in logic, based largely on theory rather than observation
ACC
the anterior cingulate cortex, an area of the brain's limbic system
action potential
the process by which a nerve cell emits or repeats a signal
Acute
in the context of pain, "acute" means pain of up to six weeks' duration
Acute pain
pain of limited duration, as opposed to chronic pain, which is often defined as pain that lasts for more than 90 days
affect
liking or disliking, or sometimes used as a synonym for "emotion"
afferents
neurons that carry signals in the direction of the brain
allodynia
pain produced by a stimulus that would not be painful under normal conditions
allostatic
having to do with adjustments to metabolism and other physiologic systems to cope with stresses
allostatic load
the work or load on the body to adjust metabolism and other physiologic systems to cope with stresses
AMA
American Medical Association
analgesia
pain relief or pain lessening
animal models
conditions created in laboratory animals to approximate human conditions for the purpose of laboratory study
arborize
branch out and connect with
astrocytes
small, star-shaped immune-system cells that surround, nourish, and regulate neurons
aversive
causing avoidance
basal ganglia
a group of brain nuclei at the base of the forebrain that are connected with the cortex, thalamus, and brain stem
behaviorism
a psychological approach that relies exlusively on observable behaviors
BJW
belief in a just world
black box
a system that is known or understood by its behavior but not by its mechanisms
bound
A neural receptor (the lock) is bound when a transmitter molecule (the key) is attached to it.
catastrophizing
exaggerating the negative nature of a condition, or, scoring high on an instrument that claims to measure catastrophizing
CBT
cognitive-behavioral therapy
CCK
cholecystokinin, a neurotransmitter
central sensitization
increased sensitivity to input from sensory neurons as a result of changes in the spinal cord and/or brain
cerebral cortex
the outer layer of the brain, which contains the bodies of neurons and hence is gray
chronic
chronic pain is pain that last more than 90 days or about twelve weeks
cingulate cortex
a region of the cortex, not neocortex, that is usually considered part of the limbic system
clinical
occuring in a clinic, or as done in a clinic
clinically
as in a medical clinic, or from the point of view of a clinical doctor
CNS
central nervous system
co-morbidity
a syndrome (signs and symptoms) that is in some way related to another syndrome or condition
cold pressor test
immersion in ice-cold water to induce pain
collagens
proteins that make up the ligaments, tendons, and fasciae
Conditioned pain modulation
a phenomenon involving the PAG/RVM system in which irritation at one location of the body reduces the perceived pain in another part of the body
conductance
the ability or propensity to conduct, the opposite of resistance
confounding
In research, confounding refers to factors that may obscure some phenomenon of interest.
connexins
proteins that span the cell membrane and align with connexins of another cell to form a channel that connects the cytoplasm of the two cells
conservative treatment
medical treatment that avoids surgery or other invasive or destructive means
Construct validity
A measurement process is said to have construct validity if the measurement process is consistent with the theory (construct) that it is based on.
Content validity
A measurement is said to have content validity if it covers (contains) what we mean when we name it.
contralateral
other side
coping strategies
strategies that are used or advocated for coping with pain, such as relaxation or diversion
correlate
Two factors are said to correlate when they vary together, either at the same time or after some lag of time. Factors correlate regardless of whether they both increase/decrease together, or whether one increases as the other decreases, providing only that the relationship is consistent.
cortex
the outer layer, especially the outer layer of the brain
CPM
conditioned pain modulation
CPP
chronic pain patient
cutaneous
having to do with the skin or surface
CWP
chronic widespread pain
cytoskeleton
a structure made up of proteins within a cell that provides rigidity
DEA
the federal Drug Enforcement Administration
dendrite
NOT AVAILABLE
dendrites
projections from a nerve cell that carry signals toward the cell body
dermatome
a region of the skin that is served by a single nerve, especially a region served by a single spinal nerve
dermatomes
"The dermatomes" generally means the map showing the areas of skin served by each spinal nerve.
