Medical Terms
During the course of dealing with your injury, you’re likely to have a lot of complex terms and jargon thrown your way by insurance adjusters, medical providers, employers and even other lawyers. In some cases, those words may be intended to intimidate or confuse you and in others, they may just be terms of art.
Part of the way we help relieve your stress is to make sure you understand what’s going on, so that you regain a sense of control and can knowledgeably participate in the process and resolution of your case. One way we do this is to talk to you person-to-person, without the typical “lawyer speak.”
To learn more about a specific term, scan our list or enter the word/s you’re looking for to see an easy-to-understand explanation.
A
Abduction
Lateral movement of the limbs away from the midline of the body. Opposite of Adduction.
Aberrant intersegmental motion
Abnormal movement between two adjacent vertebral segments.
Acceleration-deceleration injury
Injury syndromes commonly associated with hyperextension-hyperflexion of the neck. Most often caused by a rear-end auto accident.
Acetabulum
The cup-shaped cavity of the hip joint at the base of the pelvis into which the ball-shaped head of the thighbone (femur) fits. It is the “socket” of the “ball and socket” of the hip joint.
Achilles tendinitis
Inflammation, swelling and pain of the tendon which attaches the heel bone to the calf muscle.
Acquired spinal stenosis
Spinal stenosis usually due to degenerative changes.
Acromion
The triangular projection of the scapula that forms the point of the shoulder and articulates with the clavicle.
Active range of motion
Range of motion in the cervical, thoracic, lumbar spine, or any other joint of the body which patient does under his or her own power.
Activities of daily living
The normal daily activities and functions a person must perform or fulfill to maintain cleanliness, self-grooming, home maintenance, eating, working and recreation.
Acupressure
The application of manual pressure to specific points along acupuncture meridian pathways for the purpose of decreasing pain. Pain relief is believed to be accomplished by stimulating or sedating the selected acupuncture points.
Acupuncture
An oriental medicine treatment modality where needles are inserted in particular points on the “meridians” of Qi (channels of energy in the body). This is believed to have neurophysiologic effects which decrease pain and promote healing by balancing Qi.
Acute
A recent onset of an injury or problem. The precise time line of an acute condition can range from hours after onset to 16 weeks depending upon the standard of the particular physician or treatment provider.
Acute exacerbation
A sudden aggravation of symptoms or increase in severity of an already existing condition without re-injury or trauma.
Adaptive changes
Changes in a spinal segment which occur secondarily to another biomechanical problem in the spine. This usually involves loss of range of motion in a specific direction to compensate for the trauma at another area.
Adaptive scoliosis
A lateral curvature of the spine, which is secondary to soft tissue biomechanical imbalance and not to bony changes (structural).
Adduction
Movement of a limb toward the middle of the body. Opposite of Abduction.*
Adhesions
Fibrosis tissue and scar tissue that bind together tissues which are usually not attached.
Adjustment
A chiropractic term which describes the skilled application of force to a joint or motion segment to improve intersegmental motion, decrease localized muscle tension, and restore normal motion and position.
ADL
Abbreviation for Activities of Daily Living.
Adson’s test
A physical exam test used in evaluation of thoracic outlet syndrome at the junction of the brachial plexus and the scalene muscles of the neck. The patient is placed in the sitting position with one arm straight out to the side and extended slightly backwards. The patient then takes a deep breath and turns the head toward the side being tested. A positive test is loss or diminishment of the wrist pulse on the side being tested.
Afferent nerve fibers
Nerve fibers which carry sensory impulses to the central nervous system.
Allograft
A graft taken from another person (living or dead).
Ankylosing spondylitis
A chronic inflammatory disease wherein the spinal motion segments and the sacroiliac joints progressively fuse, resulting in painful restriction of spinal movement.
Ankylosis
A joint condition of decreased or full loss of range of motion, often due to advanced degenerative changes. A spinal segment which is fused can be said to be “ankylosed”. Also, the fusion of a joint either by advanced degeneration or by artificial means (surgery).
Annular bulge
A bulging out of the annulus fibrosis, the tough fibrosis outer ring that provides support to the disc, which is diffuse and, usually due to degenerative changes or trauma, leading to degenerative changes. This condition may include partial rents or tears in the annulus fibrosis.
Annular rent
Another way to describe a tear in the annulus, usually seen during discography, less commonly on MRI, or during surgery. These tears can be traumatic in origin. Also known as an annular fissure.
Annulus
See Annulus Fibrosis.
Annulus fibrosis
The outer covering of the softer, gel-like nucleus pulposus of the intervertebral disc. The intervertebral discs are located between each of the vertebrae of the spine.
Anterior
Front side, the opposite of posterior. Synonymous with ventral.
Anterior cruciate ligament
The anterior cruciate ligament (ACL) starts in the front of the lower leg bone (tibia) and attaches to back of the thighbone (femur). The ACL resists forward slippage of the lower leg bone under the thighbone. The posterior cruciate ligament (PCL) starts in the back of the lower leg bone (tibia) and attaches to the front portion of the thighbone (femur). The PCL resists backward slippage of the lower leg bone (tibia) under the thighbone (femur). The ACL is the most commonly injured ligament of the knee. A strain or partial tear might heal and only require physical therapy. Complete tears often require surgical repair, which is commonly done arthroscopically.
Anterior disc herniation
An extrusion of the nucleus pulposus through the front side of the annulus of the disc.
Anterior discectomy and fusion
The surgical removal of an abnormal intervertebral disc and replacement with bone graft and/or surgical hardware for fusion, using an anterior approach to the spine.
Anterior drawer test
If the anterior cruciate ligament (ACL) becomes injured or torn, it may become lax or loose. One test for this laxity is the anterior drawer test. Your doctor will have you lay on the exam table on your back with your hips and knees bent. He or she will sit on the edge of the table with his/her leg over the top of your foot. The doctor grasps the lower leg (tibia) with both hands just below the knee joint. The patient is told to relax. The doctor attempts to pull the lower leg forward and feels the amount of motion between the lower leg (tibia) and thigh (femur). The doctor will compare the motion from side to side. An increase in motion or lack of a firm endpoint suggests a tear of the ACL.
Anterior scalene syndrome
Compression of the bundle of nerves, veins and arteries as it passes between the anterior and middle scalene muscles. This is a cause of thoracic outlet syndrome or cervicobrachial syndrome, as this is one of the more common areas of entrapment.
Anterolisthesis
A vertebral segment which is moved forward relative to the segment below.
AO Joint
Atlanto-occipital joint is the vertebral joint formed by the occiput (a portion of the skull) at the base of the skull resting upon the atlas or first cervical vertebra (C1).
AP
Anterior to Posterior or front to back. This refers to the orientation of the patient to the x-ray beam. With AP films the patient faces away from the x-ray film and faces the x-ray machine. The x-ray photons pass from anterior to posterior through the patient. The image produced is a “front to back” view of the patient.
Applied kinesiology
A chiropractic diagnostic technique based on the theory the neuromuscular system can be accessed through specific neuromuscular pressure points. This is usually combined with manual muscle testing to determine which muscles are weak and need to be balanced. Some chiropractors use this technique as a way to plan their adjustments and to recheck the patient following the chiropractic adjustment.
