The Smart Patient's Guide to
Chronic Pain Management

A Chronic Pain Warrior’s Clinical Glossary

From A-Z, PPM has put together a brief glossary of terminology associated with the complex nature of pain.

After receiving a diagnosis of a chronic pain disorder, you may start hearing some unfamiliar terms from your doctors, care team, and peer advocates. Below, PPM has put together a brief glossary of this terminology. There are sections on pain response, care approaches, and medications.

Have an idea for another term? Email it to ppmeditorial@remedyhealthmedia.com.

 

TERMS RELATED TO PAIN EXPERIENCE AND RESPONSE

 

Acute pain – sharp pain that comes on suddenly and is caused by something specific; typically does not last longer than three months. Acute pain goes away once there is no longer an underlying cause for the pain.
May occur with: surgery, broken bones, dental work, burns/cuts, childbirth

Allodynia – pain due to a stimulus that does not normally provoke pain, such as a light touch.
May occur with: complex regional pain syndrome (CRPS), migraine, postherpetic neuralgia

Central Sensitization – a condition of the nervous system that is associated with the development and maintenance of chronic pain. The nervous system winds-up and gets regulated in a persistent, regulated state of reactivity, which lowers the threshold for what causes pain.
May occur with: arthritis, musculoskeletal disorders, headache, complex regional pain syndrome

Chronic pain – pain that is ongoing and lasts longer than three months, continuing even after an injury or illness that has caused it has healed or gone away. Pain signals remain active in the nervous system for weeks, months, or years. Some may suffer chronic pain when there is no past injury or apparent body damage.
May occur with: headache, arthritis, nerve pain, back pain, fibromyalgia

Chronic widespread pain (CWP) – a prevalent disorder (5% to 10% of the general population) characterized by pain in all four body quadrants (left/right sides of the torso), the neck, and back. These multiple pain sites are associated with higher pain intensity, longer pain duration, and greater disability. Fibromyalgia (FM) has been classified as CWP of more than 3 months, with hyperalgesia (increased pain) at 11 or more different tender points.

Comorbidity – the co-occurrence of mental and physical disorders within the same patient, regardless of the order in which they occurred or the causal pathway linking them. Having a mental disorder is a risk factor for developing a chronic condition, and vice versa. The combination is associated with elevated symptoms, functional impairment, and decreased quality of life. Many patients with chronic pain experience comorbid conditions, especially women.

Dyspareunia – persistent or recurrent genital pain that occurs just before, during, or after intercourse.
May occur with: endometriosis, pelvic inflammatory disease, vaginitis

Dystonia – a movement disorder in which muscles contract involuntarily, causing repetitive or twisting movements. The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia).
May occur with: Parkinson's disease, Huntington's disease, Wilson's disease, traumatic brain injury

Fear-Avoidance – the process of maintaining chronic pain by avoiding particular activities deemed by the individual to cause pain. In some cases, may be related to the controversial term called “pain catastrophizing,” the concept of negative pain appraisal or deeming that pain is worse than it may actually be.

Hyperalgesia – increased pain from a stimulus that normally provokes pain. Having surgery on your elbow, for example, may cause the pain to spread over time rather than improving.
May occur with: neuropathy, fibromyalgia, chronic fatigue syndrome

Inflammatory pain – an arthritic condition characterized by pain, swelling, tenderness, and warmth in the joints. Inflammatory chemicals attack joint tissue, causing swelling, increased joint fluid, cartilage and bone damage, and muscle loss.
May occur with: rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus (lupus), gout, ankylosing spondylitis

Myofascial pain – pain and inflammation that affects the fascia, or the connective tissue that covers the muscles. Might involve either a single muscle or a muscle group; in some cases, the area where one experiences pain might not be where the pain is located (which is known as “referred” pain).
May occur with: fibromyalgia, abdominal pain

Musculoskeletal pain – pain affecting the bones, muscles, ligaments, tendons, and nerves; can be both acute or chronic. Musculoskeletal pain can be localized in one area, or widespread.
May occur with: low back pain, tendonitis, myalgia (muscle pain), stress fractures

