Anatomy Basics for Back Pain Back Pain or Dorsopathy Basics Back Pain Signs & Symptoms
Medical Advice in Back Pain Back Pain Risk Factors Back Pain Common Causes
Medical Causes Rare Medical Causes Back Pain Complications
Screening and Diagnosis Self-Care and Treatment Medications and Therapies
Chronic Back Pain Treatments Surgery and Other Treatments Complementary and Alternative Therapies
Back Pain Prevention Statistics for Back Pain Glossary of Terms

Glossary of Terms

Either following definitions are used within this book, or are relevant or related to topics covered in this book:

Antibodies: are special proteins, produced by B-Lymphocytes that circulate in blood and react with toxins, bacteria, and some cancer cells. These antibodies act like biological guided missiles that seek out cells with a particular antigen on their surface. The body can then identify and remove these unwanted invaders.

Antigens: proteins that are located on surface of all cells, which help our Immune System identify invading organisms and abnormal or cancerous cells from normal healthy.

Arthritis: is a disease that causes pain, stiffness, inflammation, and damage to joint cartilage. When Arthritis causes damage to joint cartilage, then joint weakness, instability, and deformities can result which interfere with even the most basic daily tasks, such as walking, driving a car, and preparing food. Arthritis is often referred to as a single disease, but it is a term that is used to describe more than 100 medical conditions that affect joints where two or more bones meet. A widely held belief is that Arthritis is a natural or normal occurrence as a person ages. That is, Arthritis is a normal consequence of growing old. However, Arthritis is not a natural part of ageing at all. In addition, approximately 60 percent of all people suffering from Arthritis are younger than retirement age.

Autonomic Nervous System (ANS): is part of the Peripheral Nervous System (PNS) that is not under conscious control, and consists of three nervous subsystems which together are responsible for homeostasis of organs, digestion, energy conservation, energy expenditure, 'fight or flight' response, and basic physiological functions necessary to support life.

These three subsystems include: the Sympathetic Nervous System, Parasympathetic Nervous System, and the Enteric Nervous System. See Sympathetic Nervous System, Parasympathetic Nervous System, and Enteric Nervous System for further details.

Back Pain: also called Dorsopathy is pain in back region that is result of stresses, strains, inflammation, or damage to muscles, bones, joints, nerves, or other structures that make up the spine. Back pain may be persistent or intermittent, it may be localised in one place or radiate out to other areas of body. And, the pain may be a sharp piercing or burning type of pain, or a dull ache. Back pain may also spread to neck and it might also radiate out into an arm and hand, or it may be felt in the upper back, or in lower back, from where it might radiate out into a leg and foot. Back pain can also cause weakness or numbness in arms or legs.

Blood Vessels: are part of Circulatory System and function to transport blood throughout the body. Main important types of blood vessels are Arteries and Veins, which carry blood away from or towards heart, respectively.

Bone Marrow: the spongy tissue found inside our bones. Bone marrow contains immature, undifferentiated cells, called stem cells, which develop into three main types of cells found in body: Red Blood Cells (that deliver oxygen and take away waste product carbon dioxide), White Blood Cells (that protect the body from infection), and Platelets (that help blood clot).

Bone Scan: is a nuclear medicine study to detect bone abnormalities. During a Bone Scan, a small (and totally harmless) amount of radioactive material is injected into a patient's vein. This material travels through bloodstream and collects in areas of abnormal bone growth. A special device, called a Gamma camera, is sensitive to the radiation emitted by injected material, and this is used to record images of the bones in specific regions of person's body on X-Ray film. About half of the radioactive material is absorbed and localised by bones. Tumours, fractures, and infections show up on images as light or dark areas, depending on wether they caused an increase or decrease in radioactive material uptake in comparison to the surrounding "normal" bone tissue. About half of radioactive material leaves the body through kidneys and bladder as urine. It is important to drink a lot of water before, during and after exam. In addition, anyone having a study should empty their bladder immediately before images are taken.