AROM exercise
An exercise designed to increase Active Range of Motion.
Arthralgia
Joint pain.
Arthrochondritis
Inflammation of the cartilage portion of a joint.
Arthrogram
The injection of radiographic dye into a joint that is then x-rayed. The contrast dye allows for better visualization of the joint and possible irregularities. Arthrograms are being progressively replaced by MRI.
Arthrogram
The injection of radiographic dye into a joint that is then x-rayed. The contrast dye allows for better visualization of the joint and possible irregularities. Arthrograms are being progressively replaced by MRI.
Arthroscopic surgery
The use of a small camera at the end of a wand to perform surgery. Usually the surgeon makes 3 holes (called portals) into the structure he/she is going to operate on (like a joint, or perhaps the abdomen). The camera wand (arthroscope) is passed through one hole. The other two holes are used to perform the surgery. Sometimes a surgery is too difficult to perform arthroscopically and in those cases, the surgeon will make a larger incision that allows him/her to see the structures directly. This is called an “open procedure.”
Arthrosis
A disorder of a joint.
Articular dysfunction
A chiropractic term, which refers to an abnormality of spinal biomechanics involving a loss of normal movement of vertebral motion segment.
Articular fixation
A loss of one or more joint motions. One of the components of the chiropractic diagnosis of subluxation. See Subluxation. See Hypomobility.
Articular spondylolisthesis
A forward or anterior “slipping” of one vertebra in relation to another, due to trauma and/or degenerative changes within the facet joints and/or the discs.
Articular surface
The surface of a joint, lined with cartilage and synovial fluid to lubricate joint movement.
Articulation
The joint between bones. The movement of bones as a result of the joint.
Atlanto-occipital
Referring to the articulation of the joint between the occiput of the skull and the C1 vertebra (atlas). See AO Joint.
Atlas
The first cervical vertebra which moves with the occipital bone of the skull, and the second cervical vertebra in the neck. Also known as C1.
Atrophy
A wasting or decrease in size, often in reference to muscle tissue.
Autograft
A graft taken from the patient.
Autonomic nervous system
The part of the nervous system controlling involuntary bodily functions, including regulation of glands, organs, and smooth muscle tissue. The autonomic nervous system acts upon these tissues to slow or initiate their function.
Avulsion
The pulling away of one tissue from another, either by trauma or surgery.
Axilla
The armpit.
B
Bone
The hard, osseous material consisting of bone cells (osteocytes) embedded in a matrix of calcified intercellular material.
Bone spur
See Osteophyte.
Brachial
Pertaining to the arm.
Brachial plexus
A complex network of nerve tissues in the neck and armpit, which stem from the C5-T1 nerve roots. The brachial plexus contains the nerves going to the arms.
Bruit
A sound, especially an abnormal one, heard on physical examination. It is commonly used when referring to blood flow. Doctors may listen to your blood flow over larger arteries or the heart.
Bulging disc
Same as Disc Bulge.
Bursitis
Inflammation of pad-like fluid-filled sacs (bursa) found within the connecting tissue of the joints, as in the shoulder and knee.
C
Calcaneous (or calcaneus)
The calcaneous is the heel bone.
Capsulitis
Inflammation of tissues enclosing a joint.
Carpal tunnel syndrome
Soreness, tenderness, and weakness of the muscles of the thumb, index and middle fingers caused by pressure on the median nerve at the point at which it goes through the carpal tunnel of the wrist.
Cartilage
The dense connective tissue between the bodies of the vertebrae (the intervertebral discs) and between the articular surfaces of the joints.
Cauda equina
The end portion of the spinal cord and the roots of the spinal nerves below the first vertebra in the low back.
Central nervous system
The combination of the brain, spinal cord, and nerves that control voluntary and involuntary acts.
Centrum
Centrum means “center”. It is commonly used in reference to the bones of the spine called vertebrae. The centrum would specifically refer to the “body” or main weight-bearing portion of the vertebra.
Cervical
Referring to the neck. The cervical spine has seven vertebrae (C1 through C-7) which allow for head and neck movement.
Cervicogenic headache
A headache that originates in the neck.
Chiropractic
A branch of the healing arts focused on human health, disease processes, and physiological and biochemical aspects of the body including structural, spinal, musculoskeletal, neurological, vascular, nutritional, emotional and environmental relationships. Chiropractic procedures include the adjustment and manipulation of the articulations and adjacent tissues of the human body, particularly of the spinal column. Included is the treatment of intersegmental dysfunction for alleviation of related functional disorders. Chiropractors do not use medications or surgery. However, nutritional supplementation may be prescribed.
Chronic
A condition of long standing. Health care providers consider injuries or conditions still existing 12 weeks after the occurrence to be chronic.
Clavicle
The “collar bone” which articulates with the scapula, acromion and the sternum.
Concussion
Any alteration in cerebral function caused by direct or indirect (rotation) force transmitted to the head resulting in one or more of the following: a brief loss of consciousness, lightheadedness, vertigo, cognitive and memory dysfunction, tinnitus, difficulty concentrating, amnesia, headache, balance disorder, nausea or vomiting. A concussion is a brain injury.
Connective tissue
Tissue connecting and supporting muscles, tendons, and ligaments.
Conversion disorder
A condition in which a person has neurologic symptoms that cannot be explained by medical evaluation. Psychological conflict may bring on the disorder and psychological issues are manifest in physical symptoms. It is important to note that the person is not faking the symptoms; the symptoms are real and originate from psychological rather than physical factors.
Corticosteroid
A potent anti-inflammatory drug.
Costochondritis
A cause of chest pain. Costochondritis is an inflammation and associated tenderness of the cartilage (i.e., the costochondral joints) that attaches the front of the ribs to the breastbone.
Cozen’s test
A physical exam test your doctor may due to look for tennis elbow (called lateral epicondylitis). The doctor will ask you to extend your wrist and he will attempt to resist you. If this maneuver causes pain, you may have tennis elbow.
Craniocervical
This is the region of the body where your head meets your neck. “Cranio” refers to the head, and “cervical” refers to the neck.
Craniosacral therapy
A manipulation-based therapy first developed by William Sutherland, D.O. It is based upon the belief that cranial plates are mobile and connected to the spinal cord and sacrum through the meninges. Some techniques concentrate on detecting cranial plates that are “out of place” and correcting these dysfunctions. While controversial, many patients report relief of headaches and tempormandibular joint pain with the technique.
Crepitus
Crunching, rubbing or snapping sounds heard or felt when moving a joint.
Cryotherapy
The application of ice to injury sites to reduce inflammation and pain by decreasing blood flow in the area of the injury or discomfort.
CT discogram
A discogram followed by a CT Scan. The CT scan allows visualization of the disc structure following the injection of radiographic dye during the discography procedure.
CT myelogram
A myelogram followed by a CT scan. This technique visualizes the spinal nerves as they relate to the surrounding bony structures. This study is commonly used for surgical planning.
CT scan
Also called CAT scan, Computer Tomography, Computer Assisted Tomography, or Computer Axial Tomography. The use of x-ray energy passing through the body at different angles and processed through a computer to produce a cross-sectional (axial) image of an area of the body. The current term, CT Scan, is the most accurate since reformatting has allowed other planes to be imaged besides just the axial plane.
