100+ Free ABPS Interventional Pain Management Practice Questions

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Question 1

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A patient describes burning, electric, lancinating pain in a stocking distribution after diabetic polyneuropathy. Which pain mechanism BEST describes this presentation?

Nociceptive somatic pain

Nociceptive visceral pain

Neuropathic pain

Nociplastic pain

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2026 Statistics

Key Facts: ABPS Interventional Pain Management Exam

200

Approximate MCQ Items

ABPS BCIPM Interventional Pain Management exam

~4 hr

Total Exam Time

Computer-based testing

~14%

Epidural Steroid Injections Weight

Largest single domain on 2026 BCIPM content outline

~$1,800-$2,500

2026 Exam Fee

ABPS/BCIPM (verify current schedule)

Fellowship

Required Training Pathway

ACGME or AOA accredited Interventional Pain Medicine fellowship

20 mSv/yr

ICRP 2011 Lens of Eye Annual Dose Limit

Averaged over 5 years; max 50 mSv any single year

The ABPS Interventional Pain Management Certification Exam is a ~200-item, ~4-hour computer-based test administered by BCIPM/ABPS for fellowship-trained physician interventional pain practitioners. The blueprint emphasizes ESIs, facet/medial branch and RFA, sacroiliac and sympathetic blocks, neuromodulation (SCS, DRG-S), intrathecal therapy, vertebral augmentation, fluoroscopy/ultrasound and radiation safety, ASRA 2018 anticoagulation, opioid stewardship (CDC 2022), and complications. The 2026 fee is approximately $1,800-$2,500; eligibility requires fellowship training and a primary specialty board certification.

Sample ABPS Interventional Pain Management Practice Questions

Try these sample questions to test your ABPS Interventional Pain Management exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient describes burning, electric, lancinating pain in a stocking distribution after diabetic polyneuropathy. Which pain mechanism BEST describes this presentation?

A.Nociceptive somatic pain

B.Nociceptive visceral pain

C.Neuropathic pain

D.Nociplastic pain

Explanation: Burning, electric, lancinating, and dysesthetic pain in a stocking-glove distribution is the classic IASP description of neuropathic pain caused by a lesion or disease of the somatosensory nervous system. First-line agents per ASRA/AAN include duloxetine, gabapentinoids, and TCAs.

2Per the 2018 ASRA/ESRA/AAPM Practice Advisory on neurological complications of regional anesthesia and pain medicine, which is the MOST important step before performing a cervical interlaminar epidural steroid injection?

A.Use a blunt-tipped Tuohy needle without imaging

B.Confirm contrast spread under real-time fluoroscopy or CT and use a non-particulate steroid

C.Inject only at C3-C4 to avoid spinal cord injury

D.Use a paramedian approach without contrast to minimize radiation

Explanation: ASRA/AAPM advisories require image guidance with real-time contrast confirmation for cervical ESIs to detect intravascular or intrathecal placement. Non-particulate dexamethasone is preferred for cervical transforaminal injections to reduce catastrophic embolic spinal cord/brainstem injury. C7-T1 or T1-T2 interlaminar levels are preferred over higher cervical levels.

3Which radiation safety principle MOST effectively reduces operator exposure during fluoroscopically guided pain procedures?

A.Increasing the distance from the radiation source (inverse square law)

B.Routinely standing on the X-ray tube side of the C-arm

C.Removing lead shielding to improve mobility

D.Using continuous fluoroscopy instead of pulsed mode

Explanation: The inverse square law (dose proportional to 1/r^2) means doubling distance quarters exposure. Operators should stand on the image-intensifier side (away from the X-ray tube), use pulsed fluoroscopy, collimate, and wear lead. ALARA is the governing principle.

4A 62-year-old with axial low back pain and tenderness over the L4-L5 facet joints, worsened by extension and rotation, has failed conservative therapy. Per evidence-based interventional pain guidelines, what is the BEST diagnostic step before considering radiofrequency ablation?

A.Single intra-articular facet steroid injection

B.Two separate diagnostic medial branch blocks with concordant short-acting local anesthetic relief

C.Empiric lumbar fusion consultation

D.Lumbar transforaminal epidural steroid injection

Explanation: The Spine Intervention Society (SIS) and ASIPP recommend dual comparative or dual concordant medial branch blocks (with bupivacaine or lidocaine) demonstrating >=80% pain relief before lumbar medial branch radiofrequency ablation, to minimize false positives and confirm facet-mediated pain.