Bone: also called Osseous Tissue, is a type of hard endoskeletal connective tissue found in many vertebrate animals. Bones, in conjunction with muscles, support the body and help facilitate movement, and they help protect delicate internal organs. Bones are also involved with cell formation, calcium metabolism, and mineral storage. The main component of bones is also called bone. Collectively, bones of an animal are known as Skeleton.

Cancer: occurs when a mutation, that is an abnormal cell, grows in an uncontrollable fashion that cannot be recognized or contained by the body's natural defences.

Cancers of Spine: are essentially those of Vertebra (the bones) that make up the spine. There are many different types of tumour that can affect these bones. In addition, tumours may arise inside the membrane encasing the spinal cord and its contents (the Dura Mater), and these are called Intradural Tumours. Primary tumours are those growing where they are discovered, and they may be benign or malignant. Secondary, or metastatic tumours, are tumours that have travelled from a source elsewhere in body. Cancer of the Spine is a highly serious condition. Tumours can compress nerves that results in back pain and a range of other symptoms, such as weakness in arms or legs. A variety of surgical and non-surgical treatments may be available depending on the type of tumour. Surgery can often enhance quality of life for sufferer even if a complete cure cannot be achieved.

Cauda Equina Syndrome: is a grim neurological condition in which there is compression of contents of spinal canal below termination (conus) of the spinal cord. Symptoms may include weakness and/or pain in legs, groin numbness, sexual dysfunction, and the loss of bladder and/or bowel control.

Central Nervous System (CNS): represents the largest part of the nervous system, and includes the brain and Spinal Cord. Together with the Peripheral Nervous System, the CNS has a fundamental role in the support of life and function.

Computed Tomography Scan (CAT or CT scan): A CAT scan is performed by a computer linked to an x-ray machine which takes a series of pictures of the areas of interest inside the body from a variety of angles. Pictures are then combined using a computer to give a detailed three-dimensional (3D) image of area. CT scans generate pictures that may indicate problems with bones, herniated discs, or issues with muscles, blood vessels, tendons, nerves, and ligaments. In addition, CAT scans are very useful in the diagnosis and monitoring of cancer. CAT scans are capable of detecting extremely small tumours and enable doctors to determine if a tumour has spread.

Dura Mater: from Latin "hard mother", and also called the Pachymeninx, Dura Mater is the tough and inflexible outermost of the three layers of the meninges membranes which surround brain and spinal cord. The other two meningeal layers are Pia Mater and the Arachnoid Mater.

Electromyography (EMG): is a medical technique for measuring, recording, and evaluating electrical impulses generated by nerves and how muscles respond to these impulses, either at rest or while contracting. EMG is uses an instrument called an electromyograph to produce a record called an electromyogram. The electromyograph detects electrical potential generated by muscle cells when muscles contract, and when the muscles are at rest. This information can be useful for studying nerve and muscle function. Studying the pathways of nerve-conduction can indicate whether nerve compression or pinching is occurring. Such compression or pinching may be caused by the spinal canal becoming narrower (a condition known as Spinal Stenosis) or a Herniated Disc.

Enteric Nervous System: is part of the Autonomic Nervous System (ANS), which is in turn part of the Peripheral Nervous System (PNS), and is involved with the control of the digestive organs.

Epidural Space: is the space that is inside the Spine Canal but outside of a tough membrane called the Dura Mater. In humans, the Epidural Space contains lymphatics, spinal nerve roots, loose fatty tissue, small arteries, and a network of large, thin-walled blood vessels called the Epidural Venous Plexus.

Epidural Venous Plexus: a network of large, thin-walled blood vessels in the Epidural Space.

Fascia: is specialized fibrous, dense, connective tissue which surrounds muscles, bones, and joints, providing support and protection, while also giving structure to the body. The Fascia consists of three layers: the Superficial Fascia, the Deep Fascia, and the Subserous Fascia. Fascia, Ligaments, and Tendons are the tree types of dense connective tissue found in the human body.

