ABDOMINAL MUSCLES

The flat, bandlike muscles on the front of the trunk that are attached to the pelvis below and the rib cage above.

ACETYLCHOLINE

A neurotransmitter that slows heart rate; it is controlled by the parasympathetic nervous system.

ACUTE PAIN

What was the worst pain you can remember? Was it the time you scratched the cornea of your eye? Was it a kidney stone? Childbirth? Rare is the person who has not experienced some beyond-belief episode of pain and misery. Mercifully, relief finally came. Your eye healed, the stone passed, the baby was born.

In each of these cases, pain flared up in response to a known cause. Doctors call that kind of pain ACUTE PAIN. It is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself.

ACUTE PHASE or STAGE

Typically what is described as the First Stage of RSD/CRPS.

Stage one is called the acute stage and can last one to three months.

Some characteristics are warmth, coolness, burning pain, edema, increased sensitivity to touch, increased pain, accelerated hair/nail growth, tenderness or stiffness in the joint, spasms, limited mobility, some bony changes may be visible on X-Ray, abnormal amount of pain for the injury. In this stage there is decreased sympathetic activity. For the patient, she, typically a she, may feel as if their limb is on fire and is amazed when it actually feels cool to the touch (this is due to the lack of blood flow to the extremities).

ACUTE URINARY RETENTION

Inability to squeeze any urine past the enlarged prostate because the bladder has become over-distended and its muscular wall has weakened; usually requires temporary passage of a catheter.

note - You do not have to have a prostate to have acute urinary retention.

ADDICTION

Characterized by loss of control over opioid use and continued use of despite negative consequences; typically a psychiatric diagnosis. Is also used to refer to alcohol, many other drugs, habits, etc.

This is very different from "Dependence" and "Tolerance".

People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, the chance of addiction is very small when narcotics are used under proper medical supervision.

Some medications used to treat pain can be addictive. Addiction is different from physical dependence or tolerance, however. In cases of physical dependence, withdrawal symptoms occur when a substance suddenly is stopped. Tolerance occurs when the initial dose of a substance loses its effectiveness over time. Addiction and physical dependence often occur together.

See additional terms in this section; Tolerance, Dependence.

AEROBIC EXERCISE

Activity that requires increased oxygen intake, such as brisk walking, running, or cycling.

ALENDRONATE

A drug that slows bone resorption. As Fosamax, has FDA approval for postmenopausal women with bone loss or osteoporotic fractures and for prevention of osteoporosis.

ALLODYNIA

Extreme pain is produced by stimuli that do not normally induce pain (such as touch, pressure, warmth). This hypersensitivity is a large part of the RSD equation and explains why something as simple as the touch of clothing, sheets, a breeze, or the light touch of another person, can cause extreme pain.

The term allodynia was originally introduced to separate from hyperalgesia and hyperesthesia, the conditions seen in patients with lesions of the nervous system where touch, light pressure, or moderate cold or warmth evoke pain when applied to apparently normal skin.

AMYGDALA

A part of the brain’s limbic system involved in memory and emotion.

ANALGESIA

Absence of pain in response to stimulation which would normally be painful. As with allodynia, the stimulus is defined by its usual subjective effects.

ANAPHYLACTIC SHOCK

An allergic reaction marked by contraction of smooth muscle and dilation of blood vessels. If not checked rapidly by an injection of epinephrine, the reaction can be lethal.

ANESTHESIA DOLOROSA

Pain in an area or region which is anesthetic.

ANGINA

Chest pain that occurs when the heart does not get enough blood from the coronary arteries.

ANKYLOSING SPONDYLITIS

An inflammatory disease of the spine, causing pain and often leading to painful alterations of the vertebral articulations, as well as stiffness of the spine.

ANTI-INFLAMMATORY

Agents that reduce inflammation without directly antagonizing the agent that caused it.

ANTIDEPRESSANTS

Pharmaceutical agents used to treat clinical depression. See our RSD TREATMENTS section for more information.

ANTIOXIDANTS

Vitamins such as C and E that inhibit oxygen-based free radicals.

ANXIETY DISORDERS

Also known as anxiety neurosis or anxiety reaction. A condition that can be caused by both psychologic and physiologic factors. It can take two general forms: (1) acute anxiety (panic disorder), marked by repeated occurrences of intense self-limited anxiety lasting usually a few minutes to an hour, or (2) chronic anxiety, characterized by less intense reactions of much longer duration (days, weeks, or months).

ATROPHY

A wasting of a normal developed organ or tissue due to degeneration of cells. This may be due to disease, aging or undernutrition.

AUTOIMMUNE DISEASE

Disorders in which the body mounts a destructive immune response against its own tissues.

AUTONOMIC NERVOUS SYSTEM

The part of the nervous system responsible for the control of bodily functions that are not consciously directed; including heart beat, intestinal movements, sweating, etc.

