Adhesive Arachnoiditis
A chronic form of arachnoiditis in which the arachnoid membrane undergoes thickening and there is diffuse connective tissue proliferation in the subarachnoid space.

Allodynia
Extreme tenderness of the skin. It results from nerve damage causing hypersensitivity of the pain receptors in that area.

Allograft
Bone taken from the patient's hip or a bone bank, used in fusion type surgeries.

Analgesia
Reduced sensibility to pain without loss of consciousness and without the sense of touch necessarily being affected. The condition may arise accidentally, if nerves are diseased or damaged, or be induced deliberately by the use of pain-killing drugs.

Anaesthesia dolorosa
Pain in an area or region that is anaesthetic.

Anterior
Describing or relating to the front (ventral) portion of the body of limbs.

Arachnoid
The middle of three membranes covering the brain and spinal cord, which has a fine, almost cobweb-like, texture. Between it and the pia mater within lies the subarachnoid space containing cerebrospinal fluid and large blood vessels; the membrane itself has no blood supply.

 Arachnoiditis
An inflammatory process causing thickening and scarring (fibrosis) of the membranous linings (meninges) of the spinal canal. The resulting entrapment of nerve roots may result in weakness, pain, and numbness in the affected area. The condition may result from infection of the meninges, surgery, or as a response to the oil-based dyes previously used in myelography.

 Back Pain
Back pain is caused, broadly, by physical strains known as mechanical strains and stresses and their after-effects. It is also caused by deteriorating changes, known as degenerative changes, in the verterbrae, discs and other parts of the spine. Back pain may also arise from disease of the spine and from psychological factors. All of these basic causes can be influenced by heredity, occupational hazards, injuries in sport, on the road and in the home. Other causes of back pain include bad posture while standing, walking, bending, sitting and lying down, un-balanced diet and anxieties about pain. The life of soft beds, soft armchairs, soft car seats and the effect of poor muscles from dis-use or un-accustomed use can and does lead to back pain.

Bone Scan
Radiologic study where the patient is injected with a radio active tracer (usually technetium) that is absorbed by the skeleton. Increased activity is seen in arthritis, cancers and infections. A very sensitive test.

Biopsy
The removal of a small piece of living tissue from an organ or part of the body for microscopic examination.

Causalgia
An intensely unpleasant burning pain felt in a limb where there has been partial damage to the sympathetic and somatic sensory nerves.

Central Pain
Pain associated with a lesion of the central nervous system.

Claudication
There are two types of this:

• Neurogenic Claudication, which is pain induced by walking (from the Latin claudico, to limp)
• Vascular Claudication, which is pain induced by walking caused by insufficient blood flow to the legs.

Corpectomy
This is the removal of the entire vertebral body.

CT Scan
Computed Tomography
This is an excellent way of showing bony detail by x-ray.

De-afferentation
Nerve cells disconnected from normal afferent input.

Debridements
The process of cleaning an open wound by removal of foreign material and dead tissue, so that the healing may occur without hindrance.

Denervation
Interruption of the nerve supply to the muscles and skin. The muscle is paralysed and its normal tone (elasticity) is lost. The muscle fibres shrink and are replaced by fat. A denervated area of skin loses all forms of sensation and its subsequent ability to heal and renew its tissues may be impaired.

Disc Bulging
This is where the disc displaces, causing a bulge that can put pressure on a nerve root or even the spinal cord.

Discitis
Infection in the disc space; an inflammatory lesion of the vertebral disc that occurs in adults but more commonly in children.

Disc Degeneration
This is where the disc swells up, disintegrates and displaces causing pressure to be placed on the nerve root or even the spinal cord. Commonly called a herniated disc.

Dysesthesia
An unpleasant, abnormal sensation, whether spontaneous or evoked.

Dysfunction
This is simply an abnormal or impaired function, usually talking about nerves and or muscles.

Dysuria
Difficult or painful urination. This is usually associated with urgency and frequency of urination if due to cystitis or urethritis. The pain is burning in nature and is relieved by curing the underlying cause. A high fluid intake usually helps.

