Acupuncture – A Chinese therapy to relieve pain and treat health conditions. It is most often performed by putting very thin needles into the skin at certain points on the body to influence energy flow along the body’s meridians.
Arthritis – Acute or chronic inflammation of a joint that can cause pain and stiffness of the affected area.
Bone Density – Bone density is the amount of bone tissue in a certain volume of bone. It can be measured using a special x-ray called a quantitative computerized tomogram.
Cancer – Also called a malignancy, is characterized by an abnormal growth of cells.
Catheter – A small tube that is passed into the body for injecting medication or withdrawing a substance.
Cervical Spine – The region of the spine in the neck area. The cervical spine begins at the base of the skull. There are seven levels in the cervical spine.
Chronic Pain – Pain that lasts for 3 months or longer is considered chronic. Chronic pain can occur anywhere in your body and can range from mild to severe.
Complex Regional Pain Syndrome – Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems. CRPS is most common in people aged 20 – 35 years old. It affects women more often than men.
CT Scan – Computerized tomography scan. Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT stands for computerized tomography. The CT scan can reveal some soft-tissue and other structures that cannot even be seen in conventional X-rays. Using the same dosage of radiation as that of an ordinary X-ray machine, an entire slice of the body can be made visible with about 100 times more clarity with the CT scan.
Denervation Loss – of nerve supply. There are many causes of denervation. Denervation may be due to a disease as, for example, in polio where the death of motor neurons causes the denervation of muscle fibers. Denervation may be due to a chemical (such as botox) or physical injury or interruption of a nerve (as by accident or to relieve pain).
Discography Injection – of a dye into the jelly-like center of a spinal disc to help diagnose disc problems.
Dura – The tough protective membrane covering the brain and spinal cord.
Epidural – A regional injection of anesthesia into the epidural space of the spine; sensation is lost in the abdominal, pelvic and genital areas.
Epidural Space – The area between the protective covering (dura) of the spinal cord and the vertebrae (spine).
Facet Joint – Facets are small hinge-like joints between the spinal vertebrae. They help support the spine and allow for flexion and extension of the back.
Fibromyalgia – A syndrome that affects the muscles and soft tissue. Symptoms include chronic pain in the muscles, fatigue, sleep problems and painful tender points or trigger points at certain parts of the body.
Fluoroscopy – A fluoroscope is an X-ray device that allows a physician to see a patient’s anatomy on a video screen. Unlike traditional X-ray techniques, the images on the fluoroscope are presented in real-time-there is no waiting for film to be developed.
Headache – Pain located in the head, as over the eyes, at the temples or at the base of the skull.
Herniated Disc – A rupture of the disc tissue that separates the vertebral bones of the spinal column. It may create pressure on one or more of the spinal nerves which can cause pain, weakness or numbness in the neck and arms. Other names for herniated discs are prolapsed, slipped and ruptured discs.
Herpes Zoster – The term for shingles. It is marked by a rash or blisters on the skin.
HIPAA – Healthcare Insurance Portability Accountability Act. A copy of the HIPAA requirements is available in the office.
Intractable Pain – Stubborn, obstinate pain that is hard to control and manage.
Intrathecal Infusion Pump – Used primarily with cancer patients, this implanted pump can provide better pain relief with a lower dose of medication.
Intrathecal Space – The space around the spinal cord that contains the cerebral-spinal fluid.
Intravertebral Disc – Shock-absorbers for the spine. There is an intravertebral disc between each vertebrae. The disc is composed of two layers: a fibrous outer layer and a gel-like inner layer.
Joint – The junction or articulation of two or more bones that permits varying degrees of motion between the bones.
Kyphoplasty – A medical procedure used in the treatment of spinal compression fractures. It is similar to vertebroplasty. A small balloon is used to restore the height of the vertebrae. Bone cement is then injected percutaneously into a fractured vertebra in order to stabilize it and provide pain relief. This procedure is performed in the Pain Management Center.
Kyphosis – an abnormal curvature of the upper spine (thoracic area). In adults, this condition is usually caused by spinal arthritis, osteoporosis with compression fractures of the vertebrae, and/or trauma.
Lordosis – An abnormal increase in the normal curvature of the lumbar spine.
Lumbar Spine – The region of the spine in the low back area. There are five levels in the lumbar spine.
MRI – An MRI (or magnetic resonance imaging) scan is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. The receiver information is processed by a computer, and an image is produced. The image and resolution produced by MRI is quite detailed and can detect tiny changes of structures within the body.
