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Glossary
Acute pain: Pain that comes on quickly, can be severe, but lasts a relatively
short time. (1)1
Addiction: A primary, chronic, neurobiologic disease whose development and
manifestations are influenced by genetic, psychosocial, and environmental fac -
tors. It is characterized by behavior that includes one or more of the following:
impaired control over drug use, compulsive use, continued use despite harm, and
craving. (2)
Allodynia: Pain due to a stimulus that does not normally provoke pain. (3)
Allostatic load: The cumulative physiological cost to the body of chronic expo-
sure to the stress response. (4)
Analgesia: Absence of pain in response to a stimulus that would normally be
painful. (5)
Beliefs: Assumptions about reality that shape the interpretation of events and,
consequently, the appraisal of pain. (6)
Biopsychosocial model: A framework that accounts for the biological, psycho-
logical, and social dimensions of illness and disease. The biopsychosocial model
Numbers in parentheses indicate the respective references listed at the end of this
1
glossary.
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278 RELIEVING PAIN IN AMERICA
provides a basis for the understanding and treatment of disease, taking into account
the patient, his/her social context, and the impact of illness on that individual from
a societal perspective. The model states that ill health and disease are the result of
interaction among biological, psychological, and social factors. (7)
Chronic pain: Ongoing or recurrent pain lasting beyond the usual course of
acute illness or injury or, generally, more than 3 to 6 months and adversely affect-
ing the individual’s well-being. A simpler definition for chronic or persistent pain
is pain that continues when it should not. (8)
Cognitive-behavioral therapy: An empirically supported treatment focusing
on patterns of thinking that are maladaptive and the beliefs that underlie such
thinking. Cognitive-behavioral therapy is based on the idea that our thoughts,
not external factors, such as people, situations, and events, cause our feelings and
behavior. As a result, we can change the way we think to improve the way we
feel, even if the situation does not change. (9)
Hyperalgesia: Increased pain from a stimulus that normally provokes pain. (10)
Interdisciplinary: Refers to efforts in which professionals from several disci-
plines combine their professional expertise and understanding to solve a problem.
Neuromatrix theory: Proposes that pain is a multidimensional experience pro-
duced by characteristic “neurosignature” patterns of nerve impulses generated by
a widely distributed neural network—the “body-self neuromatrix”—in the brain.
These neurosignature patterns may be triggered by sensory inputs, but they may
also be generated independently of them. (11)
Neuropathic pain: Pain caused by a lesion or disease of the somatosensory
nervous system. (12)
Nociception: The neural processes of encoding and processing noxious stimuli. (13)
Opioid: Any compound that binds to an opioid receptor. Includes the opioid drugs
(agonist analgesics and antagonists) and the endogenous opioid peptides. (14)
Pain: An unpleasant sensory and emotional experience associated with actual or
potential tissue damage, or described in terms of such damage. (15)
Pain catastrophizing: An individual’s tendency to focus on and exaggerate the
threat value of painful stimuli and negatively evaluate his/her ability to deal with
pain. (16)
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279
GLOSSARY
Referred pain: Pain subjectively localized in one region although due to irrita -
tion in another. (17)
Self-efficacy: Beliefs that individuals hold about their capability to carry out
actions in a way that will influence the events that affect their lives. (18)
Sensitization: An increased response of neurons to a variety of inputs following
intense or noxious stimuli. (19)
REFERENCES
(1) American Chronic Pain Association. 2011. Glossary. http://www.theacpa.org/30/Glossary.aspx
(accessed June 9, 2011).
(2) APS (American Pain Society). 2001. Definitions related to the use of opioids for the treatment
of pain. http://www.ampainsoc.org/advocacy/opioids2.htm (accessed April 25, 2011).
(3) IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.
iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.
cfm&ContentID=1728#Allodynia (accessed June 9, 2011).
(4) NIAAA (National Institute on Alcohol Abuse and Alcoholism). 2011. Glossary. http://pubs.
niaaa.nih.gov/publications/arh312/177-179.pdf (accessed April 25, 2011).
(5) IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.
iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.
cfm&ContentID=1728#Analgesia (accessed June 9, 2011).
(6) Gatchel, R. J., Y. B. Peng, M. L. Peters, P. N. Fuchs, and D. C. Turk. 2007. The biopsycho social
approach to chronic pain: Scientific advances and future directions. Psychological Bulletin
133(4):581-624.
(7) Brown, B. T., R. Bonello, and H. Pollard. 2005. The biopsychosocial model and hypothyroidism.
Chiropractic and Osteopathy 13(1):5.
(8) American Chronic Pain Association. 2011. Glossary. http://www.theacpa.org/30/Glossary.aspx
(accessed June 9, 2011).
(9) (a) NAMI (National Alliance on Mental Illness). 2011. Treatment and services—cognitive-
behavioral therapy. http://www.nami.org/Template.cfm?Section=About_Treatments_and_
Supports&template=/ContentManagement/ContentDisplay.cfm&ContentID=7952 (accessed
May 4, 2011).
(b) NACBT (National Association of Cognitive-Behavioral Therapists). 2011. Cognitive-
behavioral therapy. http://www.nacbt.org/whatiscbt.htm (accessed May 4, 2011).
(10) IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.
iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.
cfm&ContentID=1728#Hyperalgesia (accessed June 9, 2011).
(11) Melzack, R. 2005. Evolution of the neuromatrix theory of pain. The Prithvi Raj Lecture:
Presented at the Third World Congress of World Institute of Pain, Barcelona 2004. Pain Practice
5(2):85-94.
(12) IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.
iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.
cfm&ContentID=1728#Neuropathicpain (accessed June 9, 2011).
(13) Loeser, J. D., and R. D. Treede. 2008. The Kyoto protocol of IASP basic pain terminology. Pain
137(3):473-477.
(14) Katzung, B., A. Trevor, and S. Masters. 2009. Opiod analgesics & antagonists. In Basic and
clinical pharmacology, 11th ed. McGraw-Hill Companies, Inc.
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(15) IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.
iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.
cfm&ContentID=1728#Pain (accessed June 9, 2011).
(16) (a) F. J. Keefe, J. C Lefebvre, J. R. Egert, G. Affleck, M. J. Sullivan, and D. S. Caldwell. 2000.
The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: The
role of catastrophizing. Pain 87(3):325-334.
(b) Rosenstiel, A. K., and F. J. Keefe. 1983. The use of coping strategies in chronic low back
pain patients: Relationship to patient characteristics and current adjustment. Pain 17(1):33-44.
(c) Keefe, F. J., G. K. Brown, K. A. Wallston, and D. S. Caldwell. 1989. Coping with rheumatoid
arthritis pain: Catastrophizing as a maladaptive strategy. Pain 37(1):51-56.
(d) Sullivan, M. J. L., S. Bishop, and J. Pivik. 1995. The pain catastrophizing scale: Develop -
ment and validation. Psychological Assessment 7(4):524-532.
(17) MedlinePlus. 2011. Referred pain. http://www.merriam-webster.com/medlineplus/referred pain
(accessed April 25, 2011).
(18) Smith, B. J., K. C. Tang, and D. Nutbeam. 2006. WHO health promotion glossary: New terms.
Health Promotion International 21(4):340-345.
(19) Baranauskas, G., and A. Nistri. 1998. Sensitization of pain pathways in the spinal cord: Cellular
mechanisms. Progress in Neurobiology 54(3):349-365.
