ABPM Certification Exam

Examination Outline

I. Anatomy and Physiology (15%)

A. Head and face (including eyes, ears, nose, and throat)

B. Gastrointestinal and urogenital

C. Metabolic/endocrine

D. Respiratory/cardiovascular

E. Spine (facets, discs, bony anatomy)

F. Joints (nonspinal)

G. Muscles, connective tissue, integument

H. Central nervous system (includes brain, cranial nerves, spinal cord, meninges)

I.  Peripheral nervous system (includes spinal roots, plexi)

J. Autonomic nervous system

K. Pain neurophysiology (including neurotransmitters)

II. Diagnostic Testing (11%)

Proper usage and limitations of:

A. Laboratory studies

B. Imaging studies

C. Electrodiagnostic studies 

D. Autonomic function studies

E. Vascular studies

F. Diagnostic nerve blocks

G. Functional capacity evaluation

H. Physical examination

I.  Polysomnography, EEG, SSEP, etc.

J. Psychometric testing (pain-related, BPI, MPI, NRS, VAS, etc.; excludes VII E

III. Types of Pain (12%)

A. Headaches

B. Orofacial (temporomandibular disorder, dental, ENT, atypical facial pain)

C. Chest

D. Abdominal

E. Pelvic/genital

F. Spinal disorders 

G. Trigeminal neuralgia

H. Trauma and musculoskeletal pain, NEC

I. Postamputation

J. Spinal cord injury

K. Burn

L. Postoperative

M. Cancer

N. Sickle-cell disease


P. Rheumatologic disorders (articular, nonarticular, includesconnective tissue disorders, tendonitis)

Q. Myofascial pain syndrome/fibromyalgia syndrome

R. Central nervous system lesions (CVA, MS)

S. Diabetic neuropathies

T. Herpes zoster/postherpetic neuralgia

U. Complex Regional Pain Syndromes, sympathetic dystrophy/causalgia), sympathetically maintained and  independent pain

V. Peripheral nerve entrapment and other peripheral neuropaths, NEC

W. Radiculopathy (cervical, thoracic, lumbar, sacral)

X. Pain in children

Y. Pain in elderly

Z. Extremity (including shoulder and hip)

AA. Genetic/metabolic disorders, NEX (includes osteoporosis) 

IV. Pain Assessment (14%)

Impact of the following on patient report of pain:

A. Cultural background

B. Age

C. Psychological factors

Proper usage and limitations of:

D. Subjective report methods (e.g., visual analogue scale, verbal descriptors, McGill Pain Questionnaire)

E. Pain behavior ratings/activity reports

F. Pain treatment outcomes assessment

G. Placebo trials

V. Pharmacology (16%)

A. Tolerance and physical dependence

B. Detoxification and withdrawal syndromes

C. General pharmacokinetics and pharmacodynamic principles

D. Routes of administration (including intrathecal/epidural pumps/catheters)

E. Equianalegesic doses

F. Placebo response, Nocebo response

G. Addiction (diagnosis, treatment, and epidemiology)

Mechanisms of action, contraindications, side effects, and interaction of:

H. Acetaminophen

I. Nonsteroidal anti-inflammatory agents

J. Corticosteroids

K. Local anesthetics

L. Antiarrhythmics

M. Muscle relaxants

N. Stimulants

O. Opioids

P. Anticonvulsants

Q. Antidepressants

R. Antipsychotics

S. Lithium

T. 5HT drugs (serotonin agonists/antagonists)

U. Ergot derivatives

V. Beta blockers

W. Benzodiazepines

X. Nonbenzodiazepine anxiolytics/hypnotics

Y. Neurolytic agents

Z. NMDA antagonists

AA. Calcium channel blockers

BB. Alpha agonists/antagonists

CC. Baclofen

DD. Tramadol

EE. Capsaicin

FF. Calcitonin

GG. Strontium

HH.  Bultabital preparations


VI. Pain Medicine Therapies (Non-Pharmacology) (15%)

A. Therapeutic nerve blocks

B. Epidural/subarachnoid anesthetic blocks

C. Continuous infusion of neuroaxial agents (e.g. morphine, baclofen)

D. Soft tissue injection

E. Intra-articular injections

F. Neurolytic techniques (chemical, cryogenic, radiofrequency)

G. Stimulation procedures (peripheral nerve, spinal cord)

H. Central nervous system ablative surgical techniques

I. Decompressive surgical procedures (peripheral nerve, nerve root)

J. Therapeutic heat and cold

K. Manipulation and massage

L. Physical therapy


N. Casting/splinting/orthotics

O. Conditioning exercise

P. Radiation therapy

Q. Cognitive behavioral therapy

R. Psychotherapy

S. Hypnosis

T. Biofeedback

U. Relaxation training

V. Occupational therapy

W. Vocational assessment/rehabilitation

X. Functional restoration (e.g., ergonomics, energy conservation)

Y. Nutrition

Z. Acupuncture and other complementary therapies

AA. Hospice care

BB. Multidisciplinary pain treatment


VII. Psychological/Behavioral Aspects of Pain (10%)

A. Impact of psychological factors on patient report of pain

B. DSM diagnosis of Pain Disorder

C. Other psychiatric diagnoses (e.g., somatoform, factitious, depressive, panic, anxiety, and posttraumatic stress disorders)

D. Interaction of pain problem/disorder with personality traits/disorders

E. Psychometric assessment (non-pain, e.g., MMPI, BDI, HAM-D, STAI; excludes II J): principles and tools

F. Impact of pain on work and family and influence of familial and occupational factors on pain

G. Secondary gain

H. Sexual dysfunction

I. Relationship between pain and sleep disorders

VIII. Compensation/Disability and Medical-Legal Issues (7%)

A. Differences between disease, impairment, and disability

B. Standardized guidelines for assessing impairment and disability

C. Malingering

D. Compensation and disability systems

E. Expert witness testimony

F. Interaction with the legal system (confidentiality, medical records)

G. Documentation (medical records, informed consent)

H. Coding requirements/documentation (ICD 9/10, CPT)

I. Controlled Substances Act/methadone maintenance (includes DATA 2000)

J. Ethics (living wills, do-not-resuscitate orders, durable power of attorney, assisted suicide)

K. Physician-patient relationship (e.g., termination of professtional relationship)