ABEM Pain Medicine study guide
ABEM Pain Medicine · Work through your exam, one topic at a time.
The ABEM Pain Medicine subspecialty certification is issued by the American Board of Emergency Medicine, an organization based in East Lansing, Michigan, whose stated purpose is to assure that emergency physicians have the knowledge and skills to deliver the highest quality care. ABEM maintains a Subspecialties section within its Get Certified and Stay Certified navigation, and Pain Medicine is one of the subspecialty areas associated with that structure. The ABEM Pain Medicine study guide has 6 sections and about 1,637 words.
01Basic Science of Pain: Anatomy, Physiology, and Pharmacology
Pain begins when noxious stimuli activate free nerve endings. A-delta fibers are thinly myelinated and fast, producing sharp pain; C fibers are unmyelinated, slow, and polymodal, producing dull pain.
297 words, about 1 min02Pain Assessment, Diagnosis, and Evaluation
Start with history: onset, location, quality, temporal pattern, aggravating and relieving factors, associated symptoms, prior treatments, function, sleep, mood, substance use, and patient goals. Use a numeric rating scale or visual analog scale for intensity, but function and interference matter more.
268 words, about 1 min03Pharmacologic Management of Pain
Use multimodal, mechanism-matched therapy. Acetaminophen is a first-line adjunct; keep total intake at or below 3 g/day in many adults, lower with liver disease or alcohol use.
308 words, about 2 min04Interventional Pain Procedures
Interventional care is adjunctive, not a substitute for diagnosis and rehabilitation. Common procedures include trigger-point injections, peripheral nerve blocks, facet joint and medial branch blocks, radiofrequency ablation, epidural steroid injections by interlaminar or transforaminal routes, sympathetic blocks, joint injections, spinal cord stimulation, and intrathecal pumps.
277 words, about 1 min05Behavioral, Physical, and Multidisciplinary Pain Management
Chronic pain management is multidisciplinary: physician, physical and occupational therapy, psychology, nursing, pharmacy, and vocational support. CBT targets catastrophizing, fear-avoidance, and maladaptive beliefs; acceptance and commitment therapy builds values-based activity; mindfulness and relaxation reduce arousal.
224 words, about 1 min06Practice Management, Safety, and Professionalism in Pain Medicine
Document informed consent, diagnosis, goals, alternatives, risks, and shared decision-making. For controlled substances, check the prescription drug monitoring program, use a written agreement when appropriate, obtain urine drug testing, perform pill counts, counsel on secure storage and disposal, and set clear refill rules.
263 words, about 1 min