Cubital tunnel syndrome
“Cubital tunnel” refers to a passageway along the inner part of the elbow bounded by bones, muscles and ligaments. Cubital Tunnel Syndrome involves symptoms of numbness, tingling, or weakness of the pinky and ring fingers due to compression of the ulnar nerve passing through the cubital tunnel.
D
DABCO
Diplomate of the American Board of Chiropractic Orthopedists.
DACBR
Diplomate of the American Chiropractic Board of Radiology.
DACS
Diplomate of Applied Chiropractic Science.
DC
Abbreviation for Doctor of Chiropractic.
DDD
See Degenerative Disc Disease.
De-conditioned
The loss of strength, flexibility and endurance due to long-term illness, injury, or lack of proper motion or exercise.
Decompression
In spine surgery, the term refers to the lessening of pressure on a nerve root, spinal nerve or the spinal cord. This is also a manual therapy term referring to the lessening of pressure on a nerve or joint through manual traction.
Deep tendon reflex test
A physical exam technique used to determine the existence and functioning of the nerves connected to the tested muscle. With proper technique, in normal patients, striking the tendon of the muscle will elicit a standard contraction of the muscle, thus assuring the reflex “arc” is intact. Disruption of either the sensory or motor pathways will affect the reflex.
Deep vein thrombosis (DVT)
Thrombosis means blood clot. A “deep vein thrombosis” is a blood clot that develops in a major vein that is usually deeper in the body (not on the surface). DVT’s commonly occur in the legs, but they also may occur in the arms.
Degenerative changes
Degeneration of any joint due to wear and tear, trauma, or unusual postures. The degenerative changes include disc space narrowing, osteophytes or bony spurring. These type of changes can be seen both on x-ray and MRI imaging.
Degenerative disc disease
An intervertebral disc, which has suffered the effects of the aging process or the effects of trauma. A disc becomes degenerated over time, often spanning years. Often there are small circumferential tears in the annulus fibrosis, the tough outer covering of the disc. A degenerated disc is also characterized by a loss of its height due to a drying-out of the nucleus pulposus, the gelatinous material inside the disc. It is often caused by a loss of motion between the vertebrae above and below, thus decreasing the mechanical flow of nutrients to the disc.
Degenerative facet joints
Facet joints, which, as a result of age and time or trauma, have signs of arthritic changes. The degenerative arthritic changes may include thinning of joint spaces, changes in the joint and cartilage surfaces, and inflammation of the joint and connecting tissues of the joint. Degenerative facet joints may or may not be symptomatic.
Degenerative joint disease (DJD)
In the spine, DJD refers to the inflammatory changes in the facet joint, also known as the zygapophyseal joints of the vertebral bodies. These changes often lead to bone changes and reduced range of motion at the joint. Degenerative joint disease is not limited to the spine.
Degenerative symptoms
Pain and physical restrictions are a result of degenerative changes usually in the weight-bearing joints of the body.
Denervation
The blocking of a nerve supply by trauma, degeneration or surgery.
Dermatomal somatosensory evoked potential
An electrical conductivity test specific to nerve (dermatome) patterns. See Somatosensory Evoked Potential, SSEP.
Dermatome
A specific sensory nerve distribution pattern, which can be outlined or traced on the skin.
Desiccation
Dehydration of an intervertebral disc.
Disc
See Intervertebral Disc.
Disc bulge
A broad-based enlargement of the annulus fibrosis extending past the edges of the adjoining vertebral end plates with herniation of the nucleus pulposus into or through the annulus fibrosis. See Bulging Disc.
Disc herniation
See Herniated Disc.
Disc space narrowing
A narrowing of the space between the vertebrae, produced by disc dehydration (dessication) and is often imaged by x-rays. See Degenerative Disc Disease.
Discectomy
The surgical removal of the bulging or extruding disc material (nucleus pulposus). Access to the bulging or extruding disc material may be had by removal of the lamina of the vertebral body (laminectomy) or the cutting of an opening in the lamina (laminotomy). Discectomy may be done in conjunction with a foraminotomy and/or a fusion.
Discogenic pain
Pain coming from the nerves embedded in the annular wall of the disc. Pain can arise from chemical or mechanical irritation of these nerves as a result of damage to the intervertebral disc. The outer portion of the annulus has sensory nerves and trauma or degenerative changes to the annulus can cause pain.
Discography
An imaging procedure which reveals the inner structure and condition of an intervertebral disc by injecting dye through a needle placed into the disc. A CT Scan is then performed to image the disc more precisely. Discography can also be used to determine if the disc is a source of pain, in addition to revealing the disc’s inner structure. Discography is often employed to determine a patient’s suitability for fusion surgery in the neck, mid back, or low back. But more recent medical studies have recommended against its use because the inserting of the needle into the good disk is thought to cause degeneration of that disc overtime.
Distraction
(1) Application of a force to mildly and temporarily release pressure from a joint. This tractioning of a joint space is for the purpose of releasing entrapped soft tissues, such as the joint capsule or spinal nerve roots. This may be performed manually, by application of weight, or mechanically; (2) An orthopedic test wherein the examiner places his/her hands under the chin/jaw and gently pulls up. This maneuver may relieve pressure from the nerve roots and discs. If the patient feels relief of symptoms, the test is “positive”; or (3) The diversion of a patient’s attention from the primary activity being performed during physical examination.
Diversified technique
A chiropractic technique in which the primary manipulative force is applied by the practitioner’s hands. See Manipulation, Chiropractic.
DJD
See Degenerative Joint Disease.
DO
A physician graduating from a medical school of osteopathic medicine. Osteopathic doctors can use manipulation of the spine and administration of medications as part of their treatment of spinal complaints. See Osteopathic Physician. *
Dominant hand
The hand one uses most often because it is usually more coordinated and stronger than the non-dominant hand.
Dorsal
Reference to the back or upper aspect of the body. On occasion it refers to the thoracic spine.
Double Crush Syndrome
A nerve entrapment at two or more places along a nerve. Most typically the diagnosis refers to a carpal tunnel syndrome, cubital tunnel syndrome, and/or ulnar neuropathy nerve compression at the elbow, co-existing with pressure on the spinal nerve in the neck, causing numbness or tingling, muscle weakness or loss of reflex in the arm or hand.
Dura
The outermost, toughest, fibrosis layer covering of the brain, spinal cord and nerve roots. It also holds the brain in place and contains the cerebral spinal fluid.
Dural impingement
Pressure or deformation of the dura caused by bulging disc, bone spurs, or thickened ligaments.
Dynamometer
A device which measures grip strength.
Dysesthesia
An abnormal sensation that a patient reports as uncomfortable that may include burning, tingling, numbness, or “pins and needles.”
Dysthymia
A chronic depressed mood lasting more than two years.
E
Edema
Edema refers to any collection of fluid, seen as swelling, that is outside of blood vessels or organs – usually collecting within the connective tissues that support our organs or muscles.
EMG
Electromyogram or Electromyelogram. A test to evaluate the motor function of the peripheral nerves and the related spinal nerves. The test involves use of a needle to test nerve conduction speed. The method of the EMG is to insert small needles in muscle groups and observe for electrical indications of denervation or loss of nerve function.
