ABPS Interventional Pain Management key terms

The neural encoding of actual or threatened tissue damage by specialized peripheral nerve endings called nociceptors, which convert noxious mechanical, thermal, or chemical stimuli into electrical signals carried toward the spinal cord.

An activity-dependent increase in the excitability of spinal and supraspinal neurons after repeated or intense nociceptive input, producing amplified pain responses, enlarged receptive fields, and pain that outlasts the original injury.

A progressive increase in the firing of dorsal horn neurons during repetitive C-fiber stimulation at a constant intensity, reflecting short-term synaptic plasticity and contributing to temporal summation of pain.

An increased painful response to a stimulus that normally provokes pain, arising from sensitization of peripheral nociceptors or central pain pathways.

Pain produced by a stimulus that does not normally cause pain, such as light touch or mild cooling, and often a clinical marker of central or peripheral sensitization.

Pain caused by a lesion or disease of the somatosensory nervous system, typically described as burning, shooting, or electric and often accompanied by sensory deficits, allodynia, or hyperalgesia in a nerve territory.

Pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage causing activation of peripheral nociceptors, nor evidence of disease or lesion of the somatosensory system.

The area of skin supplied by the sensory fibers of a single spinal nerve root, used clinically to map the level of radicular symptoms or nerve root involvement.

The group of skeletal muscles innervated by the motor fibers of a single spinal nerve root, assessed during examination to localize the level of nerve root compromise.

A condition in which nerve root compression or inflammation produces pain and neurologic deficits in a specific dermatomal and myotomal distribution, often with diminished reflexes or strength.

Pain arising from the zygapophysial joints or their capsular and synovial structures, typically axial and referred in a non-dermatomal pattern, and often diagnosed by response to controlled medial branch blocks.

Pain generated by the sacroiliac joint and its supporting ligaments, usually felt in the buttock and referred to the groin or posterior thigh, confirmed by diagnostic intra-articular injection.

Statistical measures of a diagnostic test: sensitivity is the proportion of people with disease who test positive, and specificity is the proportion without disease who test negative.

The probability that a patient who tests positive actually has the condition, which rises as disease prevalence in the tested population increases.

An injection of local anesthetic onto or around a target nerve or joint to determine whether that structure is the source of a patient's pain, ideally performed with controlled, comparative, or placebo conditions.

Injection of local anesthetic near the medial branch of the dorsal ramus that innervates a zygapophysial joint, used to diagnose facet-mediated pain before considering radiofrequency ablation.

A technique that applies alternating current through a needle electrode to generate heat and coagulate nerve tissue, producing prolonged interruption of pain transmission after accurate sensory and motor testing.

Delivery of radiofrequency current in short bursts that keeps tissue temperature relatively low, intended to modulate nerve function rather than destroy it, though evidence of benefit remains limited.

Injection of corticosteroid, often with local anesthetic, into the epidural space to reduce inflammation around nerve roots, commonly used for radicular pain from disc herniation or stenosis.

A spinal injection performed through the intervertebral foramen to deliver medication directly around an exiting nerve root and into the anterior epidural space.

A potentially fatal syndrome from excessive local anesthetic absorption or intravascular injection, marked by perioral numbness, tinnitus, seizures, and cardiovascular depression, treated with lipid emulsion rescue.

Delivery of electrical current to the dorsal columns via implanted epidural electrodes to modulate pain transmission, used for refractory neuropathic or ischemic pain after conservative measures fail.

Therapeutic alteration of nervous system activity using implanted or external devices such as spinal cord or dorsal root ganglion stimulators, peripheral nerve stimulators, or intrathecal drug delivery systems.

Implantation of a pump and catheter that infuses analgesic medication directly into the cerebrospinal fluid, allowing lower systemic doses for refractory chronic pain or spasticity.

A paradoxical increase in pain sensitivity associated with opioid exposure, distinct from tolerance or withdrawal, and managed by dose reduction or opioid rotation.

A reduced response to an opioid dose after repeated exposure, requiring higher doses to achieve the same analgesic effect and distinct from addiction or physical dependence.

Combining analgesics with different mechanisms, such as acetaminophen, NSAIDs, and adjuvants, to improve pain control while limiting the dose and adverse effects of any single agent.

A medication developed for another purpose, such as gabapentinoids, tricyclic antidepressants, or serotonin-norepinephrine reuptake inhibitors, that relieves neuropathic pain through non-opioid mechanisms.

The process of assessing bleeding risk before interventional procedures by reviewing anticoagulant and antiplatelet agents, renal function, and procedure-specific bleeding hazards to guide safe timing of interruption.

The process of informing a patient about the nature, risks, benefits, and alternatives of a procedure and documenting their voluntary agreement before it is performed.

A set of practices, including hand hygiene, full barrier precautions, skin antisepsis, and mask use, intended to prevent microbial contamination during invasive procedures.

A structured framework for rating the certainty of evidence and strength of clinical recommendations, used to interpret guideline statements and appraise pain literature critically.

A sequential rehabilitation approach combining laterality training, imagined movements, and mirror therapy to desensitize the nervous system in complex regional pain syndrome and chronic limb pain.

A structured psychological treatment that targets maladaptive thoughts and behaviors maintaining pain-related distress and disability, delivered as part of multidisciplinary chronic pain care.

Coordinated care combining medical, physical, psychological, and vocational interventions, typically for chronic pain, with evidence supporting improved function and reduced healthcare utilization.

An autologous concentrate of platelets and growth factors prepared from the patient's blood and injected into injured tendons, ligaments, or joints to promote tissue healing, though evidence varies by indication.

The use of biologic agents such as platelet-rich plasma, bone marrow concentrate, or mesenchymal cells to stimulate repair of musculoskeletal tissue; most pain indications lack definitive high-quality evidence.