Glossary of Medical Terms/Conditions

Acupuncture: a procedure, which involves inserting fine needles into the skin at specific points on the body to relieve chronic pain.

Acute Pain: pain that typically lasts less than 3 to 6 months, or pain that is directly related to soft tissue damage such as a sprained ankle or a paper cut. Acute pain is of short duration but it gradually resolves as the injured tissues heal.

Advanced Practice Nurse: an umbrella term used to refer to nurse practitioners (NPs), clinical nurse specialists, nurse midwives, and nurse anesthetists.

Anatomy of the spine: the spine is made up of stacked bones (vertebrae) and cushions of soft tissue (discs). When seen from the side they form the 3 natural curves of the spine. The cervical curve is the neck area. The thoracic curve is at the chest level and the lumbar curve is the lower back. The sacrum and coccyx are 2 fused bones at the bottom of the spine.

Anesthesiologist: a doctor who specializes in anesthetics or anesthesia.

Arthritis: inflammation of joints due to infectious, metabolic, or constitutional causes.

Bursitis: inflammation of a bursa (as of the shoulder or elbow).

Board Certified: the process of certifying that a physician has passed an examination and met the standards of a professional organization representing a particular medical specialty.

Cancer: a malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis.

Carpal Tunnel Syndrome: a condition caused by compression of the median nerve in the carpal tunnel and characterized especially by weakness, pain, and disturbances of sensation in the hand and fingers.

Celiac Plexus Block: an injection of anesthetic and anti-inflammatory medication around the group of nerves (celiac plexus) that affect the abdominal region. This is performed most commonly for the treatment of upper abdominal pain, which can be due to cancer or chronic pancreatitis.

Chronic Pain: pain that has lasted longer than three to six months that has had no response or inadequate response to conservative or common treatment options.

Complex Regional Pain Syndrome/CRPS: (also called Reflex Sympathetic Dystrophy/RSD) is a chronic condition that causes severe, burning pain in the affected area. Pain is the main symptom of CRPS. Most people have severe pain in an arm or a leg. Usually the pain is in a part of your body where you had surgery or an injury. The pain is usually constant and either shooting, sharp, or burning. The pain is much worse and it lasts much longer than you would expect for the kind of injury you had. Some people may not have had an injury or surgery before the pain started, but most people have.

Consultation: a meeting with a physician to discuss and evaluate a patient’s medical case and treatment options.

EMG (Electromyography): a diagnostic nerve test to assess the health of muscles and the nerve cells that control them. EMGs help determine neurological problems.

Epidural Injection: an outpatient/office procedure, which involves placement of anti-inflammatory agents into the epidural space to reduce disc and nerve inflammation, producing relief.

Facet Joints: the sliding joints allowing the vertebrae of the spine to glide over one another without losing contact.

Facet Nerve Block: an injection of anti-inflammatory and anesthetic medication in and around the facet joint area to reduce the swelling around the nerve. This is performed if your doctor suspects that your neck or lower back pain may be caused in part by the small facet joints of the spine (Facet joints are located on the side of your spine, away from the spinal cord).

Fluoroscopy: (video X-ray guidance) is used to help locate the correct lumbar vertebra and nerve root.

Foraminae: are small openings between your vertebrae through which the nerve roots exit the spinal canal and enter the body.

Genicular Nerve Block: Genicular nerves are sensory nerves that transmit pain signals from the knee to the brain. An injection of anesthetic to the nerves can interrupt pain signals to the brain helping block the knee pain. Candidates for this type of block include patients who have knee pain from degenerative osteoarthritis, ligament damage, or continued pain after knee replacement.

Greater Trochanter Injection: an injection is performed to relieve trochanteric bursitis, a common problem that causes pain in the area of the hip over the bump that forms the greater trochanter. Steroid medication can reduce the swelling and inflammation in the trochanteric bursa.

Herniated disc: a herniated disc occurs when the spongy, soft material that cushions the bones of the spine (vertebrae) slips out of place or becomes damaged. You can have a herniated disc in any part of your spine. When a herniated disc presses on a nerve, it can cause pain, numbness, and weakness in the area of the body where the nerve travels.

HydroDiscetomy: A minimally invasive treatment for patients with herniated discs. The procedure uses a high-speed water stream to remove damaged or protruding spinal disc tissue, which relieves pressure that causes back and radiculopathy (leg pain).

Injection: adding a solution (such as a drug) using a special needle, catheter or syringe) either under or through the skin or into the tissues, a vein, or a body cavity.

