Pain Management Glossary of Terms

Fibromyalgia Slideshow

Acupuncture: The practice of inserting needles into the body to reduce pain or induce anesthesia . More broadly, acupuncture is a family of procedures involving the stimulation of anatomical locations on or in the skin by a variety of techniques. There are a number of different approaches to diagnosis and treatment in American acupuncture that incorporate medical traditions from China, Japan, Korea, and other countries. The most thoroughly studied mechanism of stimulation of acupuncture points employs penetration of the skin by thin, solid, metallic needles, which are manipulated manually or by electrical stimulation.
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Acyclovir : (Brand name: Zovirax) One of a group of antiviral drugs that acts against the herpes viruses, including:

• Herpes simplex 1 which causes cold sores
• Herpes simplex 2 which causes genital herpes
• Varicella-zoster which causes both chickenpox and shingles
• Epstein-Barr virus which causes infectious mononucleosis

Adjacent: Lying nearby. Related terms include superjacent, subjacent, and circumjacent. From ad-, near + the Latin jacere, to lie = to lie near.

Amitriptyline: An antidepressant medication. In some patients with depression, abnormal levels of brain chemicals called neurotransmitters may relate to the depression. Amitriptyline elevates mood by raising the level of neurotransmitters in brain tissue. Amitriptyline is also a sedative that is useful for depressed patients with insomnia, restlessness, and nervousness. It is sometimes used to treat fibromyalgia and symptoms related to chronic pain. Brand names are Elavil and Endep. A generic version is available.

Anesthetic: A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep.

Arm: 1. In popular usage, the appendage that extends from the shoulder to the hand. However, the medical definition refers to the upper extremity extending from the shoulder only to the elbow, excluding the forearm, which extends from the elbow to the wrist. The arm contains one bone: the humerus. 2. In a randomized clinical trial, any of the treatment groups. Most randomized trials have two "arms," but some have three "arms," or even more.

Atypical: Not typical, not usual, not normal, abnormal. Atypical is often used to refer to the appearance of precancerous or cancerous cells.

Autonomic nervous system: Part of the nervous system that was once thought to be functionally independent of the brain. The autonomic nervous system regulates key functions of the body including the activity of the heart muscle (see below), the smooth muscles (e.g., the muscles of the intestinal tract), and the glands.
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Back pain: Pain felt in the low or upper back. There are many causes of back pain.
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Biofeedback: A method of treatment that uses monitors to feed back to patients physiological information of which they are normally unaware. By watching the monitor, patients can learn by trial and error to adjust their thinking and other mental processes in order to control "involuntary" bodily processes such as blood pressure, temperature, gastrointestinal functioning, and brain wave activity.
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Bone: Bone is the substance that forms the skeleton of the body. It is composed chiefly of calcium phosphate and calcium carbonate . It also serves as a storage area for calcium, playing a large role in calcium balance in the blood.
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Botox : A highly purified preparation of botulinum toxin A, a toxin produced by the bacterium Clostridium botulinum. Botox is for injection, in very small amounts, into specific muscles. It acts by blocking the transmission of nerve impulses to muscles and so paralyzing the muscles. Botox is a brand name that has passed into popular usage as a synonym for Botulinum toxin.
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Bowel: Another name for the intestine . The small bowel and the large bowel are the small intestine and large intestine , respectively.
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Brain: That part of the central nervous system that is located within the cranium ( skull ). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."
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Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Cancer: An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread).
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Chickenpox: A highly infectious viral disease also known medically as varicella -- in many countries, this disease is always called "varicella" -- that causes a blister-like rash, itching, fatigue and fever. The rash crops up first on the face and trunk and can spread over the entire body resulting in 250 to 500 itchy blisters.

Chiropractic: A system of diagnosis and treatment based on the concept that the nervous system coordinates all of the body's functions, and that disease results from a lack of normal nerve function. Chiropractic employs manipulation and adjustment of body structures, such as the spinal column, so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may be relieved. Practitioners believe that misalignment and nerve pressure can cause problems not only in the local area, but also at some distance from it. Chiropractic treatment appears to be effective for muscle spasms of the back and neck, tension headaches, and some sorts of leg pain. It may or may not be useful for other ailments.
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Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time.
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Chronic pain : Pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
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Coccydynia : Pain in the coccyx (the tailbone).
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Coccyx: The small tail-like bone at the bottom of the spine very near to the anus. The coccyx is made up of 3-5 rudimentary vertebrae. It is the lowest part of the spinal column.
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Compression: 1. The act of pressing together. As in a compression fracture, nerve compression, or spinal cord compression.
2. To shorten in time. In embryology, there may be compression of development with some stages even omitted.