5Which nerves are targeted during a lumbar medial branch radiofrequency ablation for L4-L5 facet pain?

A.L4 and L5 dorsal roots

B.L3 and L4 medial branches of the dorsal rami

C.L4 medial branch and L5 dorsal ramus

D.L4 ventral ramus and L5 medial branch

Explanation: Each lumbar zygapophyseal joint receives dual innervation from the medial branches of the dorsal rami at and one level above. The L4-L5 facet is innervated by the L3 medial branch and L4 medial branch — but at L5, the equivalent nerve is the L5 dorsal ramus itself. So for the L4-L5 facet, the L4 medial branch and L5 dorsal ramus must be targeted.

6What is the MOST common side effect of intrathecal opioid therapy via an implanted pump in the first 24 hours after implant?

A.Hyperalgesia

B.Pruritus, nausea, and urinary retention

C.Granuloma formation

D.Catheter migration

Explanation: Acute intrathecal opioid side effects mirror neuraxial opioid use: pruritus (most common), nausea, urinary retention, and respiratory depression. Granuloma is a long-term complication associated with high-concentration morphine. PACC 2017 guidelines recommend low concentrations and titration.

7Per the 2018 ASRA Anticoagulation in Pain Medicine guidelines, which procedure is classified as HIGH bleeding risk and requires the longest interruption of anticoagulants?

A.Trigger point injection

B.Peripheral joint injection

C.Spinal cord stimulator trial or implant

D.Sacroiliac joint injection

Explanation: ASRA 2018 stratifies SCS trials and permanent implants, intrathecal pump implants, and vertebral augmentation as high-risk procedures requiring full anticoagulant cessation per drug-specific intervals. Trigger points and peripheral joint injections are low-risk and typically do not require interruption.

8A patient with CRPS Type I of the right upper extremity is being considered for a stellate ganglion block. Which finding would BEST confirm a successful sympathetic block?

A.Loss of sensation in the C6 dermatome

B.Horner syndrome (ptosis, miosis, anhidrosis) and ipsilateral hand temperature rise >=1-2 C

C.Diaphragmatic paralysis on chest X-ray

D.Decreased motor strength in the hand

Explanation: A successful stellate ganglion block produces ipsilateral Horner syndrome (sympathetic blockade to the head/face) and a measurable rise in hand skin temperature (>=1-2 C), confirming sympathetic chain interruption. Loss of sensation suggests somatic block (brachial plexus spread); diaphragmatic paralysis is a complication (phrenic nerve).

9Per the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain, which is the recommended approach for initiating opioids in a patient with chronic non-cancer pain?

A.Start with a long-acting opioid for stable serum levels

B.Start with the lowest effective dose of an immediate-release opioid; reassess benefits and harms within 1-4 weeks

C.Begin at a morphine milligram equivalent (MME) >=90 mg/day for adequate analgesia

D.Combine an opioid with a benzodiazepine to enhance analgesia

Explanation: The 2022 CDC opioid guideline recommends immediate-release opioids at the lowest effective dose, reassessment within 1-4 weeks, and avoidance of MME >=50 mg/day without careful justification. Concurrent benzodiazepines markedly increase overdose risk. Long-acting opioids should not be initiated for acute or new chronic pain.

10Which complication is MOST specific to vertebroplasty and kyphoplasty?

A.Cement (PMMA) extravasation into the spinal canal or venous system

B.Esophageal perforation

C.Bowel ischemia

D.Tension pneumothorax

Explanation: PMMA cement extravasation into epidural veins, neural foramina, or pulmonary venous system is the most feared complication of vertebral augmentation, potentially causing cord compression or pulmonary cement embolism. Real-time fluoroscopic monitoring during cement injection is essential.