AXON

The part of the neuron that transmits a signal to the next cell.

BASIL GANGLIA

Clusters of neurons deep in the brain that play an important role in movement.

BI-POLAR DISORDER

A mood disorder that commonly begins with depression and is characterized by at least one period of elation sometime during the course of the illness.

BONE SCAN OR BONE DENSITY SCAN

A test, also called Tri-Phasic Bone Scan, sometimes used to check for the presence of damage caused by RSDS/CRPS to the bones. It will usually show an increased uptake but not always.

As with many other tests used for RSDS, it should not be used as a sole diagnostic tool as it CAN show the presence of RSDS but doesn‘t ALWAYS detect it, depending on the stage the patient is in, other medical issues going on with the patient etc..

It is best used as a baseline from which the Dr can compare future bone scans to to determine progress of bone/density loss.

It is not an easy diagnosis, it cannot be arrived at easily. It should not be able to be dismissed so easily either.

SEE ALSO THREE- PHASE OR TRI-PHASIC BONE SCAN

For more information on Bone Scans you can also surf to the WebMD site; BONE SCAN  

BRAIN STEM

The brain structure that is the major communication route between the brain, spinal cord, and peripheral nerves’ controls heart rate, breathing and other vital functions.

CALCIUM CHANNEL BLOCKER

Drugs that dilate the coronary arteries and increase blood flow through the coronary arteries; useful for angina and blood-pressure reduction.

CASE CONTROL STUDY

An epidemiologic study that examines selected patients who have a defined disease (cases) with persons without the disease (controls).

CASE DEFINITION

In the example of RSDS, a combination of symptoms, signs, and physiologic characteristics that serve to distinguish a case of RSDS from other disease states.

CAT SCAN - COMPUTERIZED TOMOGRAPHY (CT)

A diagnostic technique in which x-rays are taken in many different directions, and the resulting data are synthesized by a computer to generate cross-sectional and other images of the body.

CATHETER

A hollow, flexible tube that is used to add or remove fluid from the body; commonly inserted into the bladder through the urethra to empty urine after surgery.

CAUDA EQUINA

The bundle of nerve roots in the lumbar spine that come from the end of the spinal cord and proceed to the lower part of the trunk and the lower extremities.

CAUSALGIA

Severe burning pain, sometimes divided into major and minor CAUSALGIA. Latin for "Burning Pain", first name for RSD, coined by Dr Weir Mitchell. (see "Description of RSDS" on main page)

Now called CRPS Type II

CFIDS

Chronic Fatigue and Immune Dysfunction Syndrome - A synonym for chronic fatigue syndrome used by some patients and physicians. It should be stressed, however, that no immune dysfunction or aberration has been persuasively linked to chronic fatigue syndrome.

CHIROPRACTOR

A practitioner who treats disease by manipulation and by adjustment of body structures, most notably the spine.

CHRONIC

Of long duration, denoting a disease of slow progress and long continuance.(sometimes with chronic conditions, physicians consider if they last longer than 6 mo. they are chronic, rather than ‘acute‘)

CHRONIC FATIGUE & IMMUNE DYSFUNCTION SYNDROME

A synonym for chronic fatigue syndrome used by some patients and physicians. It should be stressed, however, that no immune dysfunction or aberration has been persuasively linked to chronic fatigue syndrome.

CHRONIC PAIN

Chronic pain is different. Chronic pain persists. Fiendishly, uselessly, pain signals keep firing the nervous systems for weeks, months, even years. There may have been an initial mishap- a sprained back, a serious infection, from which you‘ve long since recovered.

There may be an ongoing cause for the pain- arthritis, cancer, ear infection. This kind of pain is called CHRONIC BENIGN PAIN or CHRONIC NON-MALIGNANT PAIN. But some people suffer chronic pain in absence of any past injury or evidence of body damage. This kind of pain is called CHRONIC MALIGNANT PAIN. Whatever the cause may be, chronic pain is REAL, UNREMITTING, AND DEMORALIZING.

COMPRESSION FRACTURE

The collapse of a bone, most often a vertebra.

CONNECTIVE TISSUE

The supporting tissues of the body, such as tendons, ligaments, bone, and cartilage.

CONNECTIVE TISSUE DISORDER

A variety of inflammatory diseases of connective tissue, the most common of which is rheumatoid arthritis. Much, if not all, of this disease is now attributed to autoimmune processes.

CONTROL

A device used to verify or regulate a scientific experiment or study. A case-control study serves as a useful example. Since patients with a specific illness are examined for various characteristics, a group of healthy individuals who otherwise have as much in common with the patients as possible must be examined in parallel for the same characteristics.

CROHN'S DISEASE

A chronic inflammatory condition of the small or large intestine; associated with abdominal pain, diarrhea, fever, and weight loss.