Empty can test
A clinical test used by physicians to look for rotator cuff pathology in the shoulder. It is used to identify injury of the supraspinatus. The test is done with your arms extended out in front of you with your thumbs pointing to the ground as if you were emptying a can. The doctor asks you to resist as he attempts to push you arms to your side. A positive test is noted if this maneuver produces pain in the shoulder.
End feel
The quality of the resistance to movement that the health care provider feels when testing the range of motion end point of a particular joint.
Epidural block
The injection of anesthetic into the epidural space in order to block or desensitize a specific nerve at particular points of a nerve pathway.
Epidural space
The space outside the dura of the brain and spinal cord. The dura is the outer membrane covering the spinal cord and the brain.
Epidural steroid injection
The injection of a potent anti-inflammation drug into the epidural space around the nerve or joint for therapeutic purposes. It is used to decrease inflammation in the spinal space and spinal nerves and reduce pain.
Extension
A movement that brings two parts of a joint toward a straight position. In the lumbar spine, this is starting in a forward bent position and returning to a straight position (the neutral or standing position) or bending backwards from the neutral position. In the cervical spine the term is used to refer to the movement involved in looking-up or starting in a forward bent position and returning to a straight position.
Extradural defect
Indentation of the thecal sac or dura by disc bulge, osteophyte, defect in the bone, ligament, cyst or tumor. This terminology is often used by radiologists noting abnormalities on imaging studies.
Extruded disc
See Herniated Disc.
F
FABERE test
An orthopedic physical examination test with the patient on his or her back, the thigh and knee are flexed and one ankle is placed over the opposite knee; the knee is depressed, and if pain is produced thereby, arthritis of the hip, psoas muscle or SI joint is indicated. The name comes from the initial letters of movements that are necessary to perform it, namely, flexion, abduction, external rotation, extension. Also called Patrick’s Sign.
Facet arthrosis
Degenerative changes of the facet joints.
Facet block
The injection of anesthetic and/or steroid into a facet joint using video x-ray or CT scan to assist the practitioner in guiding a needle through the skin. This can be done for both diagnostic and therapeutic purposes.
Facet hypertrophy
Enlargement of the facet joints as a result of degenerative changes.
Facet injection
See Facet Block.
Facet joint dysfunction
A vertebral motion segment whose joint does not move freely in all directions or moves excessively. Commonly used by treatment providers to refer to a syndrome producing facet joint pain.
Facet Joints
A set of paired joints representing the articulation (joining) of the back portions of two adjoining vertebrae at the back of each vertebra articulating with the vertebra above and vertebra below. An injured or degenerative facet joint may be the source of spinal pain and stiffness. Also referred to as zygapophyseal joint.
Facet joints
A set of paired joints representing the articulation (joining) of the back portions of two adjoining vertebrae at the back of each vertebra articulating with the vertebra above and vertebra below. An injured or degenerative facet joint may be the source of spinal pain and stiffness. Also referred to as zygapophyseal joint.
Facet neurotomy
A therapeutic technique whereby the medial branch nerve supply to the facet is cut. This is done surgically, most often with radio frequency current. See Medial Branch Neurotomy. Sometimes called Facet Rhizotomy.
Facet rhizotomy
See Facet Neurotomy.
Facet syndrome
Pain coming from facet joints. Degenerated facet joints may also put pressure upon exiting spinal nerves and cause radiculopathy and/or stenosis.
FACO
Fellow of the Academy of Chiropractic Orthopedists.
FACS
Fellow of the American College of Surgeons.
FASBE
Fellow of Applied Spinal Biochemical Engineering.
Fascia
The connective tissue sheath which is continuous through-out the body. The fascial system covers the muscles, the skeleton, and the organ systems of the body. It also creates tunnels through which the nerves and blood vessels travel.
Fascial
Of or pertaining to the fascia.
Femoral nerve irritation
The femoral nerve is made up of several nerve roots as they exit the lumbar spine (spine in the low back) – commonly L2, L3 and L4. As they leave the spine, the blend together to form the femoral nerve which then passes through the buttocks and then into the front of the thigh. It provides movement and sensation to muscles and skin in this region – most commonly the quadriceps (“quads”). When the femoral nerve is irritated there may be pain, numbness, tingling and/or weakness in this same distribution.
Fibromyalgia
A syndrome involving diffuse systemic muscle pain. The diagnostic criteria has been defined by the American College of Rheumatology as pain at 11of 18 tender point sites, presence of subcutaneous nodules, and a history of widespread pain for more than three months. Trauma can be a cause of this syndrome.
Fibromyositis
An inflammatory muscle condition leading to fibrosis and muscle pain, commonly secondary to trauma.
Fibrosis
Abnormal formation of scar tissue.
Fibrositis
A term with multiple meanings that have been applied to myofascial pain, tendinitis, bursitis, capsulitis, and tenosynovitis. Generally it is understood to be an inflammation of connective tissue.
Fixation
(1) A chiropractic term for a vertebral segment which does not move well in all directions. Fixations are corrected by chiropractic adjustments. See Subluxation. (2) A manual therapy term indicating a blocking technique of one bone to allow for specific movement of an adjacent bone.
Flexion
Bending forward of the spine.
Flexion-extension injury
A sprain/strain injury of the cervical spine and adjacent structures caused by a hyperextension-hyperflexion injury. See Acceleration-Deceleration Injury, Whiplash Injury.
Flexion-extension x-rays
Side view x-rays taken at the extremes of flexion and extension of the spine to detect abnormal movement between adjacent vertebrae suggestive of ligament damage or ligamentous laxity. These views are compared to a neutral view.
Fluoroscopy
An x-ray machine capable of producing both still images and “real-time” motion of the joints or vertebrae. Often used to visualize intervertebral joint motion through flexion and extension of the neck or back or to place a syringe needle at a targeted site.
Foramen
The opening between the vertebrae through which the spinal nerve root and spinal nerve sheath pass to exit the spinal canal. The size of the foramen may be reduced by degenerative joint disease, a herniated disc, bulging disc, bone spurs, facet joint hypertrophy, or by soft tissue (cyst, tumor, ligament, etc.).
Foraminal compression test
A physical examination technique which reduces the opening of the foramen which may demonstrate if there is pressure upon the exiting spinal nerve. The test is done to detect spinal nerve root involvement, a herniated disc, bulging disc, or foraminal stenosis. The patient is seated with the head and neck in a neutral position. Pressure is increasingly applied on the head and neck in mild lateral flexion to either side. A positive result replicates numbness or tingling into a dermatome of the upper extremity. Also called Sparely’s Manuever.
Foraminal stenosis
A decrease in the overall size of the intervertebral foramen (the bony window through which the spinal nerves pass) caused by enlargement of the facet or a degenerative disc. The spinal nerve passing through the foramen can become irritated or compressed. Severe foraminal stenosis can cause radiculopathy. Surgical management can include enlarging the foremen by removing bone (foraminotomy), and/or fusion to reduce continued facet joint degeneration.
Foraminotomy
A surgical opening of the intervertebral foramen to provide more space for the spinal nerve.
Forward head
Forward translation of the head/skull in relation to the mid back. A postural dysfunction where the upper back is in flexion and the head protrudes forward over the chest. This position places the head and neck in a structural disadvantage. It is often seen after flexion-extension injuries to the cervical spine.
