Welcome to Pain Management Institute

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GLOSSARY OF TERMS

Acupuncture– a medical practice that involves inserting fine needles into the skin at specific points on the body to relieve chronic pain.
Bioelectric treatment– a precise dose of bioelectric currents (electroceuticals), is administered through electrodes placed on the skin to cause a biological change and interrupt pain signals. It can treat chronic and acute pain conditions including complex regional pain syndrome, back pain, muscle pain and headaches.
Celiac plexus block– performed most commonly for the treatment of upper abdominal pain, which can be due to cancer or chronic pancreatitis
Epidural Steroid Injections– injections near the spinal canal at the specific level required to treat pain.
Facet nerve block– 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.
Intercostal nerve block– an injection of a local anesthetic 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 given for pain caused from surgical incision in the chest area or to help determine the cause of your pain. (diagnostic
nerve block).
Intradiscal electrothermal therapy– to treat chronic pain originating from the Intervertebral discs. During this minimally invasive treatment a physician applies controlled levels of heat to a broad section of the affected disc wall. The heat contracts and thickens the collagen of the disc wall and raises the temperature of the nerve endings. Therapy may result in contraction or closure of the disc wall fissures, a reduction in the bulge of the inner disc material and a desensitization of the pain sensors within the disc. It is important for your referring physician to diagnose that a disc is a primary source of your back pain. In addition to a clinical examination, your physician may use magnetic resonance imaging, (MRI) or injection of dye in the disc (discography) to confirm the diagnosis.
Lumbar sympathetic block– an injection of local anesthetic around a group of nerves in your lower back. It may be done if you have reflex sympathetic dystrophy, (RSD), a disease involving a disturbance of circulation to the skin or neuropathic pain. (Pain caused by a disorder of the nervous system)
Spinal drug delivery systems– a computerized pump that delivers opiates, local anesthetics and other pain medication continuously into the spine to control intractable pain. Also, this infusion system can be used to relieve intractable spasticity secondary to diseases like multiple sclerosis, cerebral palsy, stroke or spinal cord injuries.
Spinal cord stimulation– a small implantable device that stimulates the spinal cord to treat pain and improve circulation.
Spinal endoscopy– a small fiberoptic scope used to evaluate the spinal nerve roots and administer medications.
Stellate ganglion block– 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: Reflex Sympathetic Dystrophy, causalgia, herpes zoster and
phantom limb pain.
TENS (transcutaneous electrical nerve stimulation) -a small extractable device that delivers electric impulses to nerve endings to stop pain.
Therapeutic nerve blocks– local anesthetic injections given near a specific nerve or group of nerves to relieve pain.
Trigger point injections– Injections of small amounts of local anesthetics and steroids in the area of the muscle where you have pain or tenderness. These areas are called trigger points because, when stimulated, they produce pain. Trigger Point Injections are performed if you have myofascial pain, which is pain in a specific muscle or muscle group.
CAT Scan (computed axial tomography scan)[also called a CT scan (computed tomography scan)] – A painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis.
Cervical Spine (neck) – has 7 vertebral bodies (segments). The top segment is connected to the skull.
Cortisone – Cortisone is a very strong anti-inflammatory medicine that may control the inflammation surrounding the nerves and may ease the pain caused by irritated nerve roots.
Degenerative Disc Disease – the flexible disc shrinks and degenerates as a normal part of aging. Limited range of motion of the spine and back or neck pain are common. The disc itself may also be directly responsible for the pain.
Discogram or Discography – provocative testing of the intervertebral disc that may help discover the intervertebral disc as a significant pain generator. Also allows for morphologic evaluation of the disc’s structure when combined with CT scan. This test has no therapeutic benefit but does help the surgeon in planning for the type of operation that should be performed.
Facet Joints – small stabilizing joints located between and behind adjacent vertebrae.
Facet Syndrome – a form of arthritis of the joints at the back of the spinal column (facet joints). The degenerated joint can directly cause pain as well as cause narrowing of the canal where the spinal nerves exit.
Fluoroscopy – Fluoroscopy is a special type of x-ray used to project live images onto a monitor (e.g. Computer/TV screen)
Herniated Nucleus Pulposus (slipped disc) – commonly occurs in the lumbar spine, followed by the cervical spine and the thoracic spine. The inner nucleus pulposes slips past the fibrous outer layer and in its new location causes severe epidural inflammation resulting in pain, numbness, tingling or weakness in your arms or legs.
Interlaminar or Transforaminal Epidural Steroid Injections – steroids deposited into the narrowed and inflamed areas “transforaminally” (across the narrowing) act to suppress nerve inflammation and firing in many patients, thereby lessening their pain and allowing them to tolerate physical therapy, ultimately resulting in improvements in their functionality.
Intraarticular Facet Injection – an injection indicated for those patients degeneration of their facet joints. The inflamed joint is the major contributor to the patient’s pain and depositing potent anti-inflammatory medications into the joint serves to cool the area and provide pain relief.
