Caudal Epidural Steroid Injection with PRP

Case Reports and a Testimonial!

Upcoming Training Courses and Services

• Regional Anesthesia and IV Vascular Access Courses:
• New York and Detroit locations scheduled
• Pain Management Board Preparation

 

Private Coaching Services:

• Ultrasound guidance Preceptorship

• Board preparation coaching

• Contact available via email Info@NRAPpain.org for interested physicians

PRP Caudal Epidural Research Review

• Study Overview: Randomized double-blind controlled pilot study comparing leukocyte-rich PRP versus corticosteroids in caudal epidural space

• 50 patients randomly assigned to two groups

• Treatment options: triamcinolone 60mg or leukocyte-rich PRP from 60ml autologous blood

• Follow-up assessments at 1, 3, and 6 months using VAS and SF-36 surveys

• Key Findings:

• Both treatments showed significant pain reduction compared to baseline

• Steroid group had lower VAS scores at one month

• PRP group demonstrated superior results at 3 and 6 months

• PRP group showed significant improvement across all SF-36 domains at 6 months

• No complications or adverse effects in either group during 6-month follow-up

Personal Treatment Experience

• Dr. Rosenblum received transforaminal PRP injection 9-10 weeks ago

• Gradual improvement noted from weeks 4-8, with more noticeable benefits from weeks 8-10

• Current status: minimal pain (0.5/10) only during weather changes

Clinical Practice Philosophy

• Treatment Approach: Minimalist philosophy focusing on turmeric, PRP, and Pilates

• Medication Strategy: Low-dose naltrexone as go-to medication, avoiding long-term drugs with side effects

• Surgical Avoidance: Prioritizing conservative treatments over unnecessary surgical interventions

Emergency Department PRP Implementation

• Case Study Results: Ultrasound-guided caudal epidural steroid injection in ER setting

• 100% pain resolution achieved

• Patient discharged directly from ER

• Cost savings: reduced from $33,000 to $4,800 (approximately $28,000 savings)

• Training Opportunities: Private training sessions available for ER physicians interested in ultrasound-guided procedures

Patient Testimonial Highlights

• Case Background: Nurse with herniated disc from March, previously considering $30,000 surgery

• Treatment Outcome: PRP injection completed two months ago with nearly complete pain relief

• Reduced from multiple pain medications to one Advil daily

• Eliminated antalgic posture and muscle spasms

• Returned to full 12-hour hospital shifts without difficulty

• Overall quality of life restored to normal levels

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

Irvan J. Bubic, Jessica Oswald,
Ultrasound-Guided Caudal Epidural Steroid Injection for Back Pain: A Case Report of Successful Emergency Department Management of Radicular Low Back Pain Symptoms,
The Journal of Emergency Medicine,Volume 61, Issue 3,2021,Pages 293-297,ISSN 0736-4679

Ruiz‐Lopez, Ricardo, and Yu‐Chuan Tsai. "A randomized double‐blind controlled pilot study comparing leucocyte‐rich platelet‐rich plasma and corticosteroid in caudal epidural injection for complex chronic degenerative spinal pain." Pain Practice 20.6 (2020): 639-646.

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