ABFM Pain Medicine key terms

Pain that arises from actual or threatened damage to non-neural tissue and is caused by activation of nociceptors. It is typically described as aching, throbbing, or cramping and often responds to treatment of the underlying cause.

Pain caused by a lesion or disease of the somatosensory nervous system. It often feels burning, shooting, or electric and may be accompanied by numbness, tingling, or hypersensitivity in a nerve territory.

An increased responsiveness of nociceptive neurons in the central nervous system to normal or subthreshold input. Clinically it contributes to widespread pain, hyperalgesia, and allodynia and helps explain conditions such as fibromyalgia.

An increased pain response to a stimulus that normally provokes pain. It can occur at the site of injury (primary) or in surrounding uninjured tissue (secondary) and is a feature of sensitization.

Pain caused by a stimulus that does not normally provoke pain, such as light touch or mild cold. It is common in neuropathic pain and reflects altered sensory processing.

A single-item pain measure in which a patient rates pain intensity from 0 (no pain) to 10 (worst imaginable). It is quick and widely used but captures only intensity, not function or emotional impact.

A multidimensional questionnaire that assesses pain intensity, location, and interference with daily activities, mood, sleep, and relationships. It helps characterize the biopsychosocial impact of pain and track response to treatment.

A brief screening tool for neuropathic pain that combines interview items about burning, painful cold, electric shocks, and tingling with examination findings such as brush allodynia and pinprick hypoesthesia.

Use of two or more analgesic drugs or techniques with different mechanisms to improve pain relief while reducing doses and adverse effects of any single agent. It often combines nonopioid, opioid, and regional approaches.

A standardized way to convert doses of different opioids to an equivalent morphine dose for comparison and safety review. MME is used in prescribing guidelines but has limitations for individual patients.

A state in which repeated opioid exposure produces diminished analgesic effect, so a higher dose is needed to achieve the same pain relief. It is distinct from addiction and is expected with long-term opioid use.

A paradoxical increase in pain sensitivity during opioid therapy, sometimes with spreading or diffuse pain. It differs from tolerance and may improve when the opioid dose is reduced or the drug is rotated.

Switching from one opioid to another to improve analgesia or reduce adverse effects. Because cross-tolerance is incomplete, the new dose is usually reduced and then titrated carefully.

A partial mu-opioid receptor agonist with high receptor affinity and a ceiling effect on respiratory depression. It is used for pain and opioid use disorder and can complicate transitions to full agonists.

A short-acting opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression. It is used in emergencies and is often coprescribed to patients at risk for opioid overdose.

Drugs such as gabapentin and pregabalin that bind voltage-gated calcium channels and reduce excitatory neurotransmitter release. They are used for neuropathic pain and have sedation, dizziness, and edema as common effects.

A class including amitriptyline and nortriptyline used at low doses for neuropathic pain and headache prophylaxis. Anticholinergic, cardiac, and sedation effects limit use in older adults and those with cardiac disease.

Antidepressants such as duloxetine and venlafaxine that treat neuropathic pain and some chronic musculoskeletal pain. They may improve mood and pain but can raise blood pressure and cause withdrawal if stopped abruptly.

Injection of corticosteroid, often with local anesthetic, into the epidural space to reduce radicular pain and inflammation. It is used for selected patients with disc herniation or spinal stenosis.

A diagnostic injection of local anesthetic around the medial branches of the dorsal rami that innervate facet joints. A positive response may support proceeding to radiofrequency ablation of those nerves.

A procedure that uses heat generated by radio waves to lesion nerves and interrupt pain signals, commonly medial branch nerves for facet-mediated pain. Benefit may last months and requires accurate diagnostic blocks.

Injection of local anesthetic, sometimes with corticosteroid, into a taut band of muscle that reproduces the patient's pain. It is used for myofascial pain and is often combined with stretching and physical therapy.

An implanted device that delivers electrical pulses to the dorsal spinal cord to modulate pain signals, mainly for persistent neuropathic or radicular pain. A trial period usually precedes permanent implantation.

Injection of local anesthetic near sympathetic ganglia, such as the stellate ganglion or lumbar sympathetic chain, to treat complex regional pain syndrome or sympathetically maintained pain. Temporary relief helps confirm the diagnosis.

The need to assess and hold blood thinners before spinal or epidural injections to reduce the risk of bleeding into the spinal canal. Guidelines specify timing based on drug half-life and procedure risk.

A structured psychological treatment that helps patients identify and change unhelpful thoughts and behaviors related to pain. It improves coping, function, and distress and is a core component of pain rehabilitation.

A psychological approach that encourages accepting pain-related experiences while committing to actions that support valued living. It emphasizes psychological flexibility rather than reducing pain intensity directly.

A model explaining how catastrophic thoughts about pain lead to fear, avoidance of activity, disuse, and worsening disability. Treatment targets gradually increasing activity and reducing avoidance.

A behavioral therapy in which a patient gradually confronts feared movements or activities in planned steps. It reduces fear and avoidance and improves function in chronic pain.

A self-management strategy that balances activity and rest by breaking tasks into manageable periods and avoiding boom-bust cycles. It aims to increase function without triggering severe pain flares.

A structured program teaching mindfulness meditation and body awareness to reduce stress and improve coping with chronic pain. Evidence supports modest improvements in pain acceptance and quality of life.

A tendency to magnify the threat of pain and feel helpless in coping with it. High catastrophizing predicts greater pain intensity, disability, and poorer treatment response.

Coordinated care from physicians, psychologists, physical therapists, and other clinicians who share a biopsychosocial approach. It emphasizes functional restoration and self-management rather than solely reducing pain intensity.

An approach that understands pain as shaped by biological, psychological, and social factors interacting over time. It guides assessment and treatment toward multidimensional rather than purely biomedical targets.

A state database that tracks controlled substance prescriptions. Clinicians use it to identify overlapping prescriptions, high-risk combinations, and possible misuse before prescribing opioids.

A brief screening questionnaire that estimates a patient's risk of aberrant opioid-related behavior using factors such as personal or family substance use history and age. It helps guide monitoring intensity.

Laboratory testing of urine to detect prescribed medications, nonprescribed drugs, or metabolites. In pain care it supports adherence monitoring and identification of unexpected substance use.

A risk-reduction approach that applies structured assessment, monitoring, and safety measures to all patients receiving opioids rather than only those judged high risk. It includes PDMP review, agreements, and testing.