Muscle Pain – This pain is caused by damage to muscle fibers through injury, chronic overuse or repetitive motions. Myofascial pain is usually described as a dull, aching constant type of pain.
Myelogram – An X-ray study of the spinal canal that uses dye to more clearly outline the space containing the spinal cord. When myelography is used, it is usually combined with a CT scan. This test may be done if you cannot have an MRI, for example, if you have a pacemaker, or if the results of an MRI are not clear.
Myofaslicial Pain Syndrome – A chronic form of muscle pain. The pain of myofascial pain syndrome centers around sensitive point in your muscles called trigger points. The trigger points in your muscles can be painful when touched and the pain can spread throughout the affected muscle. Options for treatment may include physical therapy, injections or medications.
Nerve Root – is the beginning of the nerve area where it leaves the central nervous system of the spinal cord.
Nerve Root Blocks – A local anesthetic injected into or around a nerve or into the spine. This temporarily prevents the nerve from relaying pain. A nerve block may cause temporary muscle paralysis in the affected or surrounding area.
Neuropathies – Nerve disease or damage.
Neuralgia – Pain along the course of a nerve.
Neuritis – Inflammation of nerves.
Neurolytic – A procedure or substance that destroys nerves.
Opioid – An opioid is a chemical substance that has a morphine-like action in the body. The main use is for pain relief.
Osteoporotic Compression Fracture – This is a condition in which bone density is reduced, which may predispose a person to a vertebral compression fracture with little or no trauma.
Parathesia – An abnormal sensation of the skin, such as numbness, tingling, pricking, burning, or creeping on the skin that has no objective cause.
Pathologic Vertebral Fracture – Most commonly, this type of break is from cancer in the bone, which has often traveled from other sites in the body, such as from the prostate, breast, or lungs.
Percutaneous – Through the skin or using a very small incision.
Percutaneous Discography – Percutaneous Discography is a diagnostic procedure that is performed prior to back surgery to identify which level of the spine needs fusion. It is usually performed at three levels of vertebrae: the suspected problem level, the level above and the level below.
Peripheral Neuropathy – Peripheral neuropathy is disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain.
Phantom Limb Syndrome – The perception of sensations, usually including pain, in an arm or leg after the limb has been amputated. The brain still gets messages from the nerves that originally carried impulses from the missing limb. Phantom limb syndrome is relatively common in amputees, especially in the early months and years after limb loss.
Piriformis Syndrome – Irritation of the sciatic nerve caused by compression of the nerve within the buttock by the piriformis muscle. Typically, the pain of the piriformis syndrome is increased by contraction of the piriformis muscle, prolonged sitting, or direct pressure applied to the muscle. Buttock pain is common.
Post Herpetic Neuralgia – Symptoms of shingles persist long after the rash is healed. In these cases, facial paralysis, headache, and persistent pain can be the aftermath. Possibly because the nerve cells conveying pain sensations are hardest hit, or are exquisitely sensitized by the virus attack, pain is the principal persistent complication of shingles. This pain, called post herpetic neuralgia, can be debilitating. This type of pain can lead to insomnia, weight loss, depression, and that total preoccupation with unrelenting torment that characterizes the chronic pain sufferer.
Postlaminectomy Syndrome – Also known as, failed back syndrome (FBS), this condition refers to chronic back and/or leg pain that occurs after a person has had back (spinal) surgery.
Prone – Lying face down.
Radicular Pain – Radicular pain is the result of pressure or damage to nerve roots. This pain often radiates down the path of the nerve. Quite often, radicular pain is described as sharp or jabbing pain that is associated with specific positions or activities. This type of pain is often describes as sciatica.
Radiculitis – Pain that runs down a nerve due to an inflammation or other irritation to the nerve root.
Radiculopathy – A disease involving a spinal nerve root.
Radiofrequency Ablation – Radiofrequency used to relieve chronic nerve pain by interrupting pain signals from the legs and lower back that are carried up the spinal cord to the brain. Radiofrequency can be performed in a continuous manner or in short bursts of current which is called pulsed radiofrequency.
Radiofrequency – The use of an electrical current heat to destroy tissue.
Reflex Sympathetic Dystrophy – Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems. CRPS is most common in people aged 20 – 35 years old. It affects women more often than men.
Ruptured Disc – A rupture of the disc tissue that separates the vertebral bones of the spinal column. It may create pressure on one or more of the spinal nerves which can cause pain, weakness or numbness in the neck and arms. Other names for herniated discs are prolapsed, slipped and ruptured discs.