About the ABPS Interventional Pain Management Exam

The ABPS Interventional Pain Management Certification Examination, administered by the Board of Certification in Interventional Pain Management (BCIPM) under the American Board of Physician Specialties (ABPS), validates the cognitive and procedural competencies required for physician interventional pain practitioners. Content spans pain mechanisms and assessment (IASP nociceptive/neuropathic/nociplastic 2017 framework, DN4, PainDETECT), fluoroscopy and ultrasound guidance and radiation safety (ALARA, ICRP 2011 lens dose 20 mSv/yr), epidural steroid injections (cervical/thoracic/lumbar with non-particulate dexamethasone for cervical TFESIs), facet joint and dual diagnostic medial branch blocks, conventional and pulsed radiofrequency ablation (80-90 C / 60-90 sec vs 42 C / 120 sec), sacroiliac joint procedures and Laslett provocative cluster, sympathetic blocks (stellate at C6 Chassaignac tubercle, lumbar L2-L4, celiac, hypogastric, ganglion impar), peripheral nerve and fascial-plane blocks (PENG, fascia iliaca, TAP, intercostal, occipital), neuromodulation (SCS HF10/burst, DRG-S, PNS — including 2022 FDA PDPN approval), intrathecal therapy (PACC 2017, ziconotide black-box, granuloma surveillance), vertebral augmentation, pharmacology and opioid stewardship (CDC 2022 guideline, MME, suzetrigine 2025 Nav1.8), ASRA 2018 anticoagulation/pain advisory, and complications (LAST, epidural hematoma/abscess, paralysis, pneumothorax). Eligibility requires an MD/DO with unrestricted license, completion of an ACGME or AOA accredited Interventional Pain Medicine fellowship (or equivalent), and current board certification in a primary specialty.

Questions

200 scored questions

Time Limit

~4 hours CBT

Passing Score

Criterion-referenced scaled score set by BCIPM (modified Angoff standard)

Exam Fee

~$1,800-$2,500 examination fee (ABPS/BCIPM 2026 — verify current schedule) (American Board of Physician Specialties (ABPS) — Board of Certification in Interventional Pain Management (BCIPM))

ABPS Interventional Pain Management Exam Content Outline

~14%

Epidural Steroid Injections (Cervical, Thoracic, Lumbar)

Interlaminar, transforaminal, and caudal approaches at cervical, thoracic, and lumbar levels. Particulate vs non-particulate steroid selection (dexamethasone mandatory for cervical TFESIs per ASRA/SIS to prevent embolic spinal cord/brainstem infarction), live fluoroscopic contrast confirmation and digital subtraction angiography (DSA), maximum cumulative annual steroid dose to prevent HPA suppression and bone density loss, contrast pattern interpretation (epidural spread vs vascular runoff vs intrathecal vs air pattern), prone positioning with abdominal pillow, Scotty dog view for foraminal targeting, post-procedural monitoring for vasovagal episode and motor deficit signaling epidural hematoma.

~12%

Facet Joint & Medial Branch Interventions

Facet-mediated axial pain diagnosis, dual comparative or concordant medial branch blocks (>=80% relief) per Spine Intervention Society and ASIPP to minimize false positives (~25-40% with single block), lumbar medial branch dual innervation (e.g., L4-L5 facet from L4 medial branch and L5 dorsal ramus, the L5 dorsal ramus targeted at the sacral ala/S1 superior articular process junction), cervical medial branch and third occipital nerve blocks, intra-articular vs medial branch blocks, transition from diagnostic block to thermal radiofrequency ablation.

~11%

Radiofrequency Ablation (Conventional & Pulsed)

Conventional thermal RFA (80-90 C, 60-90 seconds) producing protein coagulation lesion sized to active tip, pulsed RFA (42 C, 120 seconds) for non-thermal neuromodulation (DRG, peripheral nerves), cooled RFA (water-cooled probes producing larger lesions for SI lateral branch and genicular nerves), genicular nerve RFA for chronic knee OA after diagnostic blocks, lumbar facet RFA standard parameters, sensory and motor stimulation testing (50 Hz sensory <0.5 V; 2 Hz motor >2 V) before lesioning, post-RFA neuritis prevention with steroid.

~10%

Neuromodulation (SCS, DRG, PNS)

Patient selection per NACC 2019 (FBSS with predominant leg pain, CRPS, PDPN, refractory angina), SCS waveforms (tonic, HF10/Senza 10 kHz paresthesia-free per SENZA-RCT, Abbott BurstDR, DTM-SCS), psychological clearance and successful percutaneous trial, DRG stimulation (Abbott Proclaim DRG, FDA approved 2016 for focal lower-extremity CRPS per ACCURATE trial), peripheral nerve stimulation (PNS), Class III FDA PMA implantable devices, contraindications (active infection, untreated psychiatric illness, coagulopathy, MRI compatibility), Nevro Senza HF10 PDPN approval (2021) and Abbott Proclaim XR (2022).