didactic
teaching
diencephalon
the thalamus and hypothalamus
doctor shopping
in the context of drug enforcement, using multiple prescribers to obtain controlled drugs
dorsal root ganglia
an enlarged area of the dorsal (back) spinal nerve near the spine that contains the cell bodies of the spinal afferent neurons
dorsal root ganglion
NOT AVAILABLE
DSM
the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association
dysthesia
an unpleasant unusual sensation
EEG
electroencephalogram, measurement of the brain waves at the surface of the skull
effectors
in the context of the CNS, neural structures that cause changes in the body or in other structures of the nervous system
electroencephalograms
recordings of brain wave activity made from outside the skull
emergent behavior
behavior of a system that emerges from the interactions of the system's constituents
EMG
electromyography, measurement of the electrical activity associated with muscle activity
empirical
based upon observation rather than theory
endogenous
interior, occurring inside, or created inside
epidemiologic
based on or deriving from epidemiology, the study of occurrence of a condition, often in relation to other factors and conditions
epidemiologist
a scientist who performs epidemiology, the study of occurrence of a condition, often in relation to other factors and conditions
episodic
occurring in episodes rather than continually
etiology
the study of causes, or having to do with causes
exacerbation
becoming worse or more severe
exposures
In epidemiology, exposures are events or conditions that may be related to outcomes of interest.
extrapolating
Extrapolating is extending what is known to what isn't, based on the belief that a trend or relationship will continue to be valid in the unobserved situation.
Face validity
A measurement is said to have face validity if it measures what it seems to informed people that it should.
fascia
the layer of connective tissue covering and enclosing muscles and other compartments of the body
fasciae
plural of fascia, the layer of connective tissue covering and enclosing muscles and other compartments of the body
Fatigue
weakening or breaking down due to repetition
fMRI
Functional magnetic resonance imaging, MRI used to observe the functioning of the brain, particularly blood flow as an indicator of which brain areas are working hard.
FMS
fibromyalgia syndrome
forebrain
the brain above the midbrain, including the diencephalon and the telencephalon and the cerebrum
functional
In medicine, functional means having to do with function. A functional condition is one that affects function without identifiable physical abnormality.
functional abdominal pain
abdominal pain with no identifiable physical abnormality
Functional magnetic resonance imaging
magnetic resonance imaging that records the functioning of the tissue being imaged, often the metabolic rate of the tissue
fuzzy
vague or imprecise, not necessarily a pejorative adjective
gate-control model
a model of pain perception that recognizes the existence of brain and medullar function that affects the level of perceived pain, the sensitivity of the pain system
habituation
loss of sensitivity over a period of time or due to repeated exposure
heuristics
rules-of-thumb, procedures to solve a problem that tend to give good results much of the time
hippocampus
an area of the limbic system that is involved in memory and emotion
homeostasis
the maintenance of stable conditions, literally "staying the same"
hyperalgesia
enhanced or increased pain
hypertensives
people with persistent high blood pressure or treatments for high blood pressure
hypochondriasis
excessive fear of illness
hypothalamus
a major area of the mid-brain, underneath the thalamus, that is involved in autonomic regulation
IASP
The International Association for the Study of Pain
IC
the insular cortex, an area of the cerebral cortex that is involved in consciousness, interpersonal experience, and homeostasis
idiosyncratic
specific to an individual
immunoreactivity
degree of reaction of the immune system
independent examiners
medical examiners not employed by either party to a legal proceeding
innocuous
in the context of pain, non-painful
instrument
in psychology, a questionnaire or similar device used to characterize a behavior or an individual
insula
the insular cortex
Interneurons
neurons that are entirely contained within the spinal cord
interneurons
neurons that are entirely contained within the spinal cord
interoception
perception of conditions interior to the perceiver
intractability
Difficulty in management or control. In medicine, difficulty in treatment.
