Glossary

ablative surgery. A type of operation that can be performed on the peripheral nerves, spinal cord, brain, or brain stem that severs nerve pathways in an effort to block the transmission of pain signals.

acute. Short-term, usually specific to a certain event. Acute pain is pain that occurs because of a certain event, such as an accident or surgery, but can be expected to go away. The opposite of acute is chronic.

addiction. A syndrome (that is, group of symptoms) characterized by a psychological dependence on a drug and unusual or abnormal drug-taking behaviors. This differs from tolerance and dependence.

alternative. In medicine, treatments and therapies that are not necessarily mainstream or supported by large randomized clinical trials but which may still provide some degree of relief. Acupuncture is an alternative treatment for some pain.

analgesia. Pain relief.

analgesic. Anything that relieves pain, such as an analgesic drug. This can be anything from aspirin to general anesthesia.

anesthesiologist. A physician who specializes in anesthesia and pain relief.

breakthrough pain. Pain that occurs suddenly and can be quite severe or pain that increases to the point that the current pain killers do not help it.

catheter. Any tube that is placed in, into, or connected to the body during a medical procedure. In specific, pain pumps work with a catheter that helps route and deliver the medication.

chronic. Long-term. Chronic pain is pain that does not go away. The opposite of chronic is acute.

clinical trial (sometimes called clinical study).  A highly regulated scientific study conducted according to a specific plan or protocol which tests a medical hypothesis or theory.

combination therapy. An approach to pain management that involves using more than one treatment or approach.

conservative. In medicine, mainstream, typical, and non-extreme forms of treatments and therapies.

cryotherapy. The use of cold to reduce pain and discomfort and possibly reduce edema (fluid buildup and bruising).

dependence. The state of a person who relies on drugs. Dependence can be appropriate (diabetics are dependent on insulin) or inappropriate.

drug holiday. In medicine, a slang term for a temporary interruption in drug therapy to help a patient avoid drug tolerance. For many patients, a short drug holiday can help avoid building up tolerance to a drug over time.

dysphoria. The emotion of sadness, depression, discouragement, or anxiety. It’s the opposite of euphoria.

enrollment. The process by which a person enters a clinical trial. A person enrolls when he or she learns about the study, understands what is expected of participants, and signs the appropriate paperwork.

epidural. At or in the spinal canal, that is, on or just outside the membrane that encloses the spinal cord (the “dura mater”).

evidence. In medicine, data gathered through scientifically controlled studies that support a particular theory. Many studies have shown the serious health risks of smoking, but some people keep smoking despite the evidence.

evidence-based medicine. An approach or philosophy of medicine which relies on large, scientifically sound, randomized clinical trials for evidence on which treatment decisions are made. Most major institutions in the U.S. practice evidence-based medicine.

Food & Drug Administration (FDA). In the U.S., the regulating body that oversees implantable devices as well as many other products (including all drugs, cosmetics, and certain food additives).

hypothesis. A theory or assumption which is tested in a clinical study or other scientific experiment. A hypothesis may be stated as a question (does drug X relieve pain faster than drug Y in people with rheumatoid arthritis?) or a statement to be proven or disqualified (this pain pump is safe and effective for managing chronic pain that does not respond to oral medication).

implant. To place an implantable device into the body, done as a surgical intervention.

implantation. The medical procedure which places a pump or other medical device into the body.

implanter. A slang term in medicine for the physician who actually implants the medical device. This is not always the patient’s primary physician.

informed consent.  The process by which a person agrees to participate in a clinical trial or other study after being fully informed of the risks and benefits of that study. The term “informed consent” is also a slang term for the paperwork that must be completed for this process, officially called the “informed consent form.”

inter. This medical prefix means “from the outside into” or “into.” It sometimes contrasts with “intra.”

intra. This medical prefix means “within” or “entirely inside.” It sometimes contrasts with “inter.”

intractable. Does not respond to treatments or therapies. Intractable pain is pain that cannot be helped with ordinary medicines.

intraspinal. Within the spine, that is, a type of pain pump that delivers drugs within the spinal column.