Intercostal Nerve Block: an injection of a local anesthetic and anti-inflammatory medication in the area between two ribs. An intercostal nerve block is performed for pain due to herpes zoster (commonly known as shingles), an acute viral infection that causes inflammation of the nerves that spread outward from the spine. It may also be performed for pain caused from a surgical incision in the chest area or to help determine the cause of your pain (diagnostic nerve block).

Intrathecal Drug Delivery System (medicine pump): Outpatient/inpatient surgical treatment. A catheter (thin flexible tube) is implanted in the intrathecal space and is connected to a pump releasing medicine at a set rate. With delivery of medicine to receptors in the spinal cord, smaller amounts of medicine are needed to obtain relief from pain and a reduction in side effects. Antispasmodics such as Baclofen, and pain medicines such as Dilaudid and morphine sulfate are delivered by the pump.

Interventional Pain Medicine/Management: is a subspecialty of the medical specialty, pain management, devoted to the use of invasive techniques such as joint injections, nerve blocks, and implantable spinal cord and medicine pump systems.

Lumbar Sympathetic Block: an injection of local anesthetic around a group of nerves in your lower back. It may be done if you have complex regional pain syndrome (CRPS), a disease involving a disturbance of circulation to the skin or neuropathic pain (pain caused by a disorder of the nervous system).

MRI (Magnetic Resonance Imaging): a noninvasive diagnostic procedure using a scanner to obtain detailed images of the internal structures of the body.

Massotherapy: a general term for medical or therapeutic treatment by massage. It is one of the oldest and more effective treatments to help relieve pain, reduce swelling, relax muscles, and speed healing and is often used in combination with other pain management procedures and treatments at the Doctors Pain Clinic.

Medication: a drug or remedy.

Migraine: painful headaches often accompanied by nausea, vomiting, and sensitivity to light.

Neurostimulation (spinal cord stimulation): an outpatient procedure where a neurostimulation system is surgically placed under the skin to send mild electrical impulses to the spinal cord or to a peripheral nerve. These electrical impulses are delivered through a lead (a special medical wire) that is also surgically implanted to specifically cover the area where pain is felt.

Occipital Nerve Block: an injection of steroid or other medication in or around the greater and lesser occipital nerves located in the area at the back of the head, above the neck area but just beneath the scalp. The purpose of the injection is to help reduce inflammation and swelling of the tissue around the occipital nerves, which may also help alleviate other symptoms caused by inflammation. Certain types of tension and migraine headaches may respond to occipital nerve blocks.

Opioids: medications that relieve pain. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus. Medications that fall within this class include hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs.

Parasympathetic Nerve Block: an injection of local anesthetic in the sympathetic nerve tissue– the nerves, which are a part of Sympathetic Nervous System. The nerves are located on the either side of spine, in the back. The injection blocks the sympathetic nerves. This block is often performed as treatment for Complex Regional Pain Syndrome also known as Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, and Herpes Zoster (shingles) involving the lower extremity.

Paravertebral Facet Nerve Block: an injection into the facet joints of the spine. The facet joints are where two vertebrae meet. Facets allow the bones in your spine to glide smoothly as you move. The purpose of this procedure is to locate the specific nerve causing your discomfort.

Percutaneous Discectomy/Disc Decompression: This option is for patients suffering from low back and leg (radicular) pain due to contained disc herniation. This option is also performed on those who have failed in their conservative treatments and are interested in trying minimally invasive options before considering traditional back surgery. Percutaneous Discectomy is performed in surgery using local anesthetic or conscious sedation to allow patient monitoring in order to pinpoint the pain source. With the help of fluoroscopic guidance (live video X-Ray), a discectomy probe removes disc tissue via a tiny puncture in the skin similar to a simple injection. Removal of disc tissue may relieve painful pressure on the surrounding nerves. The total procedure takes 30-60 minutes. Visit: www.dekompressor.com

Personalized Medicine: the emerging practice of medicine that uses an individual's genetic profile/DNA to guide decisions made in regard to the prevention, diagnosis and treatment of medical conditions.

Physical Medicine & Rehabilitation Specialist: physicians who have completed training in the medical specialty of physical medicine and rehabilitation (PM&R). Specifically, rehabilitation physicians: Diagnose and treat pain, restore maximum function lost through injury, illness or disabling conditions, and provide non-surgical treatments.

Physical Therapy: the evaluation and treatment of physical disabilities designed to improve physical strength, range of motion and ability. Physical therapy is used in conjunction and to complement and enhance the pain management treatment plan.

Physiatrist: a physician specializing in physical medicine.

Phantom Pain: pain that feels like it’s coming from a body part that's no longer there. This pain is often experienced by individuals with amputated body parts.

Physician Assistant: a graduate of an accredited physician assistant educational program and is certified and state-licensed to practice medicine with the supervision of a physician.