Sciatica – Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. Branches of the sciatic nerve extend through the buttocks and down the back of each leg to the ankle and foot.
Shingles – A viral infection caused by the chickenpox virus. Symptoms include pain and a rash on one side of the body. Shingles most commonly affects people with a weakened immune system.
Slipped Disc – A rupture of the disc tissue that separates the vertebral bones of the spinal column. It may create pressure on one or more of the spinal nerves which can cause pain, weakness or numbness in the neck and arms. Other names for herniated discs are prolapsed, slipped and ruptured discs.
Somatic Pain – Specific muscular pain.
Spinal Cord Injury – A result of direct trauma of the spinal cord itself or damage to the bones and soft tissues and vessels surrounding the spinal cord.
Spinal Cord Stimulator – An implanted device used for the relief of chronic back pain that is resistant to other therapies. The SCS is about the size of a half-dollar. It is also called a neurostimulator.
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.
Spondylolisthesis – Forward movement of one of the vertebrae of the spine in relation to an adjacent vertebra. It is commonly caused by degenerative diseases like osteoarthritis. Spondylolisthesis can also be due to stress fracture, traumatic fracture, and bone disease
spondylosis Degeneration of the disc spaces between the vertebrae. This finding in the spine is commonly associated with osteoarthritis.
Steroid Injections – Steroids are medications specifically intended to reduce the inflammation. The injections are performed to reduce the inflammation associated with a damaged nerve root. The most common agents are hydrocortisone, a generic steroid, or Depo-Medrol, Aristocort, Kenalog or Celestone, all of which are brand names. Steroid injections do not usually bring immediate relief, but their effect should be noticeable after a day or so. If the patient has decreased pain after the first injection, the procedure may be repeated a couple of weeks later on. It is not uncommon for a patient to get a series of three injections.
Subcutaneous – Beneath the skin.
Sympathetic Blocks – Sympathetic nerves are located in the thoracic-lumbar area of the spine. They allow the body to monitor and control autonomic body functions (e.g., heart rate, respiration, digestive functions, etc.) in cases of emergency. Sympathetic nerves are not normally a cause of pain. When sympathetic nerves are damaged or diseased, painful symptoms can result. Once a nerve starts sending painful signals it becomes hyperactive and is more likely to continue sending painful signals. Numbing the nerve, however, gives the nerve fibers a chance to relax. Once relaxed, they are less likely to become restimulated. Pain specialists refer to this phenomenon as “breaking the cycle of pain.” Patients who suffer from sympathetic conditions usually note that the recurrence of the pain is less annoying than the initial onset.The three most common types of sympathetic injections are:
- Stellate ganglion injection – performed for upper extremity pain
- Lumbar sympathetic block, normally performed as part of treatment of complex abdominal cancer pain, and
- Celiac plexus block, normally performed as part of treatment of complex abdominal cancer pain.
Tendon Fibrous – Connective tissue that attaches muscles to bones.
Thoracic Outlet Syndrome TOS – A condition whereby symptoms are produced from compression of nerves or blood vessels, or both, because of an inadequate passageway through an area (thoracic outlet) between the base of the neck and the armpit. Any condition that results in enlargement or movement of the tissues of or near the thoracic outlet can cause TOS.
Thoracic Spine – The region on the spine in the back area. The thoracic spine is located in the chest area and contains12 vertebrae. The ribs connect to the thoracic spine and protect many vital organs.
Trigeminal Neuralgia – Also called tic douloureux, is a condition that is characterized by intermittent, shooting pain in the face. The trigeminal nerve is one of the largest nerves in the face.
Trigger point injections TPI – Used to treat extremely painful areas of muscle. A normal muscle contracts and relaxes when it is active. A small needle is inserted into the trigger point and a local anesthetic is injected. The injection of medication inactivates the trigger point and thus alleviates pain.
Trigger Point – A knot or tight, ropy band of muscle that forms when it fails to relax. The knot often can be felt under the skin and may twitch involuntarily when touched (called a jump sign).
Vertebral Fracture – Occurs when the bones of the spine become broken due to trauma. Usually the trauma necessary to break the bones of the spine is quite large. In certain circumstances, however, such as in elderly people and in people with cancer, these same bones can break with little or no force. The vertebrae most commonly broken are those in the lower back.
Vertebroplasty – A medical procedure where bone cement is injected percutaneously into a fractured vertebra in order to stabilize it and provide pain relief. This procedure is performed in the Pain Management Center.