Neuropathic pain – pain resulting from damage or dysfunction of the nervous system (including the peripheral nerves, spinal cord, and/or brain). Nerve function may change at the site of the nerve damage or dysfunction, as well as areas in the central nervous system (known as central sensitization, see above).
May occur with: spinal cord injury, complex regional pain syndrome, trigeminal neuralgia

Neuropathy – refers to any condition that affects the nervous system, the network of nerves that connects the central nervous system (brain and spinal cord) to the rest of the body. Nerve cells (neurons) are damaged or destroyed, which distorts the way they communicate with each other and the brain.
May occur with: diabetic peripheral neuropathy, Lyme disease, lupus, amyloidosis

Nociceptive pain – also known as somatic pain, is a common pain experienced as a result of an injury (paper cut, broken bone, appendicitis, etc.). Peripheral nerve fibers have special endings, called nociceptors, that can sense different types of harmful stimuli. In response to tissue damage, nociceptors at the source of the injury relay pain messages in the form of electrical impulses, which travel along a peripheral nerve to the spinal cord.

Orofacial pain – a frequent form of pain perceived in the face and/or oral cavity, caused possibly by diseases or disorders in the area, dysfunction of the nervous system, or through referred pain from other sources.
May occur with: trigeminal neuralgia, temporomandibular joint dysfunction

Somnolence – drowsiness or sleepiness.

Visceral pain – pain in the internal organs of the body (most likely in the abdomen or pelvis). Visceral pain activates the autonomic nervous system (part of the nervous system which supports the internal organs: blood vessels, stomach, intestine, liver, kidneys, bladder, genitals, lungs, pupils, heart, etc.) and may include nausea, vomiting, and/or sweating.
May occur with: gastrointestinal pain, irritable bowel syndrome, appendicitis

Get to know the terms that may come up when you have a chronic pain condition. (Source: Unsplash - Aaron Burden)

TERMS RELATED TO CARE

 

Acceptance & Commitment Therapy (ACT) – ACT, developed in 1982 by Steven C. Hayes, is a distinct form of mindfulness-based intervention in that it is a behavioral analysis that uses acceptance and mindfulness strategies mixed with commitment and behavior-change strategies. ACT encourages patients to shift their focus from reducing or eliminating pain to fully engaging in their lives, changing how they relate with their internal experiences and ultimately living a better life. Therapists aim for patients to become actively involved in what they care about and what matters most in their life, despite having and experiencing pain. ACT applies six core processes (willingness to accept, contact with the present moment, observing the self, cognitive defusion, values, and committed action) through different exercises; these interventions provide patients to become more open, present, and take action in their lives.

Behavioral/Mental Health Treatment – behavioral health treatments are ways of helping people with mental health issues through counseling and more specialized psychotherapies that seek to change behaviors, thoughts, emotions, and how individuals see and understand situations.
Examples include: cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), biofeedback

Biopsychosocial Model – an approach that systematically considers biological, psychological, and social/economic factors and how their complex interactions factor into one’s health and their healthcare delivery.

Cognitive Behavioral Therapy (CBT) – CBT is a present-focused, short-term, psychotherapy approach that encourages patients to engage in an active coping process to change their maladaptive thoughts and behaviors that oftentimes maintain and even exacerbate the experience of chronic pain. The cognitive-behavioral model is grounded in the idea of pain as a complex experience that is influenced by a patient’s thoughts and their affects, as well as one’s overall behavior. The goals of CBT in pain management include reducing the impact pain has on one’s daily life, learning skills for better coping with pain, improving physical and emotional functioning and well-being, and reducing reliance on pain medication.

Complementary and Alternative Medicine Complementary medicineis treatments that are used along with standard medical treatments but are not considered to be standard treatments, such as acupuncture, massage, and meditation. Alternative medicine is treatments that are used instead of standard medical treatments, such as changes to diet, herbal remedies, supplements. There is a push in the pain management community to use the term “integrative” care over “complementary and alternative” care as most complementary care is administered in addition to, or in unison with, other forms of treatment.

Evidence-based Medicine – when healthcare provide patients and those close to them with up-to-date and scientifically proven information on the various medical options that are available to them. It can help to find out what sorts of advantages or disadvantages a treatment or test has, when people might benefit from it, and whether it might be harmful.