CYANOTIC

A blue or dusky color due to decreased oxygen in blood or decreased bloodflow.

DEGENERATIVE SPONDYLOLISTHESIS

Spondylolisthesis caused by erosion of the facet joints over time.

DEPENDENCE

There's an important difference between opioid dependence and opioid addiction. Anyone who takes opioid drugs for more than a few weeks will develop tolerance and some physical dependence on the drug. Usually, these people are on stable, generally lower doses of medication. If they stop suddenly, they have withdrawal symptoms (usually mild). The symptoms go away, the person is "detoxed," and they go on with life. They don't seek further chances to use the drug.

People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, the chance of addiction is very small when narcotics are used under proper medical supervision.

See additional terms in this section; Addiction, Tolerance.

DEPRESSION

A neurotic or psychotic condition marked by an inability to concentrate, insomnia, and feelings of dejection and guilt. Most RSD patients have depression as a result of the changes in the limbic system from the RSD. Some Psychiatrists have it backwards and think the depression comes first.

DIASTOLIC BLOOD PRESSURE

The lower of two numbers in a blood-pressure reading and a reflection of pressure in the arteries when the heart is relaxed.

DISKECTOMY

The surgical removal of all or part of an intervertebral disk.

DISKITIS

Inflammation of an intervertebral disk.

DOPAMINE

A neurotransmitter that enables people to move normally and smoothly; made by special cells in the substantia nigra and stored in the caudate nucleus and the putamen.

Dopamine stimulates the heart and increases blood flow to the organs.

DOPAMINE AGONIST

A drug that tricks the brain into thinking it has more dopamine than it really does.

DOPAMINE PRECURSOR

An amino acid that the brain transforms into dopamine.

DOUBLE-BLIND STUDY

A RESEARCH TOOL WHEN STUDYING NEW TREATMENTS/DRUGS. DOUBLE BLIND MEANS THAT NEITHER THE DR. NOR THE PATIENT KNOWS WHO IS GETTING A PLACEBO AND WHO IS GETTING THE REAL THING. ACCORDING TO DR. SNYDER IF ANYONE TELLS YOU ABOUT A NEW "MIRACLE CURE" FOR RSD, ASK THEM TO SEND YOU THE RESULTS OF THEIR DOUBLE BLIND STUDY. IF INSTEAD THEY SIMPLY SEND YOU PATIENT REMARKS, THEN ASK WHY.

DRY EYE

An irritating syndrome usually caused by a decrease in tear production.

A very common symptom of RSD patients along with dry mouth.

DYSESTHESIA

An unpleasant abnormal sensation, whether spontaneous or evoked. Special cases of dysesthesia include hyperalgesia and allodynia. A dysesthesia should always be unpleasant and a paresthesia should not be unpleasant. It should always be specified whether the sensations are spontaneous or evoked.

DYSPEPSIA

A condition equivalent to indigestion; characterized by upper abdominal pain following meals that may be accompanied by bloating, nausea, vomiting, a sense of fullness, and general discomfort.

DYSTROPHY

Progressive deterioration.

EDEMA

Fluid build-up in the body‘s tissue.

ELECTROCARDIOGRAM

A graphic record of the electrical activity within the heart that is responsible for its contraction and relaxation.

EMG

A series of diagnostic procedures in which electrical activity in muscles is measured to determine whether the nerve pathway from the spine is intact.

How is it performed?

For an EMG, a needle electrode is inserted through the skin into the muscle. The electrical activity detected by this electrode is displayed on an oscilloscope, and may be heard through a speaker.

After placement of the electrodes, you may be asked to contract the muscle (for example, by bending your arm). The presence, size, and shape of the wave form -- the action potential -- produced on the oscilloscope provide information about the ability of the muscle to respond when the nerves are stimulated.

Is it painful?

Speaking from personal experience and as someone who has talked to thousands of other RSD patients who have undergone this procedure? Yes.

For a typical RSD patient? When they perform it in the RSD-affected area, yes. If you have full body or systemic RSD it can be very painful especially if your RSD is in flare. This isn't said to scare you but to prepare you.

You must prepare yourself ahead of time. Take whatever medications you are due to take. If you practice relaxation techniques, do that, most of all, if while the test is being performed it causes undue pain STOP IT!

Ultimately it is your body. Do not subject yourself to more pain. The test is trying to determine if your nerve pathways are intact. If you have RSD those nerve pathways are damaged and/or hyperactive and so sending electricity through them can cause them to react in more pain.

ENDORPHINES

Natural morphine-like substances produced in the body.

EPINEPHRINE

A chemical that can act as either a neurotransmitter or a hormone; it constricts blood vessels and increases heart rate; also called adrenaline.

ETIOLOGY

History or cause of the disease in question.

FACET JOINTS

The superior and inferior paired joints located on the back side of each vertebra and connecting its posterior elements to those of the vertebrae above and below.