Condition: The term "condition" has a number of biomedical meanings including the following:

1. An unhealthy state, such as in "this is a progressive condition."
2. A state of fitness, such as "getting into condition."
3. Something that is essential to the occurrence of something else; essentially a "precondition."
4. As a verb: to cause a change in something so that a response that was previously associated with a certain stimulus becomes associated with another stimulus; to condition a person, as in behavioral conditioning.

Cut: An area of severed skin. Wash a cut or scrape it with soap and water, and keep it clean and dry. Putting alcohol, hydrogen peroxide, or iodine into a wound can delay healing, and should be avoided. Seek medical care if you think you might need stitches, as delay can increase the rate of wound infection. If the cut results from a puncture wound through the shoe, there is a high risk of infection, and you should see your healthcare professional. Redness, swelling, increased pain, and pus draining from the wound also indicate an infection that requires professional care.

Cutaneous: Relating to the skin. As, for example, in cutaneous allodynia, a cutaneous papilloma, and cutaneous syndactyly. From the Latin cutis meaning skin.

Cystitis: Inflammation of the bladder. Cystitis can be due for example to infection from bacteria that ascend the urethra (the canal from the outside) to the bladder.
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Diagnosis: 1 The nature of a disease ; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies . 3 The identification of any problem. The diagnosis was a plugged IV.
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Disc: Shortened terminology for an intervertebral disc, a disk-shaped piece of specialized tissue that separates the bones of the spinal column.
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Duloxetine: See: Cymbalta.

Elbow: The juncture of the long bones in the middle portion of the arm. The bone of the upper arm (humerus) meets both the ulna (the inner bone of the forearm) and radius (the outer bone of the forearm) to form a hinge joint at the elbow. The radius and ulna also meet one another in the elbow to permit a small amount of rotation of the forearm. The elbow therefore functions to move the arm like a hinge (forward and backward) and in rotation (outward and inward). The biceps muscle is the major muscle that flexes the elbow hinge, and the triceps muscle is the major muscle that extends it. The primary stability of the elbow is provided by the ulnar collateral ligament, located on the medial (inner) side of the elbow. The outer bony prominence of the elbow is the lateral epicondyle, a part of the humerus bone. Tendons attached to this area can be injured, causing inflammation or tendonitis (lateral epicondylitis, or tennis elbow). The inner portion of the elbow is a bony prominence called the medial epicondyle of the humerus. Additional tendons from muscles attach here and can be injured, likewise causing inflammation or tendonitis (medial epicondylitis, or golfer's elbow). See also: Elbow bursitis ; Elbow pain ; Nursemaid's elbow.
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Epicondylitis: Epicondylitis is an inflammation or damage to the area of an epicondyle of bone. An epicondyle is a projection of bone above a condyle (a rounded prominence at the end of a bone, usually where the bone connects to another bone) where ligaments and tendons are attached. Two common types of epicondylitis are tennis elbow and golfer’s elbow. Tennis elbow is also known as lateral epicondylitis, which is an overuse injury to the area of the lateral (outside) epicondyle of the elbow end of the upper arm bone (humerus). Golfer’s elbow (medial epicondylitis) is an overuse injury similar to tennis elbow, but in this case the damage occurs in the area of the medial (inside) epicondyle of the upper arm bone.
See the entire definition of Epicondylitis

Epidural: Outside the dura, the outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and the spinal cord. An epidural hematoma is a collection of blood beneath the skull but outside the dura.

Extracorporeal: Outside the body, in the anatomic sense. As in extracorporeal circulation, extracorporeal dialysis, and extracorporeal shock wave lithotripsy. From extra- + corpus, meaning body.

Fasciitis : Inflammation of the fascia (a lining tissue under the skin that covers a surface of underlying tissues).
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FDA: The Food and Drug Administration, an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services.
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Femoral: Having to do with the femur or, less often, the thigh. As in the femoral head (the head of the femur), the femoral artery, and femoral vein.

