ABPMR Pain Medicine study guide
ABPMR Pain Medicine · Work through your exam, one topic at a time.
The ABPMR Pain Medicine subspecialty certification is a credential offered by the American Board of Physical Medicine and Rehabilitation to physicians who have completed accredited pain medicine training and who want board recognition in the evaluation and management of painful conditions. ABPMR lists it alongside its other subspecialty certificates - brain injury medicine, hospice and palliative medicine, neuromuscular medicine, pediatric rehabilitation medicine, spinal cord injury medicine, and sports medicine - and it is distinct from primary PM&R certification. The ABPMR Pain Medicine study guide has 5 sections and about 1,522 words.
01Pain Anatomy, Physiology, and Pharmacology
Nociception has four steps: transduction, transmission, modulation, and perception. First-order neurons sit in the dorsal root ganglion, and their peripheral terminals carry transducer channels (TRPV1, ASICs, voltage-gated sodium channels such as Nav1.7/1.8) that convert noxious stimuli into depolarization.
323 words, about 2 min02Evaluation and Diagnosis of Painful Conditions
Begin with the pain history (onset, quality, radiation, aggravating/relieving factors, timing, severity) plus functional impact. Red flags mandate urgent action: saddle anesthesia or bowel/bladder dysfunction (cauda equina), fever with spinal pain (infection), night pain with weight loss or cancer history (malignancy), significant trauma or osteoporosis (fracture), and progressive neurologic deficit.
341 words, about 2 min03Interventional Pain Procedures
Most procedures use fluoroscopy or ultrasound. Know the target, the laterality, and the structures at risk before the needle goes in.
304 words, about 2 min04Pharmacologic and Non-Interventional Management
Multimodal analgesia combines agents with different mechanisms so that individual doses and toxicity stay low. Nonpharmacologic care-physical therapy, exercise, sleep, cognitive behavioral therapy-is part of the plan, not an optional add-on.
267 words, about 1 min05Multidisciplinary, Behavioral, and Rehabilitative Care
Pain is not only nociception; distress, beliefs, sleep, and context modulate it. Screen for yellow flags early-fear-avoidance, catastrophizing, depression, anxiety, and work dissatisfaction-because they predict chronification better than imaging does.
287 words, about 1 min