Herniated Disc: also called Slipped Disc, Ruptured Disc, Bulging Disc, and Spinal Disc Herniation. (Please Note: "disc" may also be spelt "disk"). Herniated Disc is a condition in which a tear in the outer fibrous ring (called the annulus fibrosus) of an intervertebral disc allows the soft, central portion (called the nucleus pulposus) to be extruded (herniated) to the outside of the disc. When this occurs, the disc material can press on a nerve. Symptoms vary depending on the location of the herniation and the types and extent of soft tissue involved. For example, symptoms can range from little or no pain (if the disc is the only tissue injured) up to severe continuous, and unrelenting neck or back pain that can extend to regions served by the affected nerve. Other symptoms may include sensory changes such as numbness, tingling, muscular weakness, paralysis, and reflex impairment. The pain from a Herniated Disc is usually continuous and unrelenting.

Infection of the Spine or Spinal Cord: often arises as a secondary infection to an active infection elsewhere in the body, although in some cases no source of infection is found. Treatment of the infection depends on how early it is detected, how much bone or disc material has been destroyed, and whether or not there are any progressive neurological issues. The symptoms of a spinal infection usually include fever and a tender, warm area along the backbone accompanying the back pain.

Intervertebral Disc: also called Intervertebral Fibrocartilage or just simply "Disc", is made from cartilaginous material and functions to support the Spinal Column and enables it to be flexible. That is, each disc allows slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together.

Joint Cartilage: is flexible tissue that covers the ends of bones, enabling them to move against each another without causing wear or friction.

Ligament: is dense, tough, fibrous connective tissue that joins two bones together. That is, Ligaments connect bones to other bones to form a joint.

Please Note: Ligaments do not connect muscle and bone or muscle and muscle, as that is the function of Tendons. Ligaments are composed mainly of long, stringy collagen fibres, that support and connect the bones that they join, and may also limit the mobility of articulations of the bones or prevent certain movements altogether. Fascia, Ligaments, and Tendons are the tree types of dense connective tissue found in the human body.

Lymphocytes: a type of white blood cell that helps the body fight infections. Lymphocytes are created in the bone marrow, spleen, and lymph nodes, and circulate in both the blood system and the Lymphatic System.

There are two main types of Lymphocytes: B-Lymphocytes and T-Lymphocytes.

Magnetic Resonance Imaging (MRI): also known as Magnetic Resonance Tomography (MRT) and Nuclear Magnetic Resonance (NMR). An MRI scan is performed by a computer linked to a powerful magnet, and utilising radio frequency waves, to create clear images of the internal structures of the body, including the muscles, nerves, brain, spinal cord, and bones. The images produced show the presence of tumours, fractures, and other abnormalities. An MRI can provide important and highly useful information about tissues and organs, particularly the nervous system, that is not available by using other imaging techniques. MRI scans have also found a range of novel applications outside of the medical and biological fields, such as rock permeability studies, hydrocarbons studies, and produce studies, and timber quality characterization studies.

Muscle: The word "Muscle" comes from the Latin word musculus, which means, "little mouse", which refers to muscles, like the biceps, which pop-up and bulge as though a mouse were scurrying about under the skin. Muscle is contractile tissue. That is, all muscles can do is contract. The function of muscle is to produce force and cause motion, either locomotion or movement within internal organs. Many muscles in the body, such as the beating of the heart or peristalsis (which pushes food through the digestive system), contract and work without conscious thought and are essential for survival. These are called Involuntary Muscles. The other type of muscle is Voluntary Muscles, and these can be finely controlled by conscious thought. These muscles are used to move the body or the limbs, such as arms, legs, and fingers.

Nerve: are an enclosed, cable-like bundle of nerve fibres (called axons) that form an important component of Nervous System. Most nerves connect to the Central Nervous System through the spinal cord. Afferent Nerves convey sensory signals from the skin or organs to the Central Nervous System. Efferent Nerves conduct stimulatory signals from the Central Nervous System to the muscles and glands.