~10%

Pharmacology & Opioid Stewardship

WHO analgesic ladder, CDC 2022 Clinical Practice Guideline for Prescribing Opioids (50 MME reassessment threshold, avoid concurrent benzodiazepines), neuropathic agents (gabapentinoids, SNRIs duloxetine/venlafaxine, TCAs, lidocaine/capsaicin patches), trigeminal neuralgia first-line carbamazepine/oxcarbazepine, fibromyalgia EULAR 2016, methadone QT prolongation and ECG monitoring, buprenorphine partial mu agonism with ceiling effect, opioid metabolism in renal failure (avoid morphine M6G, meperidine normeperidine), serotonin syndrome with tramadol/methadone/MAOIs, ORT and SOAPP-R risk screening, naloxone co-prescribing, suzetrigine (Journavx) FDA 2025 Nav1.8 inhibitor for acute pain.

~9%

Anticoagulation & ASRA 2018 Advisory

ASRA 2018 Anticoagulation in Pain Medicine three-tier risk stratification (low/intermediate/high), high-risk procedures (SCS, intrathecal pump, vertebral augmentation, sympathetic neurolysis) requiring full anticoagulant interruption, drug-specific intervals (warfarin INR <=1.4; clopidogrel 7 days; prasugrel 7-10 days; ticagrelor 5-7 days; rivaroxaban 3 days; apixaban 3 days; dabigatran 4-5 days adjusted for CrCl; LMWH 24 hr therapeutic / 12 hr prophylactic), aspirin 81 mg generally not held for low-risk procedures, ASRA Coags app, restart timing 24 hours after hemostasis.

~8%

Sympathetic, Sacroiliac & Peripheral Nerve Blocks

Stellate ganglion block at C6 Chassaignac tubercle (ultrasound-guided, Horner syndrome confirms success, vertebral artery injection causes LAST), lumbar sympathetic L2-L4 for lower-extremity CRPS, celiac plexus neurolysis with alcohol/phenol for pancreatic cancer pain, hypogastric plexus and ganglion impar (trans-sacrococcygeal) for pelvic/perineal pain, sacroiliac intra-articular injection and lateral branch blocks (L5 dorsal ramus + S1-S3 lateral branches), Laslett provocative cluster, SI joint fusion (iFuse, LinQ), peripheral and fascial-plane blocks (occipital, intercostal with pneumothorax risk, fascia iliaca and PENG for hip fracture, TAP block for abdominal analgesia).

~8%

Intrathecal Therapy & Vertebral Augmentation

Intrathecal pump indications (cancer pain, refractory non-cancer pain), PACC 2017 medication selection and starting doses (morphine 0.1-0.5 mg/day in opioid-naive cancer patients; ziconotide 0.5-1 mcg/day with slow titration), opioid conversion (oral morphine 300 mg = IV 100 mg = epidural 10 mg = IT 1 mg), granuloma at catheter tip (high-concentration morphine/hydromorphone risk), pump pocket-fill medication error and naloxone availability, ziconotide black-box psychiatric warning, vertebroplasty/kyphoplasty selection (acute/subacute fracture with bone marrow edema on STIR/T2 MRI), biplanar fluoroscopy needle confirmation, PMMA cement extravasation prevention.

~8%

Fluoroscopy, Ultrasound Guidance & Radiation Safety

ALARA principle, inverse-square law (distance), pulsed fluoroscopy and collimation, last-image hold, image-intensifier-side operator positioning, lead apron, thyroid shield, leaded glasses, NCRP/ICRP annual occupational dose limits (50 mSv whole body, 500 mSv extremity, 20 mSv lens of eye averaged over 5 years per ICRP 2011), personal collar and ring dosimeters, iodinated non-ionic low-osmolar contrast (iohexol/Omnipaque), digital subtraction angiography for cervical TFESIs, ultrasound visualization of soft tissue/vessels with Doppler/nerves, CHG-alcohol skin antisepsis (ChloraPrep) per CDC.

~6%

Pain Mechanisms & Assessment

IASP 2017 three pain mechanisms (nociceptive, neuropathic, nociplastic with central sensitization phenotype — fibromyalgia/IBS/non-specific LBP), Cicely Saunders Total Pain framework (physical, psychological, social, spiritual), validated assessment tools (NRS, VAS, BPI, McGill, FLACC for children, BPS/CPOT for non-verbal ICU patients, DN4 and PainDETECT for neuropathic features), red flags for low back pain (cancer, infection, trauma, neurologic deficit, cauda equina), MRI indications (delayed beyond 4-6 weeks unless red flags per ACP/ACR), MRI-clinical concordance for radiculopathy, descending PAG-RVM modulatory pathway.