Sometimes this is an area used for an injection for pain.

FIBROMYALGIA

Also known as myofascial pain syndrome and fibromyositis. A group of common rheumatoid disorders (not involving the joints) characterized by achy pain, tenderness, and stiffness of muscles.Also involving very painful tender spots, notably by the shoulder, knee, ankle, etc.

SEE OUR SECTION DEVOTED TO THIS TOPIC BY CLICKIN ON THE LINK BELOW

CLICK HERE TO VISIT OUR FIBROMYALGIA PAGE

FIBROSIS

Thickening and scarring of connective tissue

FLOATERS

Tiny clusters of protein or cells that drift through the vitreous humor and appear as black specks across the visual field; most commonly benign, but may precede retinal complications.

FLUOROSCOPY

A diagnostic procedure in which x-rays that have passed through the body are projected onto a screen, providing a continuous image of the body‘s internal structures.

GASTROESOPPHAGEAL REFLUX DISEASE (GERD)

A condition in which food and acid flow back into the esophagus from the stomach, often causing heartburn and sometimes damaging the esophagus.

HEART FAILURE

A condition in which the heart loses its ability to efficiently pump blood throughout the body.

HERNIATED DISK

Displacement of some portion of the disk out of its normal location.

HIPPOCAMPUS

The part of the brain’s limbic system that is involved in learning, memory, and emotion.

HYPER DIFFERENCES

The implications of some of the above definitions may be summarized for convenience as follows;

Allodynia: lowered threshold: stimulus and response mode differ

Hyperalgesia: increased response: stimulus and response mode are the same

Hyperpathia: raised threshold: stimulus and response mode may be the increased response: same or different

Hypoalgesia: raised threshold: stimulus and response mode are the same lowered response.

HYPERESTHESIA

Increased sensitivity to stimulation, excluding the special senses. Hyperesthesia may refer to various modes of cutaneous sensibility including touch and thermal sensation without pain, as well as to pain. The word is used to indicate both diminished threshold to any stimulus and an increased response to stimuli that are normally recognized.

(note) Allodynia is suggested for pain after stimulation which is not normally painful. Hyperesthesia includes both allodynia and hyperalges

HYPERHYDROSIS

Excessive sweating.

HYPERPATHIA

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

HYPNOSIS

The use of Hypnosis in the treatment of CRPS is somewhat controversial and has had mixed results. Some of this stems from the fact that CRPS patients are wary of any treatment that might possibly insinuate the pain is in your head and that reported positive results have been few and far between. Because of the recent work by Dr Flemming though, some of these ideas need to be re-considered. He has had some very positive results but cautions that if done incorrectly, it can cause more harm than good.

For more information on the discussions we had, click on the link below;

HYPNOSIS DISCUSSION

IATROGENIC

Related to an abnormal state or condition produced in a patient through inadvertant or erroneous treatment.

IBD - IBS - INFLAMMATORY BOWEL DISEASE

A generic term for ulcerative colitis and Crohn’s disease.

IDIOPATHIC

Without a known cause.

IMAGING TESTS

Any of a variety of methods for observing the internal anatomy of the body, ranging from simple x-rays to complex three-dimensional scanning techniques using nuclear magnetic resonance, positron emission, and other techniques.

IMMUNE SUPPRESSANTS

Agents that block or restrict the activity of one or more components of the immune system, usually leading to increased susceptibility to infectious disease.

IMP or INDEPENDENTLY MEDIATED PAIN

Independently Mediated (Maintained) Pain, sometimes called SIP, or Sympathetically Independent Pain.

As RSDS progresses, more and more of the pain becomes Independently mediated, that is, it becomes centered or generated in the brain.

This explains why localized pain reduction techniques (i.e. sympathetic blocks, creams etc.) no longer work after the first few months of onset of RSDS.

See SMP, Sympathetically Mediated Pain, for reference.

Also see "SMP AND IMP, WHAT IS THE DIFFERENCE?" SMP AND IMP WHAT IS THE DIFFERENCE

INFLAMMATORY RESPONSE/FLARE RESPONSE

Irritation of the involved extremity, which may include localized heat, swelling, redness, pain, and limited movement.

INSOMNIA

Inability to sleep even in the absence of external impediments, during the period when sleep should normally occur.

INTERVERTABRAL DISK

One of the small, energy-absorbing cushions located between the vertebrae of the spine.

INTERVERTEBRAL FORAMEN

One of the two narrow spaces between adjacent vertebrae (one on each side), through which nerve roots pass.

INTRACTABLE

resistant to treatment.

IRRITABLE BOWEL SYNDROME - IBS

IBS - A functional disorder that typically involves a range of symptoms that include intermittent abdominal pain and bloating accompanied by diarrhea, constipation, or alternating episodes of both.

LABILE HYPERTENSION

Blood pressure that fluctuates far beyond what is normal.