Platelet Rich Plasma Injections (PRP): procedure for joint, tendon, ligament, or muscular injuries. PRP treat injuries by stimulating the body's own healing potential with the use of the patient's own blood. This emerging treatment option is widely used by professional athletes for acute and chronic Injuries.

Progressive (as in progressive pain management options): making use of or interested in new ideas, findings, or opportunities.

Provocative Discogram: an outpatient diagnostic X-ray test that attempts to replicate the patient's pain symptoms in order to pinpoint the pain source in the discs. Dye and an antibiotic mixture is injected into the disc enabling the physician to determine whether the disc is painful when the pressure is increased in the disc or whether the pain is typical of the patient's pain pattern.

Radiofrequency Block: an outpatient procedure in which a radiofrequency current is used to heat a small volume of nerve tissue interrupting pain signals from that specific area.

Raynaud's Syndrome: is a problem with blood flow. Your body doesn't send enough blood to your hands and feet, so they feel very cold and numb. In most cases, this lasts for a short time when your body overreacts to cold temperatures.

Reflex sympathetic dystrophy (RSD): also known as Complex Regional Pain Syndrome, is a chronic condition that causes severe, burning pain in the affected area. Pain is the main symptom of CRPS. Most people have severe pain in an arm or a leg. Usually the pain is in a part of your body where you had surgery or an injury. The pain is usually constant and either shooting, sharp, or burning. The pain is much worse and it lasts much longer than you would expect for the kind of injury you had. Some people may not have had an injury or surgery before the pain started, but most people have.

Sacroiliac Joint Injection: are a small joint in the area of the low back and buttocks where the pelvis joins with the spine. If the joints become painful they may cause pain in the low back, buttocks, abdomen, groin or legs. A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm whether or not the joint is the source of pain. Also, the temporary relief of the numbing medicine may better allow the physician to treat that joint. Also, time release cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).

Shingles: a painful skin rash caused by the Varicella Zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It is also called Herpes Zoster.

Spinal Stenosis: the narrowing of spaces in the spine (backbone) which causes pressure on the spinal cord and/or nerves. About 75% of cases of spinal stenosis occur in the low back (lumbar spine). In most cases, the narrowing of the spine associated with stenosis compresses the nerve root, which can cause pain along the back of the leg.

Sprain: a stretch or tear in a ligament (the bands of fibrous tissue that connect our bones at the joints).

Stellate Ganglion Block: an injection of anesthetic medication around the collection of nerves that affect the upper limb. This may be performed to decrease pain and increase the circulation and blood supply to the affected limb. A stellate ganglion may be performed for people who have circulation problems or the following nerve injuries: Complex Regional Pain Syndrome (CRPS), Causalgia, Herpes Zoster and Phantom Limb Pain.

Steroid: (short for corticosteroids) are synthetic drugs that closely resemble cortisol, a hormone that your body produces naturally. Steroids work by decreasing inflammation and reducing the activity of the immune system. They are used to treat a variety of inflammatory diseases and conditions.

Strain: is also a stretch or tear, this time affecting the muscle itself or a tendon (the tissue that connect the muscles to the bones).

TENS (transcutaneous electrical nerve stimulation): a small extractable device delivers electric impulses to nerve endings to stop pain.

Tendonitis: inflammation of a tendon.

Therapeutic nerve blocks: outpatient/office procedures where local anesthetic and anti-inflammatory medication injections are given near a specific nerve or group of nerves to relieve pain.

Transforaminal Epidural Injection: performed to relieve low back and radiating leg pain. The transforaminal approach is a very selective injection around a specific nerve root. By injecting medication around a specific nerve root, the doctor can determine if this nerve root is causing the problem. This type of epidural injection is used most often for diagnostic purposes, and it is commonly used in the neck. The medication injected can help reduce swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica and herniated discs. However, many patients get significant relief from only one or two injections. In some cases, it may be necessary to repeat the procedure.

Trigger Point Injections: An outpatient/office procedure where small amounts of local anesthetics and anti-inflammatory medications are injected in the area of the muscle where you have pain or tenderness. These areas are called trigger points because they produce pain when stimulated. Trigger Point Injections are performed if you have myofascial pain, which is pain in a specific muscle or muscle group.

UDS (urine drug screen): medical testing to detect a specific substance or metabolites such as drugs for medication in urine.

Vertebroplasty: A minimally invasive procedure used for patients with an acute vertebral compression fracture (collapse of vertebra) most often caused by osteoporosis, trauma and sometimes tumor. This procedure offers rapid relieve, increased mobility, improved quality of life and low complications.