atrophy, which is the typical progression of this disease when treatment is not provided early on.

Why Integrate Sexual Dysfunction Treatment into my Practice?

1. One-on-One Fluoroscopy Equipment Training
2. Spinal Procedures/ Injections – Sacroiliac Joint Injections, Diagnostic/Destructive Paravertebral Facet Joint Injections (Cervical, Thoracic, Lumbar)- chemical neurolysis, ablation, Sympathetic Nerve Blocks, and Epidural Injections (lateral foraminal, central, caudal).
3. Large Joint Injections – Shoulder, Hip, Knee, SI Joint.
4. Prolotherapy & Platelet Rich Plasma Injections for soft tissue and joints.
5. Viscosupplementation HA Therapies (Shoulder and Knee)
6. Botox Injections for the treatment of Cervical Dystonia, Migraine Headaches, Non-specific headaches, TMJ; Jaw Tension and pain, Chronic Pain, and Back Pain associated with muscle spasticity.
7. Small Joint Injections
8. Trigger Point Injections – tendons and sheath muscles
9. Other Specialty Injections – Intercostal Injections, Injections for Medial and Lateral Epicondylitis, (Golfers, Tennis Elbow), and Carpal Tunnel Syndrome.
10. Safe Administration of Pharmaceuticals for Chronic Pain including drug contracts and detailed listing of safe, less addicting medications by group.
11. Diagnostic Imaging and Interpretation

Learn more about the Pain Management Training

After completion of the course you will be able to develop a correct diagnosis of your patient’s pain symptoms and develop a personalized treatment plan for the management of pain. Attendees will learn how to perform various cervical and lumbar examinations using established “standard of care” testing methods that meet the highest standards. After performing a comprehensive history and physical exam, you will be able to create your diagnosis and treatment plan thus using either technologies or by additional testing such as the following:

• Spurling Test : nerve root compression primarily at the cervical level
• Naffziger Test: for nerve root compression to evaluate an increase or aggravation of pain or sensory disturbance over the nerve root
• Hoover’s Test: To determine the patient’s back pain as non-organic; negative sitting LSR with positive supine SLR. Jerky or quick release on motor testing…
  • Compression Test
  • Cervical Test
  • Transforaminal
  • Bilateral Trochanteric (CT)
  • Pelvic Test
• Sensory, Motor and DTR Tests: Most common tests to isolate pain and other findings.
• Gaenslens Maneuver/Test: This test flexes the hip joint on one side and extends the other hip to test for sciatica, spondyloarthritis, or other presentations of rheumatism.
• Shobar Test: is a test used to assess the amount of lumbar flexion in presentations of rheumatism while measuring the ability of a patient to flex his/her lower back.
• Slump Test: Helps to assess whether neural tension, disc herniation, or altered neurology are contributing to the patient’s pain symptoms
• Milgram’s Test: Thoracic and Lumbar Spine test designed to help diagnose nerve root irritation or inflammation.
• Bowstring Test: Lower back stress examination test commonly used to diagnose sciatic nerve injury.
• Le Segue’s Test: Passive dorsiflexion of the foot to help diagnose nerve root compression or impingement
• Braggards “Stretch” Test: Straight leg raise test that may be indicative of sciatic nerve involvement
• Waddell Test: Set of (5) tests to determine the patient’s back pain as non-organic
• CrossFit Fortis Test: Test takes into account your calf muscle, hamstring muscle and back flexibility
• Kernigs Test: Knee extension beyond 135 degrees indicative of nerve root impingement

The course study begins with didactic material that will cover the technical principles of a diverse range of procedures and diagnosis of the various pathologies associated with pain. Pathologies that will be discussed in depth suggest the most common types of pain management that you will encounter within your practice and include the following:

• Osteoarthritis
• Herniated Nucleus Pulposus (HNP)
  • Herniation
  • Disc Bulge
• Spinal Stenosis
• Segmental Instability
  • Spondylolisthesis
  • Spondylolysis
  • Spondyloloptosis
• Degenerative Disc Disorders
  • Facet Arthritis
  • Osteophytes
  • Discogenic Pain
• Muscle / Joint Pain
• Chronic Pain

Chronic pain is present in many patients where even though they suffer from any of a variety of pathologies it can only be managed by prescription drugs. As part of the program we will instruct you in a safe manner how to manage pain by the use of pharmaceutical drugs. Indications for the use of these NSAIDS as well as the contraindications for their use are discussed as well as treating testosterone deficiency which can be caused by extended NSAID use or andropause.