Electro-Myelograph (EMG)
This is used to record the electrical conductivity between nerves and muscles. One electrode is placed on the index finger and the other is placed on the little finger of the same hand. A small electrical impulse is sent up the index finger, through the arm, down the spinal cord, up the other side of the spinal cord and out through the electrode on the little finger. This impulse is monitored by an oscilloscope and the results are printed as a chart, which can be compared by a Neurologist with a chart of normal readings.

Epidural Abscess
Epidural means space above the dura (covering of the spinal cord and nerve roots). Abscess is the collection of purulent fluid or "pus". Thus, this is an accumulation of purulent fluid around the covering of the spinal cord and nerve roots.

Evaluation of Back Pain
The evaluation of back pain requires a physician experienced in this problem. The work up begins with a detailed history and physical examination. Your physician will ask about the quality of the pain, where it radiates, factors which worsen or alleviate the pain, and other questions. The physical examination concentrates on motor and sensory function. Radiographic evaluation may be indicated. The first step is usually a set of plain x-rays. If your physician is suspicious of a structural lesion, based on the history and exam, one or more additional studies may be performed.

See also:

• CT Scan
• MRI
• Myelogram and CT Scan

Erythrocyte Sedimentation Rate
Laboratory test measuring rate at which red blood cells settle in a test tube - this can be a measure of inflammation or infection in the body.

Foramina
This is the opening in the side of the vertebrae, that the nerve root exit.

Fusion
This is, the sticking together of two or more vertebrae, using bone taken from the patient's hip or metal plates and screws or both.

Herniated Disc
Also called a herniated nucleus pulposus (HNP), disc rupture or a disc prolapse.

Hyper-mobility
This is where the spinal joints are too mobile.

Hyperaesthesia
Excessive sensibility, especially of the skin.

Hyperalgesia
An abnormal state of increased sensitivity to painful stimuli.

Hyperpathia
A painful syndrome, characterised by increased reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold.

Hypertrophy
An abnormal growth of tissue due to the enlargement of each of the cellular parts without an increase in the number of cells.

Hypo-mobility
This is reduced mobility of the spinal joints.

Hypoalgaesia
Diminished pain in response to normally painful stimulus.

Inhibition
The prevention or reduction of the functioning of an organ, muscle etc. by the action of certain nerve impulses.

Kyphosis
Exessive outward curvature of the spine, causing hunching of the back.

Laminectomy
Surgical cutting into the backbone to obtain access to the spinal cord. The surgeon excises the rear part (the posterior arch) of one or more vertebrae.The operation is performed to remove tumours, to treat injuries to the spine, such as prolapsed intervertebral (slipped) disc, or to relieve pressure on the spinal cord or roots.

Lancinating
Describing a sharp stabbing or cutting pain.

Lhermitte's Sign
A tingling shock-like sensation passing down the arms or trunk when the neck is flexed. It is a nonspecific indication of disease in the cervical (neck) region of the spinal cord.

Lordosis
Inward curvature of the spine. A certain degree of lordosis is normal in the lumbar and cervical regions of the spine: loss of this is a sign of ankylosing spondylitis. Exaggerated lordosis may occur in adolescence, through faulty posture or as a result of disease affecting the vertebrae and spinal muscles.

MRI Scan
Magnetic Resonance Imaging
This is a non-invasive x-ray specifically used to show soft tissue detail of disc material, cord compression and nerve root compression.This is also the most expensive, of all x-ray types and is often left until the last resort.

Myelogram
An invasive (spinal injection of dye is used) Xray and is normally used in conjunction with a CT Scan to show excellent definition of the spaces around the nerve roots.

Neuralgia
A severe burning of stabbing pain often following the course of a nerve.

Neuritis
A disease of the peripheral nerves showing the pathological changes of inflammation. The term is also used in a less precise sense as an alternative to neuropathy.

Neurogenic
Caused by disease or dysfunction of the nervous system. Caused by nerve stimulation.

Neuropathic Pain
This is pain associated with the nerves and or nerve roots along their path through-out the body.

Neuropathy
Any disease of the peripheral nerves, usually causing weakness and numbness. In a mononeuropathy a single nerve is affected and the extent of the symptom depends upon the distribution of that nerve. In a polyneuropathy many or all of the nerves are involved and the symptoms are most profound at the extremities of the limbs.