LAMINA

One of the two thin, platelike parts of each vertebra that join in the midline and form the base of the spinous process of that vertebra.

LAMINECTOMY

An operation in which all or a portion of one or both laminae is removed to gain access to the spinal canal or to decompress the spinal cord and nerve roots.

LIMBIC SYSTEM

An area of the brain containing the amygdala, the hippocampus, and the basal ganglia; involved in emotion, memory, and certain aspects of movement.

This is an area that is specifically affected by RSD. RSD causes changes in the limbic system that results in problems with short-term memory and concentration as well as feelings of irritation and frustration on the part of the patient, among other things.

LUMBAR PUNCTURE

A procedure in which a hollow needle is inserted into the lower part of the spinal canal to withdraw fluid for testing.

LUMBAR SPINE

The five lowermost mobile vertebrae of the spine.

LUMBAR STENOSIS

Spinal stenosis in the lumbar area.

LYME DISEASE

A tick-transmitted inflammatory disorder that begins with a characteristic skin rash, and may be followed weeks to months later by neurologic, cardiac, or joint abnormalities.

LYMPH NODES

Secondary immune organs distributed at discrete locations throughout the body. These organs play a central role in the activation and trafficking of immune lymphocytes in the body.

MALAISE

A feeling of general discomfort or uneasiness, an out-of-sorts feeling, often the first indication of an infection or other disease.

MRI - MAGNETIC RESONANCE IMAGINING

A diagnostic technique in which radio waves generated in a strong magnetic field are used to provide information about the hydrogen atoms in different tissues within the body; a computer uses this information to produce images of the tissues in many different planes.

MULTIPLE SCLEROSIS

A slowly progressive central nervous system disease characterized by disseminated patches of demyelination in the brain and spinal cord.

MYELOGRAPHY

A diagnostic technique in which x-rays are taken of the spine after a contrast medium has been injected into the space within the sheath that surrounds the spinal cord and the cauda equina, enabling a radiologist to see distortions in the shape of the space (produced by a herniated disk, a tumor, a fracture, spinal stenosis, or the like).

NARCOLEPSY

A sudden, uncontrollable disposition to sleep occurring at irregular intervals, with or without obvious predisposing or exciting cause.

NARCOTICS

This is a very controversial topic. There are two different groups of Narcotics; the first are Morphine Agonists (such as Morphine and Demoral) and the second are Morphine Antagonists (such as Stadol and Ultram). The controversy surrounds which are better for treating RSD-type pain and which are detrimental. However, many patients could not survive a day without the strength of these Class IV Type Medications, they are literally life savers for a great many patients.

There are some issues surrounding Addiction, Tolerance, and Dependence. For more information regarding these topics, look for them in this section.

NERVE CONDUCTION STUDY

See EMG

NEURALGIA

Pain in the distribution of a nerve or nerves.

NEURITIS

Inflammation of a nerve or nerves.

NEUROLOGIST

A medical doctor trained to diagnose and treat disorders of the brain and other aspects of the nervous system.

NEUROPATHY

A disturbance of function or pathological change in a nerve: in one nerve, mononeuropathy; in several nerves, mononeuropathy multiplex; if diffuse and bilateral, polyneuropathy.

NEUROTRANSMITTER

A chemical released by neurons at a synapse to transmit information to other nerve cells.

NEUROVASCULAR

The effect nerves have on vessel function and the supply of blood to the tissues of the upper extremities.

NOREPINEPHRINE

A neurotransmitter that constricts blood vessels; its release is stimulated by the sympathetic nervous system.

OBSTRUCTIVE SLEEP APNEA

A disorder characterized by heavy snoring and interrupted breathing during sleep; often associated with obesity; a risk factor for stroke.

OCCIPETAL LOBE

One of the four major subdivisions of the two hemisphere of the cerebral cortex; plays a role in visual perception.

OCCIPETAL NERVE BLOCK

An injection of medication, usually Marcaine or Lidocaine, into the occipetal nerve, right at the back of the head. This procedure, while painful, is a huge help for those who suffer from migraines.

OPIOID INTOXICATION

When an individual uses a sufficient amount of an opioid, they will get "high" from the drug. Some people, however, have negative experiences when they use an opioid. When too much of an opioid is taken, an individual can overdose.

OPIOIDS

"Opioids are a class of drugs that include both natural and synthetic substances. The natural opioids (referred to as opiates) include opium and morphine. Heroin, the most abused opioid, is synthesized from opium. Other synthetics (only made in laboratories) and commonly prescribed for pain, such as cough suppressants, or as anti-diarrhea agents, include codeine, oxycodone (OxyContin), meperidine (Demerol), fentanyl (Sublimaze), hydromorphone (Dilaudid), methadone, and propoxyphene (Darvon). Heroin is usually injected, either intravenously (into a vein) or subcutaneously (under the skin), but can be smoked or used intranasally (i.e., "snorted"). Other opioids are either injected or taken orally." (from www.minddisorders.com )

There are some issues surrounding Addiction, Tolerance, and Dependence. For more information regarding these topics, look for them in this section.

