Chronic Pain Definitions & Terms

A feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. Anxiety is a multisystem response to a perceived threat or danger. It reflects a combination of biochemical changes in the body, the patient's personal history and memory, and the social situation. The anxiety that occurs in posttraumatic syndromes indicates that human memory is a complicated mental function. Moreover, a large portion of human anxiety is produced by anticipation of future events.

Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Arthropathy is a collective term for any disease of the joints. The disease may be localized to one joint, as with post-traumatic arthritis, or may affect multiple joints, as with osteoarthritis or rheumatoid arthritis. It may also be due to an underlying condition such as a bacterial infection.

A degenerative disease of the joint where the cartilage lining the joint erodes over time. Arthrosis is a broad term for degenerative and other diseases of the joint and is more commonly understood in the form of osteoarthritis. Therefore the term arthrosis is sometimes considered to be synonymous with osteoarthritis while at other times arthrosis is seen as a prelude to or the early stages of osteoarthritis.

A bulging disc is a condition in which the nucleus (inner portion) of a spinal disc remains contained within the annulus fibrosis (outer portion), unlike a herniated disc in which the nucleus leaks out of the disc. As a reference think about a car tire which is very low on air. Where it contacts the ground the tire sides bulge out.

Bursitis is a painful condition that affects the small, fluid-filled sacs – called bursae – that cushion the bones, tendons and muscles near your joints. Bursitis occurs when bursae become inflamed.

The Canal (Spinal Canal) is a cavity that runs successively through each of the vertebrae and contains the spinal cord.

Cartilage connective tissue is not as rigid or as hard as bone, and it is also less flexible than muscle. Therefore, we find cartilage in places where we need some support and structure, but a bit of flexibility as well. This includes places such as our joints, our ears, and our nose, as well as in between the vertebrae in our spinal column.

Marked by long duration, by frequent recurrence over a long time, and often by slowly progressing seriousness. Having a slow progressive course of indefinite duration – used especially of degenerative invasive diseases, some infections, psychoses, and inflammations. Chronic pain is described as any pain which lasts 3 to 6 months and longer.

A bone of the vertebrate pectoral girdle typically serving to link the scapula and sternum – called also collarbone.

The small bone at the end of the spine.

A concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination.

The cylindrical bundle of nerve fibers and associated tissue that is enclosed in the spine and connects nearly all parts of the body to the brain, with which it forms the central nervous system.

A CT scan, also called X-ray computed tomography or computerized axial tomography scan, makes use of computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of specific areas of a scanned object, allowing the user to see inside the object without cutting.

Spinal decompression is the relief of pressure on one or more pinched nerves, often called neural impingement of the spinal column. Spinal decompression can be achieved both surgically and non-surgically and is used to treat conditions that result in chronic back pain such as disc bulge, disc herniation, sciatica, spinal stenosis, isthmic and degenerative spondylolisthesis.

Degeneration of one or more intervertebral disc(s) of the spine, often called "degenerative disc disease" (DDD) or "degenerative disc disorder". It is a pathologic process that may cause acute or chronic low back pain. The typical radiographic findings in DDD are disc space narrowing, vacuum disc, end plate sclerosis, and osteophyte formation. DDD can greatly affect the sufferer's quality of life. Disc degeneration is a disease of aging, and though for most people is not a problem, in certain individuals a degenerated disc can cause severe chronic pain if left untreated.

The loss of nerve supply. Causes of denervation include disease, chemical toxicity, physical injury, or intentional surgical interruption of a nerve.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

Discectomy is a surgical procedure to remove the damaged portion of a herniated disc in your spine. A herniated disc can irritate or compress nearby nerves and cause pain, numbness or weakness. These symptoms can affect your neck or back or may radiate down your arms or legs.

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets.

Electrical muscle stimulator is any device that stimulates muscles contraction by electrical impulses. These are used in mainstream physical therapy to reduce muscle spasms, prevent the development of blood clots after surgery or cerebrovascular accidents and prevent disease atrophy of muscle.

An injection of anaesthetic into the dura mater space of the spine enveloping the spinal cord.

Small stabilizing joints located between and behind adjacent vertebrae. The facet joints, or joints with "small faces" are found at every spinal level (except at the top level) and provide about 20% of the torsional (twisting) stability in the neck and low back. The vertebrae of the chest area are normally far less mobile and permit a small amount of forward/backward and some side bending, and very little twisting.