Intradiscal Electrothermal Annuloplasty (IDEA) – to treat chronic pain originating from Intevertebral discs. A minimally invasive treatmentin which controlled levels of thermal energy (heat) is applied to a broad section of the affected disc wall. Therapy may result in contraction or closure of the disc wall fissures or a reduction in the bulge of the inner disc material.
Lumbar Spine (lower back) – five vertebral bodies that extend from the lower thoracic spine (chest) to the sacrum (bottom of the spine). The vertebral bodies are stacked on top of each other with a disc in between each one.
Lumbar Sympathetic Block – an injection of local anesthetic around a group of nerves in your lower back. It may be done if you have reflex sympathetic dystrophy(RSD), a disease involving a disturbance of circulation to the skin or neuropathic pain(pain caused by a disorder of the nervous system).
Magnetic Resonance Imaging (MRI) – The MRI scan is an imaging test that allows physicians to assess a patient’s spinal anatomy and investigate an anatomical cause of the patient’s pain. The physician will correlate the findings on the MRI scan with the patient’s signs and symptoms in order to arrive at a clinical diagnosis.
Magnetic Resonance Imaging (MRI) – a procedure for partial removal of the nucleus to relieve pressure in the disc and on the nerve roots, providing relief from disc pain.
Magnetic Resonance Imaging (MRI)– a procedural technique to remove the degenerated portion of the center of a herniated disc, reducing pressure within the disc and on the adjacent nerve roots without open surgery.
Peripheral Neuropathy – Peripheral neuropathy is a general term referring to disorders of peripheral nerves. The peripheral nervous system is made up of the nerves that branch out of the spinal cord to all parts of the body.
Radiculopathy – Radiculopathy is the medical term used to describe a “pinched nerve” in the spine. A radiculopathy occurs when a nerve is irritated by something that is either rubbing on the nerve or pressing on the nerve.
Radiofrequency Nerve Lesioning – a therapy that can be used to temporarily deactivate the pain generating nerves around the spine. This technique literally interrupts the firing of the nerves that supply the facet joints using radiofrequency energy to heat the surrounding tissue and deactivate the pain generating nerves. The result is dramatic pain relief in the properly selected patient.
Reflex Sympathetic Dystrophy (RSD) – Reflex Sympathetic Dystrophy (RSD), more recently known as Complex Regional Pain Syndrome (CRPS) is a disease brought on by damage or trauma to the Sympathetic Nervous System.
Sacroiliac Joint Block – sacroiliac (SI) joint blocks are injections that are used for diagnosing and treating the low back pain associated with sacroiliac joint dysfunction. The SI joint lies next to the spine and connects the sacrum(bottom of the spine) with the pelvis (hip).
Sciatica – pain along the course of a sciatic nerve, especially noted in the back of the thigh and below the knee. Pain radiating down the sciatic nerve into the posterior thigh and leg; can be caused by irritation of a nerve anywhere from the back to the thigh.
Selective Nerve Root Block(SNRB) – an injection primarily performed to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and or leg pain.
Spinal Column – the bony ridge that runs vertically through the trunk of our bodies and which supports the majority of our weight.
Spinal Cord Stimulator – a small implantable device that stimulates the spinal cord to treat pain and improve circulation.
Spinal Stenosis – narrowing of the bony spinal canal causes pressure on the spinal cord and spinal nerve roots. Patients usually have pain, with numbness, tingling or weakness that worsens with walking.
Spondylolisthesis -the forward slippage of one vertebra on an adjacent vertebra that most commonly occurs in the lumbar area. This condition results in lower back and leg pain that worsens with activity. The pain is due to narrowing of the spinal canal where the spinal cord resides and the foramen, where the spinal nerves exit.
Stellate Ganglion Block – an injection 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: Reflex Sympathetic Dystrophy, causalgia, herpes zoster and phantom limb pain.
Steroids – Steroids (short for corticosteroids) are synthetic drugs that closely resemble cortisol, a hormone that your adrenal glands produce naturally. Steroids work by decreasing inflammation and reducing the activity of the immune system. Steroids are used to treat a variety of inflammatory diseases and conditions.
Therapeutic Nerve Blocks – local anesthetic injections given near a specific nerve or group of nerves to relieve pain.
Thoracic Spine (upper back) – twelve vertebral bodies that have very little motion because they are firmly attached to the ribs and sternum (breastbone). Because there is little motion, this region of the spine is generally not the source of pain.
Trigger Point Injections – injections of small amounts of local anesthetics and steroids in the area of the muscle where you have pain or tenderness. These areas are called trigger points because, when stimulated, they produce pain. Trigger point injections are performed if you have myofascial pain, which is pain in a specific muscle or muscle group.
Vertebral Bodies – act as a support column to hold up the spine. This column supports about half the weight of the body, with the other half supported by the muscles.
Vertebral Disc – primary purpose is to act as a shock absorber. Discs are actually composed of two parts: a tough outer core and a soft inner core, much like a jelly doughnut.