GLOSSARY

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Advance Medical Directives
Advance directives are used to give other people, including health care providers, information about your wishes for medical care. Advance directives are important in case there is ever a time when you are not physically or mentally able to speak for yourself and make your wishes known. The most common types of advance directives are the living will and the durable power of attorney for health care.

Allodynia
When pain is caused by something that does not normally cause pain (such as clothing touching the skin).

Analgesic Medications
Medications used to prevent or treat pain.

Antidepressant
Medications used to treat depression, and also used to treat chronic pain. Antidepressants can also be helpful for pain-related symptoms, like sleep problems and muscle spasms.

Anxiolytic
Medications used to treat anxiety, and also used to treat chronic pain. Anxiolytics reduce pain-related anxiety, help relax muscles and can help a person cope with pain.

Bereavement
The act of grieving someone's death.

Caregiver
Any person who provides care for the physical and emotional needs of a family member or friend.

Causalgia (Complex Regional Pain Syndrome II)
Pain, usually burning, that is associated with autonomic changes -- change in color of the skin, change in temperature, change in sweating, swelling. Causalgia occurs after a nerve injury.

Central Nervous System
The brain and the spinal cord.

Clinical Trials
Carefully planned and monitored experiments to test a new drug or treatment.

Complementary Medicine
Approaches to medical treatment that are outside of mainstream medical training. Complementary medicine treatments used for pain include: acupuncture, low-level laser therapy, meditation, aroma therapy, Chinese medicine, dance therapy, music therapy, massage, herbalism, therapeutic touch, yoga, osteopathy, chiropractic treatments, naturopathy, and homeopathy.

Computed Tomography (CT/CAT) Scanning
A painless technique used to produce a picture of a cross-section, or "slice," of a part of the body. X-rays are used to produce this picture.

Constipation
Difficulty having a bowel movement.

Delirium
A disturbance of the brain function that causes confusion and changes in alertness, attention, thinking and reasoning, memory, emotions, sleeping patterns and coordination. These symptoms may start suddenly, are due to some type of medical problem, and they may get worse or better multiple times.

Do-Not-Resuscitate (DNR) Orders
Instructions written by a doctor telling other healthcare providers not to try to restart a patient's heart, using cardiopulmonary resuscitation (CPR) or other related treatments, if his/her heart stops beating. Usually, DNR orders are written after a discussion between a doctor and the patient and/or family members. DNR orders are written for people who are very unlikely to have a successful result from CPR -- those who are terminally ill or those who are elderly and frail.

Durable Power of Attorney for Health Care (DPOAHC)
A legal document that specifies one or more individuals (called a health care proxy) you would like to make medical decisions for you if you are unable to do so yourself.

Dyspnea
Difficulty in breathing.

End-of-Life Care
Doctors and caregivers provide care to patients approaching the end of life that is focused on comfort, respect for decisions, support for the family, and treatments to help psychological and spiritual concerns.

Entitlement
A federal program (such as Social Security or unemployment benefits) that guarantees a certain level of benefits to those who meet requirements set by law.

EPEC (Education for Physicians on End-of-Life Care)
A project designed to educate physicians across the United States about providing good end-of-life care for patients. EPEC includes a curriculum used to train doctors in clinical knowledge and skills they need to care for dying patients.

Ethics
A system of moral principles and rules that are used as standards for professional conduct. Many hospitals and other health care facilities have ethics committees that can help doctors, other healthcare providers, patients and family members in making difficult decisions regarding medical care.

Fatigue
A feeling of becoming tired easily, being unable to complete usual activity, feeling weak, and difficulty concentrating.

Fibromyalgia
A pain disorder in which a person feels widespread pain and stiffness in the muscles, fatigue, and other symptoms.

Hospice
A special way of caring for people with terminal illnesses and their families by meeting the patient’s physical, emotional, social, and spiritual needs, as well as the needs of the family. The goals of hospice are to keep the patient as comfortable as possible by relieving pain and other symptoms; to prepare for a death that follows the wishes and needs of the patient; and to reassure both the patient and family members by helping them to understand and manage what is happening.