Frontal-occipital headaches
Pain emanating from the base of the skull or in the back of the head and radiating to the forehead. This headache pain is often secondary to acceleration-deceleration injuries (also known as hyperextension-hyperflexion injuries or whiplash) involving the upper joints of the neck (O-C1, C1-2, C2-3 joints).
Full spine radiography
A method of x-ray most commonly found in chiropractic practice in which a patient’s entire spine and pelvis are produced on a single x-ray film in both the anterior to posterior (AP) and lateral projections. The x-ray film size is typically 14”x 36”.
Functional capacity evaluation
A series of tests measuring physical strength, range of motion, stamina, and tolerance to functional activities, including lifting and carrying. These tests can be used to evaluate work tolerance, and the necessity for work restrictions. More commonly referred to as a Physical Capacities Evaluation (PCE).
Functional Impairment Index (FRI)
A questionnaire used to quantify the patient’s degree of dysfunction and how it affects activities of daily living.
Functional Leg Length Discrepancy
A short leg which is the result of a biomechanical subluxation complex (inclusive of a muscle imbalance, myospasm, segmental dysfunction or combination of these factors). It is not due to bone length. Chiropractic adjustment seeks to correct leg length difference.
Fusion
A surgical procedure performed to eliminate spinal pain or immobilize unstable joint segments. Can be used to treat degenerative disc disease and to immobilize injured vertebral segments. A bone graft is placed across a spinal segment which then grows together with the patient’s bone and the area is immobilized. There is a loss of motion between two vertebrae that are fused together. The graft can be an autograft (bone taken from the patient) or an allograft (cadaver bone).
G
Gaenslen’s Test
Also known as Gaenslen’s maneuver. This is a physical exam test in which the doctor is looking for SI joint pain. To perform the test, the patient lies on his/her back with one leg hanging off the table. The other leg is bent at the hip and knee, and the patient is asked to hold the knee to his chest. The doctor than pushes the other knee further down off the table, in effect hyper-extending the hip. If this produces pain, it can suggest SI or hip joint pain, pubic symphysis pain, or femoral nerve irritation.
Gait
The manner in which a patient walks.
Gait evaluation
Observation and analysis of a patient walking. The type of gait is noted.
George’s line
An x-ray study technique to detect abnormal vertebral alignment as seen on a side view x-ray of the neck. The back-side edges of the vertebral bodies are connected with a continuous line. In a normal study, there is a smooth curving line. In an abnormal study there is an abrupt jog or offset in the line to an anterolisthesis or retrolisthesis position. If there is a sharp break in the line, or a stepping effect, this could be a sign of fracture, dislocation or gross ligamentous instability.
Giveway weakness
An abnormal muscle weakness noted upon examination. It is weakness that is inconsistent; usually involving full motor strength against initial resistance, followed by the strength “giving way”.
Glasgow coma scale
A grading system for determining neurological function and mental status (alertness) after a traumatic injury to the head. Eye opening, verbal response, and motor response are graded. The lowest score is 3 and a normal score is 15.
Goniometer
A protractor device used for measuring joint angle and range of motion.
Gonstead technique
A chiropractic technique that uses the practitioner’s hands to make corrections of the spine. This is a high-velocity (high-acceleration), low-amplitude adjusting technique. It is taught at most chiropractic colleges. It was developed over several decades by Clarence Gonstead, D.C. It also utilizes specific x-ray analysis and spinal heat readings.
GP
Abbreviation for a medical doctor who is a General Practitioner.
Grip strength testing
Determination of the amount of strength in the hand and forearms while gripping a dynamometer. It can be used to assess changes over time of the motor function of nerves exiting the lower cervical spine.
Gross instability
An orthopedic spine term which refers to excessive motion between two joints or two vertebral segments. In spinal evaluation, gross instability usually indicates ligamentous injury.
Gross range of motion
A term that usually refers to the overall range of motion of a spinal region. See Range of Motion (ROM).
H
H/A
Abbreviation for Headache.
Hawkins / Kennedy test
This is a clinical test to assess shoulder impingement – which means pinching of some of the shoulder muscle tendons against some of the bones of the shoulder. The test is performed by having the patient point their elbow straight in front of them. The examiner then moves the patient’s arm as if they were going to put their palm on the table (this is called “internally rotating the shoulder”). If this maneuver causes pain, it suggests irritation or inflammation of one of the rotator cuff tendons which is impinging (or pinching).
Heel-toe gait
A physical examination maneuver wherein the patient is asked to walk on heels and then walk on toes across the room. Inability or difficulty walking on the heels suggests an L4-L5 motor radiculopathy. Difficulty walking on the toes suggests an S1 radiculopathy. Also, commonly used to test cerebellar function.
Hellerwork
A method of deep tissue body work for 11 one-hour sessions. This technique is used to realign the body’s myofascial planes. Some degree of movement training is included. Each session covers a specific area of the body and discussion with a specific emotional focus.
Herniated disc
A rupture of the annulus fibrosis, through which the inner disc material (nucleus pulposus) extrudes. This may put pressure on the exiting spinal nerve and/or cause an inflammatory reaction leading to radiculopathy or weakness, numbness, and/or tingling in the arms or legs.
Herniated nucleus pulposus
See Herniated Disc.
Hyperabduction test
A physical exam test for thoracic outlet syndrome. The arms are raised up to an overhead position to evaluate muscle compression on the neurological and vascular flow. Also called Wright’s Test.
Hyperextension/hyperflexion
Extreme bending backward and forward of the cervical spine from an acceleration/deceleration trauma.
Hyperkyphosis
Abnormally increased spinal curve in the mid back.
Hyperlordosis
An abnormally increased spinal curve in the neck or low back.
Hypermobile subluxation
An abnormal intervertebral joint condition in which the supporting tissues have been stretched or degenerated such that there is excess movement at that level.
Hypertonicity
An increase in muscle tone or muscle tension.
Hypoesthesia
Decreased sensitivity of the skin to touch.
Hypolordosis
Loss of a normal spinal curve and straightening of the neck or low back. Often seen in the cervical spine after a rear-end auto impact.
Hypotonicity
Decreased muscle tone or muscle tension.
I
Idiopathic
A condition or disease of unknown cause or etiology.
ILA
An osteopathic or manual physical therapy term referring to the Inferior Lateral Angle of the sacrum. Often designated as a reference point in the diagnosis of sacroiliac joint dysfunction.
Iliac
Referring to the Ilium.
Iliac crest
The uppermost part of the iliac “wings.” This is the superior border of the ilium easily palpated above the lateral hip. This point is commonly used as a reference point for many physical exam techniques. This is often the site from which bone grafts are harvested.
Iliopsoas muscle
The iliopsoas muscle begins deep in the pelvis – arising from the top of the pelvic bone and sweeping forward over the hip joint before attaching to the front of the upper thigh. It is actually starts as two separate muscles that join together into one common tendon where it attaches on the thigh bone. The main action of this muscle is to flex the hip.
Iliosacral dysfunction
An osteopathic or manual physical therapy term referring to a dysfunction of the ilium on the sacrum. See Sacroiliac Joint Dysfunction.