intrathecal. A specific area of the lower spine (technically, it’s the area between the arachnoid membrane and the pia mater). The intrathecal area contains cerebral spinal fluid (CSF) and is also the area of the body where a spinal tap is performed.

intrathecal drug pump. An implantable device that contains a reservoir to hold pain medication which is delivered via a tube to the intrathecal area of the spine in order to block pain. By sending the drug directly to the intrathecal region, people may be able to get pain relief from about one hundredth the dosage of the same pain medication taken orally!

longevity. For a medical device, the length of time it can be expected to last. Implantable devices are battery powered and have a finite service life.

malignant. Cancerous. A malignant tumor is a cancerous growth.

malignant pain. Pain associated with cancer.

neuro. A prefix which refers to nerve(s). Neurostimulation is stimulation of the nerves. Neuropathy is a disease of the nerves.

neurostimulation. A therapy which involves electrically stimulating the nerves or nerve cells, sometimes used in the treatment of pain.

nociception. The process by which a pain cell (nociceptor) sends a signal to the brain.  Although nociception is associated with pain, it is not the same thing. It is not until the signal reaches the brain that the brain “translates” it into a perception of pain. It is also possible for nociception to occur at such low levels that no pain is experienced.

nociceptor. A pain cell, that is, a cell specialized to receive signals of noxious, that is, unpleasant or possibly dangerous, stimulation.

nonmalignant. Noncancerous. Nonmalignant pain is pain that is not associated with cancer.

opiate. A drug derived from opium, but sometimes used to refer to any drug that induces sleep. In its strictest sense, an opiate is a natural form of opium, in contrast to opioids, which are synthetic.

opioid. In the strictest sense, a synthetic drug that is like an opiate. However, in modern use, the term opioid is frequently used to refer to any number of narcotic drugs both natural and synthetic.

oral. Of the mouth or by mouth. Oral medications include pills that are swallowed.

pain. The unpleasant sensory and emotional experience associated with real or possible tissue damage.

pain threshold. The point at which pain is perceived. Pain thresholds can vary among people and may vary in one person over the course of the day.

palliative. Providing care and pain relief that cannot be expected to cure or even mitigate an illness but which is intended to make the patient as comfortable as possible.

paresthesia. A sensation of prickling, burning, buzzing, or tingling felt in or near the skin. Paresthesia may be experienced in patients who have neurostimulator devices or it may occur with no obvious cause. Paresthesia is not pain.

patient-controlled analgesia (PCA). Pain medicine that a patient can administer to himself or herself. A typical type of PCA is an intravenous morphine pump that many hospital patients receive after surgery.

programmable. A charactereristic of some implantable devices which allows communication with the physician even after it is implanted in the body in such a way that the physician can adjust settings or otherwise control the device. Programmability relies on a programmer (a type of computer) to communicate and transmit information back and forth from physician to device.

protocol. In a clinical trial, the official plan or “rule book” that states what is to be done in the study. Protocols may spell out how often a patient has to be checked, what is measured during a follow-up visit, or how a particular test is to be performed. In a clinical trial, the protocol has to be followed strictly.

pump. An implantable medical device which pumps or distributes a substance directly into the body.

refractory. Something that resists treatment. Refractory pain is pain that does not respond to therapy.

side effect. A result of taking a drug or submitting to a therapy other than the intended one. Some drugs have dangerous side effects which should be reported immediately to the physician.

sign. Something that a healthcare professional can observe or measure that indicates a possible health problem or complaint. A fever is a sign. This contrasts with symptom.

spasticity. A disorder of the body’s motor system in which certain muscles are continuously contracted. 

symptom. In medicine, a specific complaint or report about something wrong from a patient. For example, if a person says he has a headache, then a headache is a symptom. This contrasts with sign.

titration. Adjustment of the dose of a medicine. People on long-term medication often require occasional titration of the drug.

tolerance. Building up an immunity to a drug or other compound in such a way that more must be taken in order to achieve the same effect. Tolerance is not the same as dependence.