ABR Pain Medicine study guide
ABR Pain Medicine · Work through your exam, one topic at a time.
The Pain Medicine subspecialty certification associated with the American Board of Radiology is a credential for radiologists - most often those practicing interventional radiology - who have completed additional training in pain medicine and want to demonstrate specialty-level command of the field. It is intended for physicians whose practice includes the evaluation and treatment of acute, chronic, and cancer-related pain: image-guided injections and ablations, medication management, and coordinated multidisciplinary care. The ABR Pain Medicine study guide has 5 sections and about 1,466 words.
01Anatomy, Physiology, and Neurobiology of Pain
Pain begins at free nerve endings transduced by ion channels such as TRPV1, acid-sensing channels, and voltage-gated sodium channels (Nav1.7, Nav1.8). A-delta fibers are thinly myelinated and signal fast, sharp "first pain." C fibers are unmyelinated, polymodal, and produce slow, dull "second pain." A-beta fibers are low-threshold mechanoreceptors, not nociceptors, a frequent distractor.
343 words, about 2 min02Pain Assessment, Diagnosis, and Patient Evaluation
Evaluation starts with a focused history: onset, quality, radiation, aggravating and relieving factors, temporal pattern, associated symptoms, prior treatments, and function. Classify pain as nociceptive, neuropathic, or nociplastic; these labels guide therapy but frequently coexist.
295 words, about 1 min03Pharmacologic Management of Pain
Acetaminophen is first-line for mild pain but has hepatic ceilings. NSAIDs are effective for inflammatory nociceptive pain; their risks include GI bleeding, renal injury (especially with ACE inhibitors and diuretics), and cardiovascular events.
276 words, about 1 min04Interventional and Procedural Pain Management
Interventional care begins with indication, consent, anticoagulation review, and image guidance. Common procedures include epidural steroid injections (interlaminar, transforaminal, caudal), facet medial branch blocks and radiofrequency ablation, sacroiliac joint injection, trigger point injection, sympathetic blocks (stellate, lumbar, celiac, ganglion impar), peripheral nerve blocks, spinal cord stimulation trials, and intrathecal drug delivery.
292 words, about 1 min05Multidisciplinary, Rehabilitative, Psychological, and Professional Aspects
Pain care is biopsychosocial. Biological, psychological, and social factors interact, and treating only the nociceptor often fails.
260 words, about 1 min