intractable
untreatable or difficult to treat
introspection
examining one's own thoughts or experiences, or examing the thoughts or experiences of others
introspective
examining one's own thoughts or experiences or relying on others' reports of their thoughts or experiences
invidious
making discriminatory distinctions
ipsilateral
same side
Ischemic pain
pain from ischemia, that is, lack of circulation
isokinetic testing
testing of musculoskeletal function at a constant speed
laminae
Generically, laminae are layers; specifically, the cross-sectional layers of the spinal column.
laminae of Rexed
layers in the gray horns of the spinal column
lateral
toward the side or outside
LBP
lower back pain
lesion
injury or damage to tissue
Lesion evidence
evidence derived by observing individuals with lesions (injuries)
lesion evidence
evidence derived by observing individuals with lesions (injuries), especially brain damage
limbic system
a group of midbrain regions that physically are between the brain stem and the cerebral cortex, once thought to be the center of affect or emotion
localize
to locate clearly
localized
occurring at or affecting a specific location, or seeming to do so
magnetic resonance imaging
Creating visual images of the body's interior by use of intense magnetic waves, more commonly called MRI.
maladaptive
inadequate or counterproductive
mass discharge
simultaneous "firing" of a large number of neurons or endocrine cells
MDD
major depressive disorder
medial
toward the middle or center
MEG
magnetoencephalography, observation of magnetic waves near the surface of the skull
meme
a practice or idea that is transmitted culturally, or satiric images that appear in popular culture
meta-analysis
an analysis combining or comparing the results of multiple studies
meta-study
a study of multiple studies, a meta-analysis
Microglia
small immune-system cells that surround, nourish, and regulate neurons
micturition
elimination of urine from the urethra
mind
generally used to mean the cognitive processes as a whole, whether conscious or subconscious
modulate
change
modulating
changing, causing to change
morphological
having to do with physical form, or the study of the physical form of body components
morphology
form or structure
MPQ
the McGill Pain Questionnaire
MPS
myofascial pain syndrome
MRI
magnetic resonance imaging, creation of visual images inside the body using magnetic waves
msec
milliseconds. One second = 1,000 msec.
mu-opioid agonists
chemical substance which bind to, or facilitate the binding of other substances, to mu-opioid receptors, which are responsible for the effects of morphine, endogenous opioids, and opioid drugs
myelin
NOT AVAILABLE
myotome
the area of muscle served by a specific nerve, especially the area of muscle served by a spinal nerve
myotomes
areas of muscle served by a specific nerve, especially the areas of muscle served by spinal nerves
NDSA
non-dermatomal sensory abnormalities, patterns of sensation that do not follow the dermatomes
neocortex
The evolutionarily new part of the cerebral cortex, about 90% of the cortex. The hippocampus and olfactory system make up the remaining 10%.
neonates
newborns
neurogenic
caused by neuronal activity
neuromas
disorganized masses of nerve tissue, such as that which develops when a nerve is cut
neuropathies
diseases of the nerves
neuropathy
disease of the nerves
neuropeptides
a class of neurotransmitters
neuroplastic
neuronal tissues that change over time, especially as a result of stimulation or lack thereof
NMDA
N-Methyl-D-aspartic acid, an amino acid that is involved in pain sensation and regulation
nocebo
a negative placebo, that is, a sham treatment that causes pain to increase
nociceptive
causing or carrying pain, or any nervous system processing of noxious stimuli, whether or not it results in pain
nociceptive-specific
applies to afferent neurons of the spine that respond only to high-threshold signals
nociceptors
neurons that originate or carry signals caused by noxious stimulation
noise
variations in the measurement of an object or process whose cause is difficult or impossible to identify
non-specific
having no specifically determined cause
non-specific lower back pain
lower back pain with no specific determined cause
norepinephrine
a neurotransmitter
normals
individuals with normal behavior or functioning
Normative
indicating what is what is expected or desired, or sometimes simply what is normal or expected
normative
indicating what is what is expected or desired, or sometimes simply what is normal or expected
NS
nociceptive-specific
NSAIDs
non-steroidal anti-inflammatory drugs, such as ibuprofen
numerical rating scale
a rating scale that takes on numeric values, especially in this context the "pain from zero to ten" scale
objective
in medical and scientific practice, observable by a second party, as contrasted to subjective
occult
invisible or unobservable from the perspective of an observer or class of observers
operational definition
A definition that is defined in terms of an operation or procedure. Whether an object fits the definition is determined by following that operation or procedure.