Fibromyalgia: A syndrome characterized by chronic pain , stiffness, and tenderness of muscles, tendons, and joints without detectable inflammation . Fibromyalgia does not cause body damage or deformity. However, undue fatigue plagues the large majority of patients with fibromyalgia and sleep disorders are common in fibromyalgia.
See the entire definition of Fibromyalgia

Fluoroscopy: An x-ray procedure that makes it possible to see internal organs in motion.
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Fracture: A break in bone or cartilage. Although usually the result of trauma, a fracture can be caused by an acquired disease of bone such as osteoporosis or by abnormal formation of bone in a disease such as osteogenesis imperfecta ("brittle bone disease"). Fractures are classified according to their character and location as, for example, a greenstick fracture of the radius.
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Ganglion: The celebrated 2nd century Greek physician Galen ((c. 130-201 A.D.) who lived and worked in Rome first used the word ganglion to denote a nerve complex. Ganglion still is used to refer to an aggregation of nerve cell bodies. Another use of the word ganglion is for a tendon cyst that most commonly pops up near the wrist.
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Headache : A pain in the head with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache, like chest pain or back ache, has many causes.
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Herniated disc: Rupturing of the tissue that separates the vertebral bones of the spinal column.
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Herniation: Abnormal protrusion of tissue through an opening. For example, a intervertebral disk (one situated between the vertebral bodies) can protrude and impinge on a nerve root.

Herpes: A family of viruses. Herpes also refers to infection with one of the human herpesviruses, especially herpes simplex types 1 and 2.
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Herpes zoster: Also called shingles, zona, and zoster. The culprit is the varicella-zoster virus. Primary infection with this virus causes chickenpox (varicella). At this time the virus infects nerves (namely, the dorsal root ganglia) where it remains latent (lies low) for years. It can then be reactivated to cause shingles with blisters over the distribution of the affected nerve accompanied by often intense pain and itching.

Immune: Protected against infection. The Latin immunis means free, exempt.

Immune system: A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.
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Injury: Harm or hurt. The term "injury" may be applied in medicine to damage inflicted upon oneself as in a hamstring injury or by an external agent on as in a cold injury. The injury may be accidental or deliberate, as with a needlestick injury. The term "injury" may be synonymous (depending on the context) with a wound or with trauma.

Interstitial: Pertaining to being between things, especially between things that are normally closely spaced.
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Interventional: Pertaining to the act of intervening, interfering or interceding with the intent of modifying the outcome. As, for example, an interventional radiologist.

Involuntary: Done other than in accordance with the conscious will of the individual. The opposite of voluntary.
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Joint: A joint is the area where two bones are attached for the purpose of motion of body parts. A joint is usually formed of fibrous connective tissue and cartilage. An articulation or an arthrosis is the same as a joint.
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Lateral: 1. In anatomy, the side of the body or a body part that is farther from the middle or center of the body. Typically, lateral refers to the outer side of the body part, but it is also used to refer to the side of a body part. For example, when referring to the knee, lateral refers to the side of the knee farthest from the opposite knee. The opposite of lateral is medial .
2. In radiology, slang for a lateral X-ray .
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Lateral epicondylitis: See: Tennis elbow.

Lateral femoral cutaneous nerve: A nerve that supplies sensation to the outer portion of the thigh. Abbreviated LFCN. See also: Meralgia paresthetica.

Leg: In popular usage, the leg extends from the top of the thigh down to the foot. However, in medical terminology, the leg refers to the portion of the lower extremity from the knee to the ankle.
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Massage: The manipulation of muscle and connective tissue to enhance the function of those tissues and promote relaxation and well-being. Therapeutic massage can ease tension and reduce pain. Massage can be a part of physical therapy or practiced on its own. It can also be highly effective for reducing the symptoms of arthritis, back pain, carpal tunnel syndrome, and other disorders of the muscles and/or nervous system.

Medication: 1. A drug or medicine. 2. The administration of a drug or medicine. (Note that "medication" does not have the dangerous double meaning of "drug.")

Muscle: Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. Muscle which is responsible for moving extremities and external areas of the body is called "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle."