OSTEOPATH

A doctor who has training analogous to that of an M.D. and may use medicine and surgery in addition to manipulation therapy to treat disease.

OSTEOPHYTE

A bony outgrowth, or spur, on the margin of a joint or intervertebral disk.

OSTEOPOROSIS

A degenerative disease that decreases the density of bone, leaving it vulnerable to fracture.

OSTEOPOROSIS TYPE 1

Primary osteoporosis in which bone loss is due to estrogen decline associated with menopause.

OSTEOPOROSIS TYPE 2

Primary osteoporosis where bone loss is due to aging.

OSTEOPOROSIS, SECONDARY

Bone loss associated with an identifiable medical condition, tratment with certain drugs, or immobility.

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 recognize.

PARASYMPATHETIC NERVOUS SYSTEM

One of two branches of the autonomic nervous system; it is involved in the regulation of digestion, circulation, voiding, and other bodily functions.

PATHOGENISIS

The mode of origin of any tissues.

PATHOPHYSIOLOGY

Derangement of function seen in disease.

PERCUTANEOUS DISKECTOMY

the removal of part of an intervertebral disk by means of a narrow probe inserted through the skin and muscle of the back.

PERIPHERY

The part of the body away from the center

PHYSIATRIST

A medical doctor trained as a rehabilitation specialist.

PLACEBO

a. Medicine. A substance containing no medication and prescribed or given to reinforce a patient‘s expectation to get well. b. An inactive substance or preparation used as a control in an experiment or test to determine the effectiveness of a medicinal drug.

PLACEBO EFFECT

Improvement in one‘s condition that occurs as the result of having been treated but cannot be attributed to the treatment used.

POSTMENOPAUSAL OSTEOPOROSIS

Bone loss resulting from the deficiency of estrogen associated with menopause; sometimes called Type 1 osteoporosis.

PRIMARY OSTEOPOROSIS

Bone loss that doesn’t result from an identifiable pathological process.

PROCESS

Any one of several bony projections from each vertebra, some of which mesh with similar structures on the vertebrae immediately above and below.

QUANTATIVE COMPUTED TOMOGRAPHY (QCT)

A modification of computed tomography that provides measurement of bone mass as well as an image.

RADIO FREQUENCY ABLATION - RFA

Radio Frequency Ablation is yet another name for sympathectomy, not recommend by most Doctors for treatment of CRPS. In this method the nerve is burned.

In one of his famous RSD "Puzzles" Doctor Hooshang Hooshmand wrote,

"RSD (CRPS) is not a surgical disease. The trauma of surgery only aggravates the condition.

The most traumatic of all invasive treatments is Radio frequency nerve ablation and block. It is done with a heat generating Radio frequency electrode causing a boiling hot temperature at the target area which coagulates, destroys and kills the nerve fibers and nerve cells.

Because the Radio frequency damage causes high temperature in the adjacent areas of the target, it also destroys the adjacent normal nerves causing a much larger lesion and scar formation with spread and aggravation of pain in a permanent fashion. "

You can read more by going to EMG? MRI? RFS? GOOD OR BAD? or read about SYMPATHECTOMIES by going scrolling down in this MEDICAL TERMS section.

RAYNAUDS PHENOMENON

Spasm of the arteries of the toes or fingers with paleness and numbness of the fingers

RECEPTORS

Structures on the outside of a cell membrane that permit attachment of specific chemicals.

REFLEX

An involuntary response to a stimulus by the nervous system affecting muscle, bone, vessels, skin, and so forth.

RHEUMATOLOGIST

A medical doctor trained to diagnose and treat disorders of the joints and other parts of the musculoskeletal system.

RHIZOTOMY

Surgical destruction of nerve roots and also of nerves (such as those around intervertebral joints) in order to relieve pain. Another version of a sympathectomy.

SCIATICA

Pain along the course of the sciatic nerve (from the buttock, down the back and side of the leg, and into the foot and toes), often due to a herniated disk.

SCOLIOSIS

An abnormal lateral curvature of the spine.

SLEEP APNEA

A group of potentially lethal disorders in which breathing recurrently stops during sleep for long enough to cause measurable blood deoxygenation.

SMP or SYMPATHETICALLY MAINTAINED PAIN

SMP makes up the majority of the pain in the beginning of the RSDS.

This type of pain is very responsive to local pain reduction efforts, most notably sympathetic nerve blocks.

As your RSD progresses, the SMP is gradually replaced by IMP or independently Mediated/Maintained Pain, that is brain-centered/generated.

This is why blocks usually work best in the early stages of RSD. Once your pain becomes IMP it is much harder to affect/reduce it.