The femoral nerve is located inside the leg and provides muscles that help the leg to bend and straighten. It also allows people to feel sensations within the front part of the thigh and a section of the lower leg. While the much larger sciatic nerve also passes through the thigh on its way to the lower leg and foot, only the femoral nerve innervates the tissues of the thigh. Nerve signals carried by the femoral nerve are crucial to the function of the legs, including standing, walking, and running.

Fibromyalgia is the most common musculoskeletal condition after osteoarthritis. Still, it is often misdiagnosed and misunderstood. It is characterized by chronic widespread pain and a heightened pain response to pressure. Other symptoms include feeling tired to a degree that normal activities are affected, sleep problems, and troubles with memory. Some people also report restless leg syndrome, bowel or bladder problems, numbness and tingling, and sensitivity to noise, lights or temperature.

Fibromyalgia is frequently associated with depression, anxiety, and posttraumatic stress disorder.

The term fibrosis describes the thickening and scarring of connective tissue, usually as a result of injury. Fibrosis may refer to the connective tissue deposition that occurs as a part of normal healing or to the excess tissue deposition that occurs as a pathological process.

Foraminotomy is surgery that widens the opening in your back where nerve roots leave your spinal canal. A foraminotomy is performed to relieve the symptoms of nerve root compression in cases where the foramen is being compressed by bone, disc, scar tissue, or excessive ligament development and results in a pinched nerve.

Gout is a disease in which defective metabolism of uric acid causes arthritis, especially in the smaller bones of the feet, deposition of chalkstones, and episodes of acute pain. Gout is usually characterized by recurrent attacks of inflammatory arthritis—a red, tender, hot, and swollen joint. Pain typically comes on rapidly in less than twelve hours. The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or urate nephropathy.

Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior. A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk.

The iliac crest is the curved ridge at the top of the pelvic bone. It forms the prominent bone of the hip. The iliac bone crest is the uppermost edge of the ilium, one of three fused bones, the ilium, the ischium, and the pubis, that together make up the pelvis.

As with all spinal fusion surgery, a posterior lumbar interbody fusion(PLIF) involves adding bone graft to an area of the spine to set up a biological response that causes the bone to grow between the two vertebral elements thus stabilizing and ending motion at that area.

An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae. Each disc allows slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together. Their role as shock absorbers in the spine is crucial.

The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. A surgical instrument is introduced into the spine with a balloon that is inflated to expand the bone. A cement-like material called polymethylmethacrylate (PMMA) is injected which hardens quickly, stabilizing the bone. By creating space in this way, kyphoplasty procedures may correct deformity or restore body height.

See Vertebroplasty definition for differences between the two procedures.

Laminectomy is surgery that creates space by removing the lamina – the back part of the vertebra that covers your spinal cord. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

Visual examination of the abdomen by means of a laparoscope.

Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell. Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment.

A microdiscectomy surgery is used to treat a herniated disc. It is most commonly performed on the lumbar (lower) region of the spine. During this procedure, a portion of bone or disc material is removed in order to provide relief to a compressed nerve root in the spinal column.

Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body.

Of or relating to the fascia surrounding and separating muscle tissue.

Pertaining to both nerves and muscles, as in neuromuscular blockade by an anesthetic agent. The neuromuscular junction (the meeting place of a nerve and a muscle fiber), and neuromuscular transmission (the transfer of "information" from the nerve to the muscle).

Peripheral neuropathy, a result of damage to your peripheral nerves. It often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.

A combining form meaning "bone," used in the formation of compound words.

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. The effects can range in severity from mild to quite severe, disabling pain. Typically, it starts with the breakdown of the flexible joint tissue known as cartilage and can lead to stiff and immobile joints.

In the United States Doctors of Osteopathic Medicine, or D.O., are fully licensed physicians who practice in all areas of medicine. A D.O. receives special training in the musculoskeletal system, the body's interconnected system of nerves, muscles and bones. Osteopathic physicians focus on prevention, tuning into how a patient's lifestyle and environment can impact their wellbeing. A D.O. strives to help you be truly healthy in mind, body and spirit - not just free of symptoms.

Osteoporosis is a disease where decreased bone strength increases the risk of a broken bone. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. Osteoporosis may be due to lower than normal peak bone mass and greater than normal bone loss. Bone loss increases after menopause due to lower levels of estrogen.