Neck: The part of the body joining the head to the shoulders. Also, any narrow or constricted part of a bone or organ that joins its parts as, for example, the neck of the femur bone.
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Nerve: A bundle of fibers that uses chemical and electrical signals to transmit sensory and motor information from one body part to another. See: Nervous system.

Neuralgia: Pain along the course of a nerve.
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Neuroma: A tumor that arises in nerve cells.

Neuropathic pain: Chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord). Neuropathic pain can occur after trauma and many diseases such as multiple sclerosis and stroke. It is common and affects more than 2 million people in the US alone. This type of pain is notoriously difficult to treat.

Neuropathy: Any and all disease or malfunction of the nerves.

Onset: In medicine, the first appearance of the signs or symptoms of an illness as, for example, the onset of rheumatoid arthritis . There is always an onset to a disease but never to the return to good health. The default setting is good health.
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Osteoporosis: Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein . Osteoporosis predisposes a person to fractures, which are often slow to heal and heal poorly. It is more common in older adults, particularly post-menopausal women; in patients on steroids; and in those who take steroidal drugs. Unchecked osteoporosis can lead to changes in posture , physical abnormality (particularly the form of hunched back known colloquially as " dowager's hump "), and decreased mobility.
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Pacemaker: A system that sends electrical impulses to the heart in order to set the heart rhythm. The pacemaker can be the normal "natural" pacemaker of the heart or it can be an electronic device.
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Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia . Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
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Pain management: The process of providing medical care that alleviates or reduces pain. Pain management is an extremely important part of health care, as patients forced to remain in severe pain often become agitated and/or depressed and have poorer treatment outcomes. Mild to moderate pain can usually be treated with analgesic medications, such as aspirin or ibuprofen . For chronic or severe pain, opiates and other narcotics are often used, sometimes in concert with analgesics; with steroids or non-steroidal anti-inflammatory drugs when the pain is related to inflammation; or with anti-depressants, which can potentiate some pain medications without raising the actual dose of the drug, and which affect the brain's perception of pain. Narcotics carry with them a potential for side effects and addiction, so patients and caregivers must weigh the level of pain against these dangers in the pain management process. The risk of addiction is not normally a concern in the care of terminal patients.
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Peripheral: Situated away from the center, as opposed to centrally located.
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Physical therapy: A branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities. Physical therapists work with many types of patients, from infants born with musculoskeletal birth defects, to adults suffering from sciatica or the after- effects of injury, to elderly post-stroke patients.

Piriformis muscle: A muscle that begins at the front surface of the sacrum (the V-shaped bone between the buttocks at the base of the spine) and passes through the greater sciatic notch to attach to the top of the thigh bone (femur) at its bony prominence called the greater trochanter. The gluteus maximus muscle covers over the piriformis muscle in the buttocks.
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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. The piriformis syndrome is one of the causes of sciatica .
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Plantar: Having to do with the sole of the foot.
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Plantar fasciitis: Inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue in the sole of the foot stretching from the heel to the front of the foot.
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Pregnant: The state of carrying a developing fetus within the body.
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Radiculopathy: Any disease of the spinal nerve roots and spinal nerves. It is synonymous with radiculitis.
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Referral: The recommendation of a medical or paramedical professional. If you get a referral to ophthalmology, for example, you are being sent to the eye doctor. In HMOs and other managed care schemes, a referral is usually necessary to see any practitioner or specialist other than your primary care physician (PCP), if you want the service to be covered. The referral is obtained from your PCP, who may require a telephone or office consultation first.
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Reflex: A reaction that is involuntary. The corneal reflex is the blink that occurs with irritation of the eye. The nasal reflex is a sneeze.
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Rest: 1. Repose. Relaxation.
2. A fragment of embryonic tissue that has been retained after the period of embryonic development. Also called an embryonic rest.