Nociceptor
A receptor specifically sensitive to a noxious stimulus or to a stimulus which would become noxious if prolonged.

Noxious Stimulus
One which is damaging to normal tissues.

Osteomyelitis
Infection of the bone. Vertebral Osteomyelitis means infection of the vertebral bones of the spinal column.

Osteophytes
Bony ridges or spurs. These "growths" can form on all joints in the spine.

Pain
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

Pain Threshold
The least experience of pain which a subject can recognise.

Pain Tolerance Level
The greatest level of pain which a subject is prepared to tolerate.

Parasthesia
An abnormal sensation, whether spontaneous or evoked. Tingling sensations. Pins and Needles etc.

Posterior
Situated at or near the back of the body or an organ.

Radiculopathy
Dysfunction of a nerve root by any cause. Symptoms are weakness, pain, numbness or tingling or a combination of these.

Radiculalgia
This is pain along the distribution of one or more of the sensory nerve roots.

Sciatica
This is pain that travels into the buttocks, back of the thigh and often into the calf and foot. This is usually caused by an irritation of the nerve root of the sciatica nerve, often from compression by a disc or a degenerative disease.

Scoliosis
This is a lateral (sideways) curving of the spine. this can result in one leg being shorter than the other.

Spinal Joints
The spine itself:

• Cervical Vertebrae - There are 7 of these joints, each is separated by a disc.
• Thoracic Vertebrae - There are 12 of these joints, each is separated by a disc.
• Lumbar Vertebrae - There are normally 5 of these joints, but sometimes people are born with only 4 or even 6 of these joints.
• Sacrum - 5 fused sacral vertebrae.
• Coccyx - 4 fused vertebrae (but the first may be separate).
• Pelvic Bones - There are 3 of these bones which form a joint in front and two joints behind, called Sacroiliac Joints.

Parts of the Vertebrae:

• Bony Processes (or Protuberances)
• Articular Process - This is the top of the Transverse Process and forms the top half of the facet joint.
• Transverse Processes - These stick out on each side of the vertebrae.
• Spinous Process - This is the large bony ridge that sticks out the back of the spine.

Other Parts.

• Lamina - This is the bridge of bone between the transverse Process & the Spinous Process.
• Apophyseal Joint - Also called the Facet Joint or Zygopophyseal Joint and is where the vertebrae sits together at the rear of the spine. Whiplash type injuries result in pain associated with this area of the spine
• Pedicle - This is at the base of the Articular Process.(Pedicle + Lamina = Vertebral Arch )
• Body - This is simply the body of the vertebrae, the disc sits on top of this part.
• Spinal Canal - This is simply the hole (or opening) in which the spinal cord travels down the spine.
• Intervertebral Foramen - This is simply the hole (or opening) through which the nerve roots exit the spine.
• Foramina = plural of foramen.

Spinal Stenosis
Also called Spondylosis. This is the narrowing of the spinal canal. This is typically found in the lumbar or cervical spine (lower back and neck, respectively)

Spondylitis
This is an inflammation of one or more of the vertebrae of the spine. Spondylitis may be due to injury or to some disease, such as arthritis or tuberculosis. Spondylitis is often a chronic, crippling condition leading to, stiffening of the spinal joints (spondylosis) and deformation (Kyphosis).

Spurling's Sign
This is the reproduction or exacerbration of pain upon pushing down on the head and bending it toward the involved side.

Staphylococcus Aureus
Common bacteria in skin infections. The most common bacteria in bone infections.

Tomograph
This is a special x-ray of the spine in which different sections of the vertebrae can be shown.Specifically used to diagnose diseased bone.

Types of Pain:

• Episodic Pain - This is pain that occurs suddenly and normally only lasts 1 or 2 days. This type of pain is normally caused by disc displacements commonly known as Slipped Disc's (prolapsed disc).
• Localised Pain - This type of pain occurs at the pain site. for example, kidney related pain is located in the kidney area of the body.
• Referred Pain - This type of pain occurs somewhere else, other than the pain site. For example, Gall Bladder related pain can be located in the back.

DISCLAIMER

This information must not be treated as a medical diagnosis but it is for medical information ONLY. If you suspect you may have any of the conditions listed PLEASE CONTACT YOUR DOCTOR IMMEDIATELY.