Also see "SMP AND IMP, WHAT IS THE DIFFERENCE?" SMP AND IMP WHAT IS THE DIFFERENCE

SNS OR SYMPATHETIC NERVOUS SYSTEM

One half of the Autonomic Nervous System, Involuntary control over sympathetic functions like vasoconstriction of blood vessels of the skin, and so forth,

ALSO one of two divisions of the autonomic nervous system (the other is the parasympathetic) having fibers leaving the central nervous system via a chain of ganglia close to the spinal cord.

SPINAL FUSION

Joining two or more vertebrae with a bone graft in order to eliminate motion and relieve pain.

SPINAL STENOSIS

A reduction in the size of the spinal canal, which may result in compression of the spinal cord or nerve roots.

SPINAL TAP

See lumbar puncture.

SPONDYLOLISTHESIS

Forward displacement of a vertebra in relation to the vertebra immediately below.

SPREADING OF RSD

According to a national study done on 809 RSD Patients, it was found that RSD spreads in 75-80% of cases, with only 8% of these cases becomming full body or systemic. Most spreading wrist to hand, hand to shoulder,foot to knee for instance, and in some cases to opposite limbs. In rarer cases to eyes, ears, etc.

RSD can spread in any stage and of course you can have symptoms from more than one stage at one time.

For much more on spreading of RSD see our whole section on it, the big blue button" DOES RSD SPREAD

SUBACUTE

A zone between acute and chronic, denoting the course of a disease.

SUBSTANCE P

An undecapeptide present in the intestine where it induces contraction of the intestine and dilation of blood vessels; it is also present in a number of neuronal pathways in the brain and in primary sensory fibers of peripheral nerves, and may be a neurotransmitter associated with transmissions of pain impulses.

SYMPATHETIC NERVOUS SYSTEM

One of two divisions of the autonomic nervous system; it prepares the body for action by raising blood pressure and elevating heart and breathing rate.

SYNAPSE

The tiny gap between an axon terminal that sends a chemical signal and the neuron that receives it.

SYNDROME

A collection of signs and symptoms that together create a distinct picture for the Health Professional to help define a particular disorder.

The higher of two numbers in a blood-pressure reading and a reflection of pressure in the arteries when the heart contracts.

TEMPORAL LOBE

One of the four major subdivisions of the two hemispheres of the cerebral cortex; plays a role in hearing, long-term memory, and behavior.

TENS - TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION

Use of low-voltage electrical current to provide pain-suppressing stimulation. Normally only effective for RSD patients early on in the disease when most of their pain is Sympathetically-mediated.

THERMAL PARATHESIA

Transitory, unpleasant sensations of heat or cold in certain body regions.

THERMOGRAPHY

A test designed to determine heat differences between different parts of the body, (i.e. comparing the temperature difference between two feet). Sometimes used to confirm diagnosis of RSDS but results are dubious if more than one extremity is involved, i.e. both feet or both hands.

This test can provide useful information but should NOT be used as a litmus test for RSDS since only in certain Stages of this disease there may be no significant showing on a thermogram. Best used as a test to determine progression of RSD over time.

THYROID

A two-lobed structure located in front of and on either side of the trachea, producing the hormone thryoxin; of or relating to the thyroid gland.

OPIOD TOLERANCE

A reduction in response to a given dose of drug after repeated administration. This is very different from "addiction" and "dependence".

People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, the chance of addiction is very small when narcotics are used under proper medical supervision.

Some medications used to treat pain can be addictive. Addiction is different from physical dependence or tolerance, however. In cases of physical dependence, withdrawal symptoms occur when a substance suddenly is stopped. Tolerance occurs when the initial dose of a substance loses its effectiveness over time. Addiction and physical dependence often occur together.

See additional terms in this section; Addiction, Dependence.

TRANS ISCHEMIC ATTACKS, TIA

A TIA is when the nerves clamp down on the veins and shut off the blood flow to the heart, brain and anything else it feels like doing.

TRANSVERSE PROCESS

The winglike projection on each side of a vertebra, to which muscles and ligaments are attached and, in the chest area, the ribs are connected.

TRI-PHASIC BONE SCAN - THREE PHASE BONE SCAN

BONE SCAN

Here is some information I put together regarding tri-phasic, or three-phase, bone scans and related information in response to some questions posted in one of our forums. Remember, we are not medicl professionals but simply fellow patients and loved ones. Never start, stop, or change what you are doing with your Doctor based on what you read on the internet but rather, share what you learn with your Doctor and together formulate the best plan possible for your current and future care.

What is a bone scan and can it be used to diagnose RSD/CRPS?

First, we should define what a bone scan is.

A bone scan is a nuclear scanning test that identifies new areas of bone growth or breakdown. It can be done to evaluate damage to the bones, detect cancer that has spread (metastasized) to the bones, and monitor conditions that can affect the bones (including infection and trauma). A bone scan can often detect a problem days to months earlier than a regular X-ray test.