Iliotibial Band Syndrome
An inflammatory condition of the thick band of tissue (iliotibial band) extending from the hip to the knee down the side of the leg. Patients report a snapping or pain at the lateral hip or knee or both.
Ilium
One of the bones of each half of the pelvis, forms a joint with the sacrum.
Impairment
Loss of normal function of a body part as a result of deterioration, disease or injury, which may be partial or complete, temporary or permanent.
Impairment rating
The degree of permanent impairment assigned to a patient with residual pain and/or loss of function when the patient has reached maximum medical improvement.
Impingement
Abnormal compression or encroachment of one anatomical structure on another.
Impingement Syndrome
A syndrome in which soft tissue is entrapped or impinged between two hard (bone) tissue structures with resultant inflammation, pain, and dysfunction.
Inferior
Relative anatomical position a body part or region as being below that of another.
Inflammation
The reaction of tissue to injury, characterized by increased blood flow and exuding of fluid from the blood vessel into the tissues. Inflammation may be characterized by swelling, redness, and increased warmth of the tissue.
Infraspinatus muscle
The shoulder blade is a triangular shaped bone. It sits like an inverted triangle with the point aimed toward the floor. It’s one of the major bones that make up the shoulder joint. The medical term for the shoulder blade is the “scapula”. You can feel that bone on yourself. You can actually feel a ridge of bone that runs near the top of the shoulder. That ridge is called the spine of the scapula. The ridge separates two major muscles of the shoulder. The one that sits below the spine is called the infra-spinatus (infra meaning below) muscle. The infraspintaus is one of the four muscles that makes up the rotator cuff.
Instability
Excessive motion which is beyond normal physiologic motion. Spinal instability can be a result of traumatic disruption of the ligamentous supporting structures, degenerative disc disease, or fracture.
Intersegmental dysfunction
Disease or mechanical dysfunction of the vertebrae as they function with each other, resulting in symptoms of pain, discomfort or loss of motion.
Intersegmental range of motion palpation
A manual spine evaluation method of assessing vertebral position by touch with the spine in a static position or in motion. The relative motion of two vertebrae is measured in several directions.
Intervertebral
Between two adjacent vertebrae.
Intervertebral disc
A soft tissue structure in between each vertebrae of the spine. It contains a fibrosis outer ring call the annulus fibrosis and a gelatinous center called the nucleus pulposus.
Inversion
Reversal of the normal relationship of positions between anatomical parts.
J
Joint mobilization
Low-amplitude, low-velocity forces applied to restore joint range of motion. In the fields of manual spine treatment, five different grades of mobilization exist and vary in amplitude and velocity.
Jump sign
A sudden contraction of muscle seen as a twitch in response to stimulation of a trigger point or other area of muscular hypertonicity or spasm.
K
Kemp’s test
An orthopedic test in which a patient is in a seated position and is placed into simultaneous extension and rotation of the lumbar spine. A true positive test produces numbness or tingling radiating to the legs. This indicates disc involvement. Many examiners use it to assess the facet joints as well.
Kinesiology
The study of movement.
Kyphosis
An extreme reversal of the normal curve in the neck or low back. The normal posteriorly arching curve of the mid back.
L
Lachman’s Test
This is a clinical test used to assess the anterior cruciate ligament (ACL). The patient lays on their back on the exam table. The examiner places one hand behind the knee on the lower leg bone, and uses the other hand to grasp the thigh just above the knee. The patient is asked to relax. The examiner then attempts to slide the lower leg forward under the thigh bone (which he is holding still). If the ACL is intact, the examiner should feel a firm stopping point – like he is tugging on a rope. If there is no firm endpoint, the test is “positive” and suggestive of a torn ACL tendon.
Lamina
The posterior part of a vertebra which forms the roof of the spinal canal.
Laminectomy
A surgical technique in which the lamina and spinous process are removed to lessen the pressure on the spinal canal or the spinal nerves exiting an intervertebral foramen.
Lasegue Test
A test of the low back used by spinal care health providers in which the hips are passively flexed with the knee in full extension. A positive test produces low back or sciatic pain prior to reaching 90 degrees of hip flexion and no pain when the hip is flexed with the knee bent. Synonymous with straight leg raise test. This test helps to distinguish low back disorders from disease of the hip joint.
Lateral
X-rays views taken from the side. Also, the body or anatomical part from the side.
Lateral bending
Side to side bending.
Lateral epicondylitis
Also known as “Tennis Elbow”. The muscles of the forearm that allow you extend the wrist and the fingers attach to the part of a bone just outside of the elbow called the lateral epicondyle (lateral meaning “outside”; epi meaning above; “condyle” meaning knuckle – so “lateral epicondyle” means the place above the knuckle on the outside of the elbow). When these muscles or their tendons become inflamed or torn it may cause pain. Patients often complain of pain when pinching or gripping, or when extending the wrist – all things done when playing tennis – hence the name “tennis elbow.”
Lateral flexion
Bending to one side.
Latissimus dorsi muscle
This is a large triangular shaped muscle which attaches to the middle of the back and spreads up and out toward the shoulder. It is one of the stabilizers and movers of the shoulder joint.
LBP
Abbreviation for Low Back Pain.
Leg length discrepancy
A difference in length between the lower extremities that, if anatomical, will usually result in lateral deviations of the sacral base, and can be a cause of low back pain. Many chiropractors and manual practitioners use leg length compared side to side to assess subluxation dysfunction and determine the effectiveness of their treatments.
Lhermitte’s sign
A physical finding in cervical myelopathy. The patient is usually seated with the head and neck in neutral position. The head and cervical spine are then flexed forward toward the patient’s chest. A positive test is reproduction of sharp, electric, radiating pain or paresthesia along the spine and into one or both arms/hands; seen mainly in multiple sclerosis but also in other disorders of the cervical cord.
Ligament
The strong tissue connecting the articular ends of bones which serves to bind the joint together and permits or limits motion.
Ligamentous laxity
An over-stretching or a lessening of tension of ligaments from chronic over-pressure or traumatic injury. In the spine, this may be a result of degenerative joint disease or acute trauma. It can be the cause of excess motion at vertebral segments, i.e., segmental instability.
Ligamentum flavum
Literally, yellow ligament. A ligament, which attaches on the laminae (the backside surface of the spinal canal) of the vertebrae.
Lipping
An overgrowth of bone in response to injury or chronic degenerative processes. See Osteophyte.
LMP
Abbreviation for Licensed Massage Practitioner. See Massage Therapy.
Lordosis
The spinal curve of the low back and neck. The term is used to refer abnormally increased curvature (hyperlordosis) or to the normal curvature (normal lordosis)
Low-velocity thrust
A type of chiropractic adjustment in which a slow manipulation or mobilization is applied to a joint.
LPN
Abbreviation for Licensed Practical Nurse.
Lumbar
Relating to the low back. The lumbar spine has five vertebrae stacked on top of the sacrum (L1 – L5).
Lumbar lordosis
The normal curvature of the spine in the low back area.
Lumbar plexus
A grouping of nerves formed by the ventral branches of the second to fifth lumbar nerves.
Lumbar radiculopathy
Lumbar spinal nerve or sacral spinal nerve impingement caused by a herniated disc, resulting in pain and possibly numbness and tingling and/or weakness sensation into one or both legs.