Sacrum: The large heavy bone at the base of the spine, which is made up of fused sacral vertebrae. The sacrum is located in the vertebral column, between the lumbar vertebrae and the coccyx. It is roughly triangular in shape and makes up the back wall of the pelvis. The female sacrum is wider and less curved than the male.
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Sciatic nerve: The largest nerve in the body, the sciatic nerve begins from nerve roots in the lumbar part of the spinal cord (in the low back) and extends through the buttock area to send nerve endings down to the legs.
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Sensation: In medicine and physiology , sensation refers to the registration of an incoming ( afferent ) nerve impulse in that part of the brain called the sensorium , which is capable of such perception. Therefore, the awareness of a stimulus as a result of its perception by sensory receptors. (Sensory is here synonymous with sensation.)
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Shingles: An acute infection caused by the herpes zoster virus, the same virus as causes chickenpox. Shingles is most common after the age of 50 and the risk rises with advancing age. Shingles occurs because of exposure to chickenpox or reactivation of the herpes zoster virus. The virus remains latent (dormant) in nerve roots for many years following chickenpox.
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Shock: In medicine, shock is a critical condition brought on by a sudden drop in blood flow through the body. There is failure of the circulatory system to maintain adequate blood flow. This sharply curtails the delivery of oxygen and nutrients to vital organs. It also compromises the kidney and so curtails the removal of wastes from the body. Shock can be due to a number of different mechanisms including not enough blood volume (hypovolemic shock) and not enough output of blood by the heart (cardiogenic shock). The signs and symptoms of shock include low blood pressure (hypotension), overbreathing (hyperventilation), a weak rapid pulse, cold clammy grayish-bluish (cyanotic) skin, decreased urine flow (oliguria), and mental changes (a sense of great anxiety and foreboding, confusion and, sometimes, combativeness).
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Side effects: Problems that occur when treatment goes beyond the desired effect. Or problems that occur in addition to the desired therapeutic effect.
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Skin: The skin is the body's outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body's largest organ. It is made up of two main layers; the outer epidermis and the inner dermis.

Somatic: 1. Relating to the body. a. As distinguished from the mind (the psyche). b. As distinguished from the gonads.
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Spasm: A brief, automatic jerking movement. A muscle spasm can be quite painful, with the muscle clenching tightly. A spasm of the coronary artery can cause angina. Spasms in various types of tissue may be caused by stress, medication, over-exercise, or other factors.

Spinal cord: The major column of nerve tissue that is connected to the brain and lies within the vertebral canal and from which the spinal nerves emerge. Thirty-one pairs of spinal nerves originate in the spinal cord: 8 cervical , 12 thoracic , 5 lumbar, 5 sacral, and 1 coccygeal. The spinal cord and the brain constitute the central nervous system ( CNS ). The spinal cord consists of nerve fibers that transmit impulses to and from the brain. Like the brain, the spinal cord is covered by three connective-tissue envelopes called the meninges . The space between the outer and middle envelopes is filled with cerebrospinal fluid ( CSF ), a clear colorless fluid that cushions the spinal cord against jarring shock. Also known simply as the cord.
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Spine: 1) The column of bone known as the vertebral column, which surrounds and protects the spinal cord. The spine can be categorized according to level of the body: i.e., cervical spine (neck), thoracic spine (upper and middle back), and lumbar spine (lower back). See also vertebral column. 2) Any short prominence of bone. The spines of the vertebrae protrude at the base of the back of the neck and in the middle of the back. These spines protect the spinal cord from injury from behind.

Steroid: A general class of chemical substances that are structurally related to one another and share the same chemical skeleton (a tetracyclic cyclopenta[a]phenanthrene skeleton).
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Subarachnoid: Literally, beneath the arachnoid, the middle of three membranes that cover the central nervous system. In practice, subarachnoid usually refers to the space between the arachnoid and the pia mater, the innermost membrane surrounding the central nervous system.
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Syndrome: A set of signs and symptoms that tend to occur together and which reflect the presence of a particular disease or an increased chance of developing a particular disease.
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Tailbone Popular name for the coccyx, the small bone at the bottom of the spine made up of 3-5 rudimentary vertebrae.

Tennis elbow: A painful injury to the tendon that is attached to the outer part of the elbow due to repetitive twisting of the wrist or forearm which causes irritation and inflammation of the extensor tendon. This tendon attaches to the lateral epicondyle of the humerus. The condition is therefore also known as lateral epicondylitis. Tennis is not the only culprit. Any action that involves repetitive twisting of the wrist or forearm such as using a screwdriver can lead to this injury.