Nervous System: is essential for life and function. For example, the Nervous System allows the sense organs to provide information that the brain can process, controls the movements of the voluntary and involuntary and muscles in the body, and regulates the internal organs so that they can maintain and support life.

Osteoarthritis (OA): also known as Degenerative Arthritis, Degenerative Joint Disease (DJD), Arthrosis, Osteoarthrosis, and, in more colloquial terms, "Wear and Tear". The word "Osteoarthritis" is derived from the Greek words "osteo", meaning "of the bone", "arthro", meaning "joint", and "itis", meaning inflammation. Osteoarthritis is the most common form of Arthritis, and is a condition where the cartilage that covers and acts as a cushion inside joints has become excessively worn causing low-grade inflammation and pain in the joints. As the bone surfaces become less well protected by cartilage, the sufferer will experience pain upon movement and weight bearing activities, such as walking and standing. Over time, the pain often causes a decrease in the amount of movement of the sufferer, which compounds the situation as muscles begin to atrophy and ligaments may become more lax. OA is the most common form of arthritis.

Osteoporosis: is a disease of bone in which the bone mineral density (BMD) is reduced, bone micro-architecture is disrupted, and the amount and variety of non-collagenous proteins in bone is changed. As a result of these changes, Osteoporotic bones are weaker, more brittle, and far more susceptible to fracture. The bone mineral density of Osteoporosis sufferers is at least 2.5 standard deviations below the peak bone mass of an average, healthy 20-year-old person. Osteoporosis can occur in men and pre-menopausal women of any age. However, the vast majority of Osteoporosis sufferers are post-menopausal women.

Parasympathetic Nervous System: is part of the Autonomic Nervous System (ANS), which is in turn part of the Peripheral Nervous System (PNS), and is involved with the homeostasis of organs, digestion, energy conservation, and basic physiological functions necessary to support life.

Pathologist: a doctor who specializes in the study of tissues and cells to identify diseases.

Peripheral Nervous System (PNS): is an essential part of the nervous system, and consists of the all nerves and neurons that exist outside of the Central Nervous System (CNS). That is, the PNS consists of all nerves and neurons in the body, expect for this in the brain and Spinal Cord. The PNS connects the muscles and organs of the body to the Central Nervous System, so that they can be controlled and monitored. Unlike the Central Nervous System, the PNS is not protected by bone or the blood-brain barrier, leaving it exposed to toxins and physical injuries. The PNS is divided into the Somatic Nervous System (SNS) and the Autonomic Nervous System (ANS).

Prognosis: is the likelihood of recovery based on how a disease is expected to progress and respond to treatment. Prognosis is based on information gathered from many hundreds or even thousands of other patients who have had the same disease and who were treated in a similar manner. However, it is important to remember that no two patients are alike and that statistics gathered from large groups of people may not accurately predict what will happen to a particular patient.

Red Blood Cells: are blood cells that deliver oxygen and take away the waste product carbon dioxide.

Sciatica: also called Lumbago. Sciatica is a relatively common form of low back pain and leg pain, and occurs when a herniated disc impinges on the Sciatic Nerve causing a sharp, shooting pain that travels from the back of the thigh to the back of the calf, and may also extend as far up as the hip and as far down as the foot. In addition to the sharp, shooting pain, other symptoms can include numbness and difficulty in moving or controlling the leg. Typically, these symptoms are felt on only one side of the body.

Somatic Nervous System: is the part of the Peripheral Nervous System (PNS) that is involved in the voluntary control of body movements (via skeletal muscles), and also the reception of external stimuli. That is, the Somatic Nervous System includes all nerves and neurons between the Central Nervous System (CNS) and the muscles, sense organs (eyes, ears, nose, etc), and skin. The Somatic Nervous System consists of afferent fibres that receive information from external sources, and efferent fibres that are responsible for muscle contraction.

Spinal Canal: also called Vertebral Canal, is a hollow tube like structure that runs along the Spinal Column and houses the Spinal Cord. That is, the spinal canal is the space in vertebrae through which the spinal cord passes.