Lumbar sprain
An acute injury to the ligaments of the low back.
Lumbar strain
An acute injury to the musculature and tendons of the low back.
Lumbosacral joint
The area of attachment where the last lumbar vertebra (L5) meets the sacrum (S1).
Lumbosacral sprain
An acute injury to the ligaments of the lumbar and sacral spine. It may be associated with an injury to muscles and tendons.
Lumbosacral strain
An acute or chronic injury to the muscles and tendons of the lumbar and sacral spine.
M
MacNab’s line
A x-ray indicator line used to evaluate facet joints. No longer considered to be a reliable indicator of facet joint dysfunction.
Magnuson’s test
A test to evaluate a patient who overstates symptoms. See Malingerer.
Maitland technique
A manipulative physical therapy technique developed by Geoffrey Maitland which concentrates on establishing normal segmental spinal motion through the use of mobilization.
Malingerer
A medical-legal term for one who consciously and willfully misrepresents or overstates illness or symptoms in order to escape work duties or school and/or for financial gain. True malingering is thought to be rare. See Secondary Gain.
Malposition
A chiropractic term for a vertebra, which is out of normal position with respect to the vertebral segments above and below it.
Manipulation
The general application of a force to a joint that takes it beyond its normal or restricted range of motion. This term applies generally to joint manipulations by manual therapy practitioners.
Manual muscle testing
Physical exam testing used to grade muscle strength. The most common scale is graded 0-5. A 5/5 rating means the muscle that can hold a strong manual resistance, 4/5 against moderate resistance, 3/5 against gravity, 2/5 cannot overcome the force of gravity, 0/5 is a muscle absent the ability to resist.
Massage therapy
Deep or light pressure applied to the musculoskeletal system for the purpose of muscle relaxation, myofascial release, increasing joint function, increasing lymphatic drainage, realigning scar tissue, or increasing local blood flow.
Mastoid process
The rear portion of the temporal bone on each side of the head behind the ear.
Maximum medical improvement (MMI)
A medical-legal term used in insurance claims to describe a point in time when the patient’s condition will no longer improve with or without further healthcare treatment.
Maximum voluntary effort
A determination made during physical capacity evaluation testing whether a patient is giving his/her true maximum effort.
McMurray’s test
This is a clinical test used to determine if there is a tear in the meniscus of the knee. The meniscus is a cushion of cartilage that separates the end of the thighbone (femur) from the top of the leg bone (tibia). To perform the test, the patient lays on his/her back on the exam table. The examiner holds the knee with one hand and the foot with the other hand. The knee starts bent to 90 degrees. The examiner than puts a stress on the knee by placing the “knee hand” on the outside of the knee and pressing inward, while at the same time extending the knee and turning the foot outward. If there is pain during this maneuver, it suggests a tear in the meniscus.
Medial branch
A network of nerves serving the facet joints of the spine.
Medial branch neurotomy
A surgical technique whereby the medial branch nerve supply to the facet joints is cut by use of a radio frequency current to produce small, well-localized, heat lesions. Also called Medial Branch Rhizotomy. See Facet Neurotomy.
Medial compartment disease
The knee is divided into three compartments. There is one on the inner part of the knee called the “medial compartment”. There is one on the outer part of the knee called the “lateral compartment”, and there is one behind the kneecap called the “anterior compartment”. Wear and tear on the bones or cartilage can cause arthritis and joint space narrowing. This is broadly referred to as “compartment disease.”
Median nerve
One of the nerves of the medial branch. It innervates the lateral aspect of the forearm and hand including thumb, 1st and 2nd fingers. It is the nerve compressed by Carpal Tunnel Syndrome.
Meniscus
A crescent-shaped fibrocartilage structure which acts as a cushion between two bones which meet at a joint. The most common meniscus that we hear about is in the knee. There are actually two menisci (pleural of meniscus) in the knee – one on the inside called the “medial meniscus”, and one on the outside called the “lateral meniscus.”
Migraine headache
A headache caused by excessive dilation of the arteries in the brain. Symptoms include severe head pain, sensitivity to light (photophobia), occasionally sensitivity to smells, nausea, dizziness, vomiting, and/or visual disturbances. See Vascular Headache.
Military neck
A cervical spine that has a straightened rather than the normal lordotic curve.
Mobilization
Low-amplitude, low-velocity forces, which are used to restore joint function. It is of common practice among manual therapists, osteopaths, and chiropractors. There are different grades and techniques of mobilization.
More probable than not
A medical-legal term used to imply a likelihood of greater than 50 percent.
Motion palpation
A manual treatment term, which refers to assessing by touch the spinal motion segments while moving the patient through specific maneuvers. It is used to check relative motion between two adjacent vertebral segments.
Motion restriction
An osteopathic, chiropractic, or manual treatment term referring to the direction a spinal segment or a joint cannot move.
Motion segment
A unit made up of two adjacent vertebrae, which move against one another and the soft tissue which connects them.
Motor deficit
A term that describes loss of muscle strength in a particular area due to impairment of nerve conduction.
Movement dysfunction or restriction
An osteopathic, chiropractic, or manual treatment term in which the dysfunction or restriction refers to the direction in which a spinal motion segment or joint will not move.
MRI
Abbreviation for Magnetic Resonance Imaging. An imaging technique, which uses magnetic fields to obtain detailed pictures of both soft tissue and bony anatomy.
Multiple Sclerosis (MS)
A central nervous system disorder which commonly affects the brain stem, brain, spinal cord, and peripheral nerves, characterized by white matter lesions (or sclerotic changes), resulting in wasting away of these nervous system parts.
Muscle contraction headache
A headache caused by myofascial pain and spasming of the cervical muscles.
Muscle spasm
Involuntary contraction of muscle or muscle guarding to prevent its use in an attempt to protect an injured area. Also known as Muscular Splinting.
Muscle stimulation
An electrical application to decrease pain and spasm of the muscles. Often used by physical therapists.
Muscular splinting
Increased local muscle tone or spasm due to involuntary muscle contraction. Often a protective response to injury or pain.
Myalgia
Pain of the muscles.
Myelogram
The injection of a radiographic contrast liquid into the subarachnoid space through a space through a lumbar puncture. This effectively outlines the spinal cord and spinal nerves on an x-ray.
Myelopathy
Dysfunction of the spinal cord.
Myofascial
Referring to the muscles and fascia.
Myofascial pain
Pain coming from muscles and fascia.
Myofascial pain syndrome
Pain coming from the muscles and fascia which in turn, is spread out to other areas of the body.
Myofascial release
Deep tissue massage for the purpose of relaxing and lengthening tight and restricted muscle and connective tissues.
Myofascial trigger point
Classically, a taut palpable band in muscle that is painful to touch and refers pain to an adjacent body area. See Trigger Point.
Myofascitis
An inflammation of the muscles and fascia covering the muscles. See Myofascial Pain.
Myofibrosis
Infiltration of muscle tissue by scar tissue often leading to inflammation.
Myositis
Inflammation within the muscles.
Myotherapy
The application of progressively stronger pressure on a trigger point. This pressure causes reduced blood flow within that portion of the muscle followed by increased blood flow response on the release of pressure.