~4%

Complications & Safety

Local anesthetic systemic toxicity (LAST) per ASRA 2017 checklist (lipid emulsion 20% 1.5 mL/kg bolus then 0.25 mL/kg/min infusion; low-dose epinephrine; avoid vasopressin/calcium channel blockers/lidocaine), epidural hematoma after ESI (anticoagulant association, emergent MRI and decompression within 8 hours), epidural abscess (Staphylococcus aureus including MRSA most common), cervical TFESI catastrophic spinal cord/brainstem infarction (avoid particulate steroids), pneumothorax (intercostal blocks, thoracic ESI), cement extravasation (vertebroplasty), cauda equina syndrome (saddle anesthesia, urinary retention, bilateral weakness — emergent MRI), high-dose steroid HPA suppression, vasovagal episode.

How to Pass the ABPS Interventional Pain Management Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by BCIPM (modified Angoff standard)
Exam length: 200 questions
Time limit: ~4 hours CBT
Exam fee: ~$1,800-$2,500 examination fee (ABPS/BCIPM 2026 — verify current schedule)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPS Interventional Pain Management Study Tips from Top Performers

1Memorize the ASRA 2018 Anticoagulation in Pain Medicine high-risk vs low-risk procedure stratification and drug-specific hold intervals: SCS/intrathecal pump/vertebral augmentation are HIGH risk requiring full interruption (warfarin INR <=1.4, clopidogrel 7 days, rivaroxaban 3 days, apixaban 3 days, dabigatran 4-5 days adjusted for CrCl, ticagrelor 5-7 days, prasugrel 7-10 days). Trigger points and peripheral joint injections are LOW risk and typically not held. Aspirin 81 mg usually not interrupted for low-risk; case-by-case for high-risk. Use the ASRA Coags app for reference.

2Always use NON-particulate dexamethasone for cervical transforaminal ESIs and confirm contrast spread with live fluoroscopy plus digital subtraction angiography (DSA). Particulate steroids in cervical radicular arteries (vertebral artery branches feeding the anterior spinal artery) have caused catastrophic spinal cord and brainstem infarction. The ASRA/SIS multispecialty working group consensus is unambiguous: dexamethasone is the cervical TFESI standard.

3Know the lumbar medial branch innervation: each facet receives DUAL innervation from medial branches at and above the joint. The L4-L5 facet is innervated by the L3 medial branch and L4 medial branch — but the equivalent at L5 is the L5 DORSAL RAMUS itself, targeted at the junction of the sacral ala and S1 superior articular process. This anatomy is heavily tested. Dual diagnostic medial branch blocks with concordant >=80% relief are required before RFA per SIS/ASIPP.

4Conventional thermal RFA parameters: 80-90 C for 60-90 seconds with sensory (50 Hz <0.5 V — confirms proximity) and motor (2 Hz >2 V — excludes ventral ramus) stimulation testing before lesioning. Pulsed RFA: tip temperature kept <=42 C with brief high-voltage pulses for 120 seconds, producing non-thermal neuromodulation — used at the DRG and peripheral nerves where thermal injury is unsafe. Cooled RFA produces larger lesions for SI lateral branch and genicular nerves.

5Patient selection for SCS per NACC 2019: FBSS with predominant leg pain (Level 1), CRPS (Level 1), refractory angina, PDPN refractory to medical therapy (Nevro Senza HF10 FDA 2021, Abbott Proclaim XR 2022). Required steps: failed conservative care, psychological clearance, and successful percutaneous trial (>=50% pain relief). Contraindications: active infection, untreated psychiatric illness, coagulopathy. SENZA-RCT showed HF10 superiority to traditional tonic SCS; ACCURATE trial showed DRG-S superiority to tonic SCS for focal lower-limb CRPS.

6ASRA 2017 LAST (Local Anesthetic Systemic Toxicity) checklist: stop injection, ABCs (100% O2, mild hyperventilation), lipid emulsion 20% 1.5 mL/kg bolus over 1 minute, then 0.25 mL/kg/min infusion (max cumulative 12 mL/kg). Continue lipid 10 minutes after circulatory stability. Use LOW-dose epinephrine (<=1 mcg/kg boluses, NOT high-dose ACLS doses), AVOID vasopressin/calcium channel blockers/beta-blockers/lidocaine. Maximum bupivacaine without epinephrine is 2-2.5 mg/kg (~175 mg in a 70 kg adult). Drug interactions (beta-blockers, amiodarone, calcium channel blockers) augment cardiotoxicity.