For a bone scan, typically, a radioactive tracer substance is injected into a vein in the arm. The tracer then travels through the bloodstream and into the bones. Areas that absorb little or no amount of tracer appear as dark or "cold" spots, which may indicate a lack of blood supply to the bone (bone infarction) or the presence of certain types of cancer. Areas of rapid bone growth or repair absorb increased amounts of the tracer and show up as bright or "hot" spots in the pictures. Hot spots may indicate the presence of a tumor, a fracture, or an infection.

A bone scan may be done on the entire body or just a part of it. (WebMD)

Second, we have to differentiate between bone scans and x-rays and their use, from a practical sense, concerning RSD patients.

Do X-rays have a use in diagnosing RSD patients? Different Doctors will have different answers here. X-rays CAN show patchy thinning, or osteoporosis, in some patients. This is not always indicative of RSD of course and if a patient is believed to have RSD the appearance of osteoporosis on x-rays is not always a confirmation but it is an indicator. An x-ray is not something that is typically used to diagnose RSD, but it can be one of many pieces of information gathered. Typically Doctors prefer the more informative bone scan.

Is a bone-scan a way to diagnose RSD?

Some Doctors will use this method to diagnose RSD but according to a study done a number of years ago by Doctors Lee and Weeks in the Journal of Hand Surgery, it is only accurate in diagnosing RSD 55% of the time! You can find links below to a number of articles where the number quoted is even lower and/or where Doctors do not recommend the use of tri-phasic bone scans to rule in/out RSDS/CRPS because of the inaccuracy of the method.

Yet there are still Doctors who use this test as a way to rule in or out an RSD diagnosis. As Doctor Hooshang Hooshmand once noted, "If I have a heart attack and they tell me that they are going to do a test that has 55% chance of diagnosing my heart attack, obviously I'm not going to consent to such a test."

There are many reasons why bone scans are not accurate, from the spreading of RSD to the changes in bone circulation that take place during the different stages of RSD, and diseases that mimic RSD like arthritis.

Now bone scans can be helpful in ruling out some things when considering the diagnosis of RSD; things like stress fractures. The tri-phasic bone scan in particular;

TRICYCLIC ANTI-DEPRESSANTS

A mood-lifting drug that has anticholinergic effects.

TRIGEMINAL NEURALGIA

Trigeminal neuralgia (TN -- tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed - lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.

Information courtesy of the Trigeminal Neuralgia Association. Please visit their website for a boatload of information on this very painful condition.

Trigeminal Neuralgia Association  

TRIGGER POINT

A painful area that, when stimulated, also elicits pain elsewhere in the body--such as in the hip, the leg, or another area of the back.

Also used in the term "trigger-point injection".

TROPIC

Resulting from interruption of nerve supply

TRYPTOPHAN

Amino acid found in fresh foods, particularly foods low in animal fat, caffeine, chemical preservatives, and sugar. Foods rich in Tryptophan have been found to be helpful to people in Chronic Pain.

TYROSINE

Amino acid found in high amounts in the typical American diet. It is a precursor to adrenaline, which is a strong sympathetic stimulant. Foods rich in Tyrosine should be limited, especially in Chronic Pain patients.

ULTRASOUND

A noninvasive imaging method that uses high-frequency sound waves to view blood vessels and measure how fast blood is flowing through them.

VASCULARITY

Relating to blood vessels.

VASOCONSTRICTION

Narrowing of blood vessels.

VASOCONSTRICTOR

A substance that constricts blood vessels.

VASODILATION

Widening of the blood vessels.

VASODILATOR

A drug that relaxes the muscle in the walls of the blood vessels, allowing the vessels to dilate or widen.

VASOMOTOR

Causing widening or narrowing of blood vessels, denoting the nerves which have this action.

VASOSPASM

Contraction of the muscle coats of blood vessels.

OPIOID WITHDRAWAL

Tolerance to opioids occurs quickly. Regular users of opioids take doses that would kill someone who has never used before. After regular use, the human body adapts to the regular presence of the drug and the person only feels "normal" when they have opioids in their system. Therefore, when an opioid-dependent individual stops using opioids abruptly, he or she will experience withdrawal symptoms.

Acute withdrawal typically lasts no more than seven to ten days, but some symptoms of withdrawal (such as craving, insomnia, anxiety, lack of interest) can last six months or longer. Although withdrawal is very uncomfortable, it is not life-threatening unless there is an underlying medical condition, such as heart disease. In addition to physical withdrawal, "psychological withdrawal" often occurs. The individual who is dependent on opioids has difficulty imagining living without the drug, since they were dependent on it to function. This is similar to how someone addicted to nicotine may feel after giving up cigarettes.

from www.minddisorders.com