Therapy: The treatment of disease .
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Tic: A repetitive movement that is difficult, if not impossible, to control. Tics can affect any group of muscles. The most common are facial tics, such as eye- blinking, nose-twitching, or grimacing. Tics that affect the muscles used to produce speech are known as vocal tics, and can range from grunts or whistles to the repetition of complete words or phrases. Complex motor tics involve multiple, sequenced movements, and can include behaviors such as twirling in place, tapping a certain number of times, or stooping to touch the ground. Tics are believed to arise in differences in or damage to the basal ganglia, a structure deep within the brain that controls automatic movements and that also affects impulsivity.

Tic douloureux: A synonym for trigeminal neuralgia. From the French, meaning literally a painful tic. See: Trigeminal neuralgia.

Tissue: A tissue in medicine is not like a piece of tissue paper. It is a broad term that is applied to any group of cells that perform specific functions. A tissue in medicine need not form a layer. Thus,

• The bone marrow is a tissue;
• Connective tissue consists of cells that make up fibers in the framework supporting other body tissues; and
• Lymphoid tissue is the part of the body's immune system that helps protect it from bacteria and other foreign entities.

Topical: Pertaining to a particular surface area. A topical agent is applied to a certain area of the skin and is intended to affect only the area to which it is applied. Whether its effects are indeed limited to that area depends upon whether the agent stays where it is put or is absorbed into the blood stream.
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Torticollis: The most common of the focal dystonias, torticollis is a state of excessive of inadequate muscle tone in the muscles in the neck that control the position of the head. It can cause the head to twist and turn to one side, and the head may also be pulled forward or backward.
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Toxin: One of a number of poisons produced by certain plants, animals, and bacteria.
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Trauma: Any injury , whether physically or emotionally inflicted. "Trauma" has both a medical and a psychiatric definition. Medically, "trauma" refers to a serious or critical bodily injury, wound, or shock . This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. In psychiatry , "trauma" has assumed a different meaning and refers to an experience that is emotionally painful, distressful, or shocking, which often results in lasting mental and physical effects.
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Trigeminal neuralgia: Also called tic douloureux. Inflammation of the trigeminal nerve (the fifth cranial nerve) that most commonly causes paroxysms of very intense lightning pain in the areas of the face the nerve supplies -- the lips, eye, nose, scalp, forehead, gums, cheek, and chin -- on the involved side of the face. A less common "atypical" form of the disease causes a more constant, dull, burning, or aching pain.
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Trigger: Something that either sets off a disease in people who are genetically predisposed to developing the disease, or that causes a certain symptom to occur in a person who has a disease. For example, sunlight can trigger rashes in people with lupus.

Vertebrae: The preferred plural of vertebra. (The alternate plural is vertebras.) See also: Cervical vertebrae; Coccygeal vertebrae; Lumbar vertebrae; Sacral vertebrae; and Thoracic vertebrae.

Vertebroplasty: A nonsurgical method for the repair of vertebral fractures and compression due to osteoporosis .
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Virus: A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)-this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.
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X-ray: 1. High-energy radiation with waves shorter than those of visible light. X-rays possess the properties of penetrating most substances (to varying extents), of acting on a photographic film or plate (permitting radiography), and of causing a fluorescent screen to give off light (permitting fluoroscopy). In low doses X-rays are used for making images that help to diagnose disease, and in high doses to treat cancer . Formerly called a Roentgen ray. 2. An image obtained by means of X-rays.
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Zovirax: Brand name of Acyclovir.

From the Doctors at MedicineNet.com

Cortisone Injection - Read about cortisone injection treatment for inflammation, allergic reaction, sciatica and arthritis. Learn about side effects and complications of a cortisone shot. Source:MedicineNet Spinal Fusion - Minimally invasive lumbar spinal fusion is an operation that is less invasive to the traditional lumbar spinal fusion to treat degenerative disc disease and other vertebral problems. There are advantages and disadvantages to the procedure. Source:MedicineNet Botox - Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum.Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles. Source:WebMD Medical Reference from The Cleveland Clinic Read 90 more Pain Management related articles ... Taking Multiple Pain Relievers May Cause Complications Artificial Cervical Disc Surgery Cheaper Than Fusion Skin Pain, Sensitivity Rises With Migraine Soft Bed or Hard Bed for Back Pain? Health Tip: Having Neck Pain? Women Risk Bone Loss After Knee Surgery Sugar Water Eases Pain of Infant Vaccinations Health Tip: Getting Up After a Fall Chronic Pain Harms Brain's Wiring Fibromyalgia Patients More Sensitive?