Piriformis syndrome is typically caused by the luteal muscles becoming too tight and putting pressure on the sciatic nerve, which can radiate throughout the hip and buttocks as the pelvis is caused additional wear and tear. Working out in worn out shoes, inflexibility, length discrepancies of the legs and muscle imbalances can contribute to this condition.

Post-traumatic stress disorder (PTSD or PTS) is a disorder that comes from having seen or lived through a shocking, scary or dangerous event. PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster. Families of victims can also develop PTSD, as can emergency personnel and rescue workers.

Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear, and even guilt. These reactions are common, and for most people, they go away over time. For a person with PTSD, however, these feelings continue and even increase, becoming so strong that they keep the person from living a normal life.

Those who may develop PTSD include but are not limited to survivors of:

• Domestic violence, physical assault, rape, sexual assault and/or abuse other random violent acts in public (at work, school)
• Car accidents
• Natural disasters
• major catastrophic event (e.g., terrorist attack, plane crash)
• Combat veterans or civilian victims of war
• Those diagnosed with a life-threatening illness or who have had major medical procedures
• Professionals who respond to victims in trauma situations such as emergency medical service workers, police, and military
• Those who learn of the sudden, unexpected death of a close friend or relative

In rheumatoid arthritis, the body's immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs. 

Rheumatoid arthritis affects joint linings, causing painful swelling. Over long periods of time, the inflammation associated with rheumatoid arthritis can cause bone erosion and joint deformity. Rheumatoid arthritis In rheumatoid arthritis, the body's immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs.
Rheumatoid arthritis affects joint linings, causing painful swelling. Over long periods of time, the inflammation associated with rheumatoid arthritis can cause bone erosion and joint deformity.

The sacroiliac joint or SI joint (SIJ) lies next to the bottom of the spine, below the lumbar spine and above the tailbone (coccyx). It connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest), which are joined by strong ligaments. The human body has two sacroiliac joints, one on the left and one on the right.

The sacrum is a large triangular bone at the base of the spine which forms by the fusing of the sacral vertebrae of S1-S5. It forms the solid base of the spinal column where it intersects with the hip bones to form the pelvis. The sacrum is a very strong bone that supports the weight of the upper body as it is spread across the pelvis and into the legs.

Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down through your hips and buttocks and down each leg. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve.

•  Lower back pain
• Pain in the rear of the leg that is worse when sitting
• Leg pain that is often described as burning, tingling or searing (not a dull ache)
• Weakness, numbness or difficulty moving the leg or foot
• A sharp pain that may make it difficult to stand up or to walk

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. Most cases are mild with few symptoms. Some children develop spine deformities that get more severe as they grow. Severe scoliosis can be painful and disabling.

Spondylosis is common and worsens with age. This condition is often used to describe degenerative arthritis (osteoarthritis) of the spine. It is also commonly used to describe any manner of spinal degeneration. A common form of spondylosis is cervical spondylosis (sometimes called neck arthritis) in which the facet joints in the neck become enlarged causing the ligaments around the spinal canal to thicken and bone spurs to form.

Spondylolisthesis is the condition in which one vertebral body is slipped forward over another. If the vertebra slips too far, it may press on nerves and cause severe back pain or nerve crowding that produces leg pain or numbness.

A narrowing or stricture of a passage or vessel. Spinal stenosis can put pressure on the spinal cord and the nerves within the spine. It comStenosis (spinal)

Transcutaneous electrical nerve stimulation is the electrical stimulation of the skin to relieve pain by interfering with the neural transmission of signals from underlying pain receptors.

The thoracic spine refers to the upper- and middle-back. It joins the cervical spine and extends down about five inches past the bottom of the shoulder blades, where it connects with the lumbar spine. The thoracic spine is made up of twelve vertebrae, labeled T1-T12.

Pain and compromised movement of the jaw joint and the surrounding muscles. Temporomandibular joint disorder is a disorder of the temporomandibular joints(s) that causes pain, usually in front of the ear(s), sometimes in the form of a headache.

This vertebral augmentation procedure may involve either no manipulation or only external reduction of the fracture by extension, i.e., physical manipulation of the patient when placing the patient on the operating table before the material is injected into the fracture site.

See Kyphoplasty definition for differences between the two procedures.