Hospice Home Care
Most hospice patients receive care while living in their homes. Home hospice patients have family members or friends who provide most of their care, with help and support from the trained hospice team. The hospice team visits at the house to provide medical and nursing care, emotional support, counseling, information, instruction and practical help. A home care aide may also be available to help with daily care, if needed.

Hyperalgesia
Extreme sensitivity to pain.

Hyperpathia
An exaggerated response to something that causes pain, with continued pain after the cause of the pain is no longer present.

Informed Consent
The process of making decisions about medical care that are based on open, honest communication between the health care provider and the patient and/or the patient's family members.

Living Will
A legal document which outlines the kinds of medical care a patient wants and doesn't want. The living will is used only if the patient becomes unable to make decisions for him/herself.

Magnetic Resonance Imaging (MRI)
A painless technique that uses magnetic fields and radio waves (without radiation) to create clear cross-sectional pictures of the body.

Myofascial Pain
Muscle pain and tenderness.

Nerve Blocks
Injections of anesthetic (or numbing) substances into nerves in order to reduce pain.

Nutrition/Hydration
Intravenous (IV) fluid and nutritional supplements given to patients who are unable to eat or drink by mouth, or those who are dehydrated or malnourished.

Opioid
A type of medication related to opium. Opioids are strong analgesics. Opioids include morphine, codeine, and a large number of synthetic (man-made) drugs like methadone and fentanyl.

Pain
An unpleasant feeling that may or may not be related to an injury, illness, or other bodily trauma. Pain is complex and differs from person to person.

Acute Pain
Pain that has a known cause and occurs for a limited time. Acute pain usually responds to treatment with analgesic medications and treatment of the cause of the pain.

Chronic Pain
Pain that occurs for more than one month after healing of an injury, that occurs repeatedly over months, or is due to a lesion that is not expected to heal.

Pain Due to Nerve Injury
Pain caused by an injury or other problem in the nervous system.

Palliative Care
The total care of patients with progressive, incurable illness. In palliative care, the focus of care is on quality of life. Control of pain and other physical symptoms, and psychological, social and spiritual problems is considered most important.

Patient-Controlled Analgesia (PCA)
Pain medication given through an IV or epidural catheter. Patients control the dose of medication they take, depending on how much is needed to control the pain. PCA is usually used for patients recovering from intra-abdominal, major orthopedic, or thoracic surgery, and for chronic pain states, such as those due to cancer.

Peripheral Nervous System
The nerves throughout the body that send messages to the central nervous system.

Peripheral Neuropathy
Pain caused by an injury or other problem with the peripheral nervous system.

Phantom Pain
Pain that develops after an amputation. To the patient, the pain feels like it is coming from the missing body part.

Pharmacotherapy
The treatment of diseases and symptoms with medications.

Physician Assisted Suicide
Actions by a doctor that help a patient commit suicide. Though the doctor may provide medication, a prescription, or take other steps, the patient takes his/her own life (for instance, by swallowing the pills that are expected to bring about death).

Postherpetic Neuralgia (PHN)
Painful condition following shingles (herpes zoster).

Psychological Approaches
Techniques used to help patients cope with over their pain and deal with emotional factors that can increase pain. Such strategies include biofeedback, imagery, hypnosis, relaxation training, stress management, cognitive-behavioral therapy, and family counseling.

Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome I)
Pain, usually burning, that is associated with "autonomic changes" -- change in color of the skin, change in temperature, change in sweating, swelling. Reflex sympathetic dystrophy is caused by injury to bone, joint, or soft tissues.

Rehabilitation
Treatment for an injury, illness, or pain with the goal of restoring function.

Trigeminal Neuralgia
A disorder of the trigeminal nerve that causes brief attacks of severe pain in the lips, cheeks, gums, or chin on one side of the face.

Treatment Withdrawal
A syndrome that might occur when a medication that has been used regularly to treat pain is no longer used, or when the dose is decreased. Showing symptoms of withdrawal does not mean that a patient is addicted to his/her pain medication.

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