Frequently Asked Questions

What is the ABPS Interventional Pain Management Certification Examination?

The ABPS Interventional Pain Management Certification Examination is administered by the Board of Certification in Interventional Pain Management (BCIPM) under the American Board of Physician Specialties (ABPS). It validates the cognitive and procedural competencies required for physician interventional pain practitioners across pain assessment, fluoroscopy/ultrasound guidance and radiation safety, epidural steroid injections, facet/medial branch interventions, RFA, sacroiliac and sympathetic blocks, peripheral nerve blocks, neuromodulation, intrathecal therapy, vertebral augmentation, pharmacology, ASRA anticoagulation, and complications.

Who is eligible to take the BCIPM Interventional Pain Management exam?

Candidates must hold an MD or DO with a valid unrestricted medical license, current board certification in a primary specialty (anesthesiology, PM&R, neurology, family medicine, emergency medicine, or surgical specialty as recognized by BCIPM), and have completed an ACGME or AOA accredited Interventional Pain Medicine fellowship (or equivalent training pathway recognized by BCIPM). A documented log of interventional pain procedures and letters of reference are typically required.

What is the format of the exam?

The BCIPM Interventional Pain Management exam is a computer-based test of approximately 200 single-best-answer multiple-choice questions over approximately 4 hours. Items are blueprinted to the BCIPM content outline covering ESIs (~14%), facet/medial branch (~12%), RFA (~11%), neuromodulation (~10%), pharmacology (~10%), anticoagulation/ASRA (~9%), sympathetic/SI/peripheral blocks (~8%), intrathecal/vertebral augmentation (~8%), fluoroscopy/ultrasound/radiation safety (~8%), pain mechanisms (~6%), and complications (~4%). Testing is offered at secure CBT centers per the BCIPM schedule.

How much does the 2026 exam cost?

The 2026 BCIPM Interventional Pain Management examination fee is approximately $1,800-$2,500 — always verify the current schedule on the ABPS website. Candidates should also budget for any required supplemental verification of fellowship training and ongoing Continuous Certification (CC) fees after passing. Cancellation and refund policies follow the BCIPM schedule with decreasing refunds as the exam date approaches.

When is the 2026 exam administered?

BCIPM offers the Interventional Pain Management examination at multiple test administrations each year per the published ABPS/BCIPM schedule. Candidates schedule specific appointments after application approval. Exact 2026 dates should be confirmed on the ABPS Interventional Pain Management page.

How is the exam scored?

BCIPM uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports typically include domain-level feedback so candidates know their strongest and weakest content areas.

What are the highest-yield 2026 topics?

Highest-yield topics include the 2018 ASRA Anticoagulation in Pain Medicine advisory (drug-specific intervals for warfarin/DOACs/antiplatelets and high-risk procedure stratification), ASRA/SIS recommendations for non-particulate dexamethasone in cervical TFESIs to prevent catastrophic spinal cord/brainstem infarction, dual diagnostic medial branch blocks with >=80% relief before lumbar RFA, conventional thermal RFA parameters (80-90 C, 60-90 sec) vs pulsed RFA (42 C, 120 sec), CDC 2022 opioid prescribing guideline (50 MME reassessment threshold), Nevro Senza HF10 (2021) and Abbott Proclaim XR (2022) FDA approvals for PDPN, FDA approval of suzetrigine (Journavx, January 2025) as the first Nav1.8 inhibitor for acute pain, ICRP 2011 lens-of-eye dose limit (20 mSv/yr averaged over 5 years), PACC 2017 intrathecal starting doses, ziconotide black-box psychiatric warning, and the ASRA 2017 LAST checklist with lipid emulsion 20%.

How should I study for this exam?

Use a structured 6-12 month plan layered on fellowship and clinical practice. Map to the BCIPM content outline: begin with pain mechanisms and assessment, then ESIs and facet/RFA, sacroiliac/sympathetic/peripheral blocks, neuromodulation, intrathecal therapy and vertebral augmentation, then pharmacology/opioid stewardship, ASRA anticoagulation, fluoroscopy and ultrasound, and complications. Use Raj's Practical Management of Pain, Bonica's Management of Pain, Waldman Atlas of Pain Management Injection Techniques, ASRA 2018 anticoagulation guidelines, ASRA 2017 LAST checklist, SIS Practice Guidelines, NANS/NACC neuromodulation guidance, PACC 2017, and CDC 2022 opioid guideline. Complete 2-3 timed full-length mock exams.