Spinal Column: also called the Backbone and Vertebral Column, is a flexible column of Vertebrae that houses the Spinal Cord in its Spinal Canal. In humans, the Spinal Column is located at the dorsal aspect of the torso, and consists of thirty-three (33) vertebrae including: the Sacrum (5 fused vertebrae), Cervical region (7 vertebrae), Thoracic region (12 vertebrae), Lumbar region (5 vertebrae), and Tailbone (4 coccygeal bones).

Spinal Cord Segments: In humans, the spinal cord can be divided up into 31 different sections known as spinal cord segments, starting from the brain down to the base of the spine as follows: 8 cervical segments, 12 thoracic segments, 5 lumbar segments, 5 sacral segments, and 1 coccygeal segment.

Spinal Cord: The spinal cord is the part of the central nervous system that is enclosed in and protected by the Spinal Column. In humans, the spinal cord extends through the Spinal Canal, starting at the brain and extending downward. The spinal cord can be divided up into 31 different sections known as spinal cord segments. In every spinal cord segment, two sets of nerve rootlets emerge from the cord on each side.

Spinal Stenosis: a condition in which the spinal cord and nerves are compressed or pinched as a result of narrowing of the Spinal Canal. This narrowing is often the result of natural degeneration that occurs in the spine with age, or as a result of Arthritis or bone overgrowth. Spinal Stenosis can also be caused by a Herniated Disc or a tumour. Spinal Stenosis may affect various regions of the spine, such as the Lumbar Spine, the Cervical Spine, or both. When the Spinal Stenosis affects the Lumbar region of the Spine, lower back pain as well as pain and/or numbness and other unusual sensations in the legs may be experienced.

Spondylolisthesis: is a condition where one vertebra in the spinal column slips forward over another causing compression or pinching of the nerves emerging from the spinal cord. The instability of the adjacent vertebrae can be caused by degenerative changes or by congenital or traumatic disruption of the joints in the vertebrae. Spondylolisthesis occurs most commonly in the lumbar spine.

Spondylosis: is a deformity or degeneration in the joints of two vertebrae, particularly in the neck area, where as the space between the two adjacent vertebrae narrows, causing compression or pinching of the nerves emerging from the spinal cord. The deformity or degeneration normally occurs as a result of aging or Arthritis, and can cause severe pain in the neck, shoulder, upper limbs, and related areas.

Sympathetic Nervous System: is part of the Autonomic Nervous System (ANS), which is in turn part of the Peripheral Nervous System (PNS), and is involved with energy expenditure and the 'fight or flight' response.

Tendon: also called Sinew, is a tough band of dense, fibrous connective tissue that connects muscle to bone, or muscle to muscle. Tendons are similar to Ligaments except that ligaments join one bone to another. Tendons are designed to withstand tension that is placed on them when the muscles they are connected to contract, for example, during movement. Fascia, Ligaments, and Tendons are the tree types of dense connective tissue found in the human body.

Transcutaneous Electrical Nerve Stimulation (TENS): is an electrical stimulation procedure that utilises a device that emits weak electrical currents at particular skin locations to the underlying nerve pathways below. This technique can prevent the successful transmission of pain signals. Although safe and painless, TENS doesn't work for everyone, nor does it work for all types of back pain. TENS is usually more effective for acute pain rather than for chronic pain, and TENS is often used with other treatments.

Tumour: a mass of cancer cells.

Vertebra: are the individual irregular bones that make up the Spinal Column.

X-Rays: use specially focused and aimed bursts of radiation to take pictures of areas inside the body. The amount of radiation used in most X-Rays and other diagnostic tests are so small that it poses little risk to the patient under normal usage levels. X-ray images allow a doctor to see if any bones are out of alignment and also see whether you have any broken bones or other bone abnormalities. However, X-ray images have their limitations. For example, they cannot directly show problems with the spinal cord, muscles, fibrous tissues (called Fascia), nerves, or discs.

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