Integrative Care – a practical strategy to healthcare, integrative medicine focuses on the patient as the center of care and addresses the full range of physical, emotional, mental, social, spiritual, and environmental influences that affects a person’s health. The aim is to treat the whole person and address immediate needs as well as long-term, complex issues and/or treatment goals.

Interventional Pain Management – a medical subspecialty which uses special, invasive procedures to relieve pain, which may include injections, epidural or intrathecal delivery of drug systems, and radiofrequency denervation to cut off a damaged nerve.
Examples include: spinal cord stimulation (SCS), trigger point injections, nerve blocks

Multidisciplinary Care – a practice in which healthcare professionals from multiple specialties attend to the same patient, working autonomously between each other to, for example, treat a comorbid symptom of a patient’s condition. Overlaps in some cases with “transdisciplinary care” (see below).

Multimodal Treatment – the concurrent use of more than one therapeutic intervention that, combined, aims to help treat pain.
Examples include: combinations of opioid and non-opioid treatment regimens; the use of over the counter drugs and physical therapy, etc.

Regenerative Medicine – the process of replacing or "regenerating" human cells, tissues, or organs to restore or establish normal function, either by replacing damaged tissues and organs in the body altogether or by stimulating the body's own repair mechanisms to speed up healing.
Examples include: stem cells, prolotherapy

Transdisciplinary Care – a practice in which healthcare professionals collaborate closely with one another when treating a patient to share their knowledge and skills (such as best practices and approaches) in order to make better decisions and create a broader treatment plan. For example, a patient recovering from physical trauma may need close attention and collaboration between their primary care doctor and physical therapist. Overlaps in some cases with “multidisciplinary care” (see above).

 

From types of pain to care approaches, knowing the medical terminology is key to understanding your chronic pain treatment plan. (Source: Unsplash - Syd Wachs)

TERMS RELATED TO MEDICATIONS

 

Opioids – potent painkillers that provide immediate relief to intense pain by changing your brain’s perception of pain messages. Typically prescribed only if other medication options aren't successful. They may be prescribed for low back pain, neuropathic pain, or arthritis pain, for example. Learn more about different pain medications here.
Examples include: oxycodone (Endocet), tramadol (Ultram), morphine

Opioid Agonist – a drug that activates certain receptors in the brain. For example, full agonist opioids activate the opioid receptors in the brain, resulting in a full opioid effect.
Examples include: oxycodone, methadone, hydrocodone, morphine

Opioid Antagonist – a drug that blocks opioids by attaching to the opioid receptors, without activating them. Antagonists cause no opioid effect and therefore block full agonist opioids.
Examples include: naltrexone, naloxone

Medication-assisted treatment (MAT) – the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a "whole patient" approach to the treatment of substance use disorder (SUD).
Examples include: buprenorphine/naloxone, methadone, naltrexone

Opioid Addiction & Opioid Dependence – These terms are often confused but are in fact, quite distinct. Opioid addiction is defined as the compulsive and uncontrollable use of drugs despite adverse consequences. Opioid dependence occurs when the body adapts to the presence of a drug, causing withdrawal symptoms when drug use is reduced or discontinued. You can read more on this difference, including learning more about opioid use disorder (OUD), by clicking here.

Opioid Receptors

  • delta (δ, DOR) – delta opioid receptors are located in several areas of the brain and in part of the spinal cord. Delta-opioid receptors play a role in pain as well as gut motility, mood, and regulation of the cardiovascular system.
  • kappa (κ, KOR) – kappa opioid receptors are located primarily in areas of the brain. These receptors play a role in pain, urination, feeding, hormone regulation, and immune system functions.
  • mu (μ, MOR) - mu opioid receptors are located throughout our bodies but primarily in areas of the brain and spinal cord known to be involved in pain awareness, reward systems, breathing, and emotional response to pain. These receptors play a role in pain but can also contribute to side effects including reduced breathing, dependence, and suppression of the immune system. Activation of mu opioid receptors in our gastrointestinal tract contribute to constipation.
Updated on: 09/10/19
Continue Reading:
50-Plus Resources, Including Groups for Veterans, to Help You Live Better with Chronic Pain
close X
SHOW MAIN MENU
SHOW SUB MENU