Pain Management Training Objectives

Upon Completion of this program, the physician should be able to:

• Expand current practice to include pain management services. Be able to perform all the injection procedures detailed in a proper and efficient manner in adherence with the latest “standard of care” protocols.
• Learn proper needle placement and techniques using injection models and/or human cadavers (tissue) under image guidance. Trigger point injection training and other joint injections are discussed or demonstrated using the palpatory method and/or image guidance.
• Diagnose and evaluate patients with chronic lumbosacral pain and develop an approved treatment plan using accepted injection techniques.
• Test, Diagnose and treat the patient suffering from joint pain using various “evidenced based” injection therapies.
• Receive training on specialty injections with Botulinum Toxin-A; Botox® for a variety of pain related conditions (i.e. migraines, bruxism, tmj) associated with muscle spasticity.
• Evaluate and diagnosis the patient for testosterone deficiency and be able to administer testosterone for patients with low testosterone secondary to chronic narcotic usage or andropause.
• Fully understand specific supplies, protocols, and appropriate solutions needed including billing and coding requirements.
• Learn how to perform these injections using the Palpatory Method, as well as learn to perform the various injections using the image guidance for proper needle placement. This may includes working on advanced injection models or human cadavers depending upon location.
• Properly document each patient chart and procedure performed adhering to strict medical necessity and selection criteria.
• Utilize specific methods for compliance to help ensure correct procedure and standard of care thus preventing over-utilization of these procedures.
• Be able to attract new and existing patients using proven business and internet or conventional marketing methods.

The American Academy of Procedural Medicine offer these pain management courses to help you become confident and have a full understanding in performing and integrating these new procedures after leaving the event. Besides the confidence you will gain from your pain management course and certification; you will also receive practical business training to become financially successful with these new services.

Physicians who successfully complete the Pain Management Certification program and demonstrate proficiency with the newly learned injection procedures will receive a Certificate of Achievement as well as allow physicians to advance towards getting their AAOPM Board Certification in Pain Management.

Day 1

7:00am–7:30am

Check-in and registration.

7:30am–8:00am

Overview of essential supplies and medications used in pain management, including guidance on sourcing and patient-specific application, focusing on pharmacologic and corticosteroid options.

8:00am–8:45am

Detailed anatomy of the lower spine and sacroiliac region, emphasizing key anatomical landmarks for accurate needle placement. Neuroanatomical pathways and injection depth/safety will also be covered.

8:45am–9:00am

Break

9:00am–11:00am

Instruction on diagnostic and therapeutic lumbar facet joint injections using both palpation techniques and image guidance, including ultrasound and fluoroscopy methods.

11:00am–12:00pm

Joint aspiration and injection techniques for various joints: sacroiliac, shoulder, AC, hip, knee, and digits. Introduction to ultrasound and image-guided procedures, with emphasis on safety and compliance.

12:00pm–1:00pm

Lunch

1:00pm–2:00pm

Exploration of regenerative therapies like prolotherapy, PRP, botulinum toxin, and biologics for soft tissue conditions including neuropathies, scar tissue, and muscle spasticity.

2:00pm–3:00pm

Therapies for joint lubrication and myofascial pain relief, including viscosupplementation and trigger point injections.

3:00pm–3:15pm

Break

3:15pm–4:30pm

Identification and treatment options for lumbar spine conditions such as herniated discs, spinal stenosis, instability, spondylolysis/listhesis, and degenerative disc disease. Alternatives like fusion and TDR will be discussed.

4:30pm–5:15pm

Non-destructive lumbar facet therapies including diagnostic, therapeutic, and neurolytic procedures. Practice includes hands-on sessions with live volunteers or models using non-imaging approaches.

5:15pm–6:00pm

Intro to fluoroscopy in pain management, covering pathology review, fluoroscopic imaging, needle targeting, radiation safety, dosage management, and standard protocols per NCRP guidelines.

Day 2

7:30am–8:00am

Day two registration. Participants divided into small working groups (A & B).

8:00am–9:15am

FDA-approved contrast agents used under fluoroscopy are reviewed. Fluoroscopic techniques for transforaminal epidurals, nerve root, and medial branch blocks are discussed, including physical exam indicators and patient positioning.

9:15am–10:15am

Discussion of advanced facet joint injection techniques including diagnostic, therapeutic, and neurolytic methods. Overview of transforaminal and translaminar epidural injection procedures.

10:15am–10:30am

Break

10:30am–12:00pm

Hands-on practice using cadaveric or anatomical models. Training includes fluoroscopic guidance for lumbar and sacroiliac joint injections.

12:00pm–1:00pm

Lunch

1:00pm–2:15pm

Clinical strategies for managing chronic pain and opioid prescriptions. Topics include patient assessment, medication alternatives, contracts, testing protocols, and legal requirements.

2:15pm–3:30pm

Proper medical billing practices for procedures: facet joint injections, arthrocentesis, trigger point injections, and prolotherapy. Focus on coding accuracy and reimbursement guidelines.

3:30pm–3:45pm

Break

3:45pm–4:45pm

Live demonstration and final instructional session on trigger point and joint injections. Final certification in pain management awarded upon completion.

4:45pm–6:00pm

Optional lab time for continued practice on cadaver or anatomical models. Extra training on image-guided lumbar and sacroiliac injections, as well as trigger point techniques.

DISCLAIMER: The following is a summary of the course agenda. The full course agenda will be emailed to you a few days prior to the course. If you have any questions or need additional information, please contact our office.