opiates
drugs dervied from opium
opioids
chemical compounds, including drugs, chemically similar to opium
PAG
periaqueductal gray, a region of the brain stem involved in modulation of pain messages
pain affect
emotional arousal or action tendency caused by pain or perceived as being caused by pain
pain behavior
behavior motivated or influenced by pain, or behavior that is believed to be related to a painful condition
Pain behavior
behavior motivated or influenced by pain, or behavior that is believed to be related to a painful condition
pain matrix
the areas of the brain stem and the brain involved when pain signals are processed
pain network
the network of brain and brain stem areas that are involved in processing signals associated with pain
palpation
examination by touch
paraesthesia
burning. prickling, or itching of the skin without an apparent cause
pathogenesis
origin and development of a disease
pathological
having to do with disease
paucity
lack of
peripheral nerves
the nerves outside of the brain and spine
PET
positron emission tomography, an imaging technique that relies on positrons emitted by radioactive materials inserted into the subject organism
PFC
pre-frontal cortex
phrenology
the false science that relates a person's character to the shape of his/her skull
phylogenetic
related to evolutionary development
polymorphism
multiple forms, especially different forms of genes
practice guidelines
a written guideline for doctors on how to treat a condition or complaint, often published by a professional association
pre-clinical
prior ro the medical clinic, usually in the context of the development of a drug or other treatment procedure
prevalence
the number of cases as a proportion of the population
primary somatosensory cortex
an area of the brain's cortex engaged in early processing of sensory signals from the skin and body
projection neuron
a spinal neuron that feeds information up or down the spine across multiple spinal segments
proprioception
perception of the location and movement of the parts of one's body in relation to the other parts
Propriospinal
relating to the spine or connecting segments of the spine
propriospinal
connectiong segments of the spine
protocol
In experimentation, a detailed procedure describing or controlling how each subject is treated. In medical practice, a procedure or set of rules for handling a situation.
psyche
used in this work to refer to mind or spirit in a general, non-scientific sense
psychogenic
caused by state of mind
PTSD
post-traumatic stress disorder
punctate
pointed
radicular pain
pain following the pattern of a dermatome or myotome and therefore likely caused by some injury or irritation to a spinal nerve
radiculopathy
pain following the pattern of a dermatome or myotome and therefore likely caused by some injury or irritation to a spinal nerve, or pain of another cause but of a similar nature
radiographic
imaging techniques that use radiation such as x-ray, fluoroscopy, CT, or MRI
Ratio scale data
data that has a zero point and for which ratios make sense
reactivity
responsiveness
receptive fields
the area over which a neuron receives input
recurrent
occurring repeatedly
referred pain
pain which originates in one place in the body but is sensed as originating in another place
regional
affecting one or more quadrants (quarters) of the body
regional pain
pain affecting one or more quadrants of the body
Riley-Day syndrome
A medical condition in which insensitivity to pain is one symptom. Also known as familial dysautonomia, since it runs in families.
rostral
toward the nose
Rostral
toward the nose
RVM
the rostral ventromedial medulla, an area of the brainstem that is involved in pain modulation
S1
the primary somatosensory cortex
S2
the secondary somatosensory cortex
salience
prominence or noticeability
second pain
a slow, aching, and poorly-localized pain that occurs following the fast, sharp, and clearly localized first pain, as the result of injury
secondary hyperalgesia
Increased pain that develops outside the receptive fields of the affected sensory neurons in the aftermath of an acute injury. It is due to increased sensitivity of spinal interneurons.
secretory
secreting
self-limiting
a condition that limits itself such as a common cold, which normally will end without medical intervention
shaman
a traditional healer, especially in non-Western cultures
sickness behavior
the typical reaction to infection that includes lack of activity, lack of appetite, depressed mood and other cognitivie changes, pain and hyperalgesia
silent nociceptors
sensory neurons that do not fire under normal conditions
sleep-onset insomnia
delayed falling asleep
SNS
sympathetic nervous system
soma
the body of a cell
somae
the bodies of cells
somatic
of the body or, of the body excluding the viscera
somatic nerves
nerves outside of the spine and brain
somatization
the tendency to feel or express general distress as bodily pain
somatosensory cortex
the area of the brain's cortex engaged in processing sensory signals from the body
somatotopic
arranged in spatial correspondence with the body
somatotopically
arranged in spatial correspondence with the body
specificity
the notion that there are specific pain sensors, specific pain pathways, and/or specific pain centers in the brain
SSDI
Social Security Disability Insurance
standard behaviorist model of pain
NOT AVAILABLE
standard pain management
"standard" pain therapy, which includes behavioral therapy
stocking numbness
numbness that is felt in a stocking pattern surrounding the leg/foot
stocking pain
pain that is felt in a stocking pattern surrounding the leg/foot
stress response
activation of the body by a mass discharge from the hypothalamus, which results in high levels of epinephrine and norepinephrine in the bloodstream
STT
spinothalamic tract, a tract or group of related fibers extending up the spine into and/or through the thalamus
sub-acute
In the context of pain, sub-acute means "lasting for six to twelve weeks."
subjective
not observable by a second party
subliminal
below the threshold of conscious awareness
Surface EMG
electromyography studies or results in which the electrical readings are taken at the exterior surface of the skin
sympathetic tone
the level of activation of the "fight-or-flight" response or the level of activation of the sympathetic nervous system
syndrome
a pattern of signs and symptoms associated with some condition
synovial joints
a joint with a fibrous joint capsule that contains synovial fluid
telencephalon
the most forward part of the brain, the cerebral hemispheres
teleological
having a purpose or goal
TENS
trans-cutaneous electrical nerve stimulation, a device or technique for pain moderation through counter-irritation
TMD
temporomandibular disorder, a disorder involving pain in the area of the temporal muscle and mandible (jawbone)
tonic
a process or condition that remains at a stable level, such as "muscle tone"
total institution
an institution in which inmates sleep, eat, and perform activities based on institutional rules with restricted autonomy
tracts
a bundle of nerve fibers that connects areas of the central nervous system
transcription factors
proteins that control the rate of transcription of DNA to messenger RNA
trepanation
drilling through the skull to access the brain
trigger point
irritable spots in the fascia surrounding muscle tissue
Type A pain
Fast pain, initiated primarily by A-delta neurons
Type C
Type C pain, slow aching pain initiated primarily by type C sensory neurons
Type H pain
"Humoral pain," slower than Type C pain and generally involving long-term sensitization of pain pathways and/or pro-inflammatory compounds that gain access to the spine and brain
vagus nerve
either of a pair of large autonomic nerves that originate as cranial nerves and travel into the abdomen
Validity
the extent to which a concept or measurement is well-founded or accurate with respect to some real-world entity
VAS
visual analog scale, in pain studies, a scale of pain intensity where the intensity of pain is analagous to the proportion of distance marked off along a line
vesicles
cell compartments surrounded by a membrane which store and release neurotransmitters
viscera
the internal organs, especially those contained in the abdomen and chest
visual analog scale
in pain studies, a scale of pain intensity where the intensity of pain is analagous to the proportion of distance marked off along a line. Also known as VAS.
Von-Frey filaments
plastic fibers that are used in pain experiments to apply a known pressure over a known area. The fiber bends when it reaches its maximum force.
Voxel
A three-dimensional pixel, as produced in MRI and CT scans
WDR
wide-dynamic-range neurons of the dorsal horn
wide-dynamic-range
spinal neurons that respond to both innocuous and noxious stimulation
wide-dynamic-range neurons
spinal neurons that respond to both innocuous and noxious stimulation
wind-up
in pain physiology, the increased excitability of a neuron after it has been stimulated repeatedly or forcefully