N
Navicular
This is a bone of the foot. It sits in a row of bones that separate the ankle bones from the long bones of the foot.
Navicular drop test
This is a clinical test in which the examiner is attempting to assess the strength of one of the arches of the foot. The patient sits with his feet flat on the floor and the examiner marks the height of the navicular bone. The patient is asked to stand, and the examiner again measures the height of the navicular. If the navicular bone “drops” by more than 10mm when the patient stands, it suggests a laxity or weakness in the medial longitudinal arch.
NCS
Abbreviation for Nerve Conduction Study.
NCV
Nerve Conduction Velocity. An electrodiagnostic test to evaluate the nerve roots.
Neer’s test
This is a clinical test looking for shoulder impingement (pinching of rotator cuff tendons). To perform the test, the patients arm is held straight out in front of them by the examiner. The examiner takes the hand from palm up to palm down, and then raises the arm over the patient’s head. The examiner holds on to the patient’s shoulder blade (called the scapula) to stabilize it. Pain with this maneuver is a sign of subacromial impingement.
Nerve block
The injection of local anesthetic into tissue surrounding a nerve for diagnostic or treatment purposes.
Nerve conduction study
Evaluates the function of peripheral nerves and the related spinal nerves. A nerve conduction study records the speed (velocity) of small electrical impulses upon the pathways of a nerve or nerves in order to determine if they are functioning properly.
Nerve conduction velocity
A diagnostic test to evaluate the function of peripheral nerves and nerve roots.
Nerve root
A bundle of the motor and sensory branches which join to form a spinal nerve which exits the spinal cord through a bony opening called the intervertebral foramen. Two nerves leave at each spinal motion segment, one on the right and one on the left.
Nerve root compression
Pressure on a spinal nerve most commonly as a result of a herniated disc, foraminal stenosis, lateral stenosis or a combination thereof.
Nerve root decompression
The surgical release of pressure on a spinal nerve.
Nerve root sheath
The covering of the nerve root continuous with the dura.
Network chiropractic
An integration of chiropractic techniques which utilizes light touch or taps to relieve spinal tension to clear the body of central nervous system interference. Changes in the sequence or timing of adjustments are determined by objective changes such as leg length. This technique is reported to “release” spinal imprints caused by physical, emotional, or chemical stress.
Neural arch
The arch of bone which attaches to the back portion of the vertebral body and surrounds the neural elements that pass through the vertebral canal. Of the vertebral bodies, it consists of the pedicles and lamina.
Neural foramina
More correctly termed the intervertebral foramen. The space through which a spinal nerve and spinal nerve sheath must pass to exit the spinal canal.
Neuralgia
Pain, generally sharp or severe, along the distribution of a nerve or spinal nerve.
Neuritis
Inflammation or irritation of a nerve.
Neurogenic TOS
A thoracic outlet syndrome involving compression of the brachial plexus passing out of the neck, under the clavicle, and through the axilla. The compression can cause denervation of the corresponding muscle groups, or pain involving the neck and arm. See Thoracic Outlet Syndrome.
Neurologically intact
A normal neurologic exam.
Neurologist
A physician who specializes in treating disorders of the nervous system and has completed an ACGME approved specialty training program in neurology to be “board certified”.
Neurology
The study of the nervous system.
Neuromuscular therapy
A combination of soft tissue mobilization techniques based on the belief adhesions and hardening of the muscle fibers can block nerve impulses through impingement and irritation of the nervous structures as they pass through the musculature. The therapy techniques include deep tissue manipulation, myofascial release, cross fiber friction, and trigger point therapy.
Neuropathy
Dysfunction or disease of a nerve, often manifested by change of sensation and/or muscle strength. Neuropathy can apply to any nerve, including the sympathetic nervous system.
Neurosurgeon
A physician who specializes in surgery of the brain and nervous system and who has completed an ACGME approved specialty training program in neurosurgery.
Neurotomy
The cutting or division of a medial branch nerve by surgical means to temporarily or permanently prevent the transmission of pain. Often misnamed rhizotomy.
Nociceptors
Free nerve endings within the peripheral nervous system. They are normally stimulated by noxious stimuli and are responsible for the perception of pain.
Non-anatomic sensory loss
Reported loss of sensation by the patient on neurological exam that clearly does not correspond to any known nerve in the peripheral nervous system or spinal nerve pattern.
Nondominant hand
The hand opposite the most used one. The non-dominated hand generally possesses less strength and less coordination.
Nonforce technique
A chiropractic term which refers to a light adjusting force technique being administered to correct spinal subluxation.
Nonorganic pain behaviors
Patient behaviors to express pain that do not relate to anatomic or organic cause. This phrase is often used by doctors hired by an insurer to conduct a medical examination of an injured person to discredit the patient.
Nonorganic signs
This term applies to any magnified pain behavior or malingering. See Nonorganic Pain Behaviors.
Nonspondylitic spondylolisthesis
A slippage of one vertebra on another without a fracture in the pars interarticularis. This usually refers to a degenerative spondylolisthesis which is caused by degenerative facet joints and not a fracture in the neural arch.
Normocephalic
Medical term referring to a person whose head and all major organs of the head are in a normal condition and without significant abnormalities.
NSAID
Abbreviation for Non-Steriodal Anti-Inflammatory Drug. More commonly known as ibuprofen, aspirin, and naprosyn.
Nucleus pulposus
The soft, squishy and spongy inner portion of the intervertebral disc.
Nystagmus
Involuntary, rapid movement of the eyes – usually a sign of a pathological problem such as a traumatic brain injury or inner ear (also called “vestibular”) injury.
O
O
An abbreviation for Objective.
O’Brien’s (active compression) test
A clinical test for shoulder injuries. It was primarily developed to test for AC joint injuries (the joint connecting the collar bone to the shoulder), however it may also test for labral tears of the shoulder. The test is performed by the examiner bringing the patient’s straight arm across the chest and turning the hand as if pouring out a can of pop. The examiner then asks the patient to hold that position as the examiner attempts to push the hand and arm toward the ground. A positive finding is demonstrated by pain reported at the top of the AC joint with this maneuver, but not if the hand is supinated.
OA
An abbreviation for Osteoarthritis or Occipito-Atlantal joint.
Ober’s test
A clinical test to assess tightness of the iliotibial band (ITB) and the tensor fascia lata (TFL). Together this muscle and connective tissue travel down the side of the thigh from the top of the pelvis to just below the knee. The test is performed with the patient lying on the non-painful side, on a table. The examiner stands behind the patient and gently pulls the bent knee backwards. The examiner attempts to lower (adduct) the leg down toward the table and release it. A positive test is found if the leg remains in the abducted position.
Objective
A finding that is measurable by the examiner and not dependent on the patient’s statement.
Occipital
Referring to the back of the head or the base of the skull.
Occipital-frontal headaches
Pain which is usually described as starting at the base of the skull or in the back of the head and radiating to the forehead.
Occipito-Atlantal joint
The spinal joint between the base of skull and the top vertebra of the spine (atlas). This designation is often used in the osteopathic or manual treatment community rather that Atlanto-Occipital Joint.
Occupational medicine
A specialty of medical practice concentrating on work-related diseases and injuries.
Occupational therapist
A licensed health care provider who assists in restoring activities of daily living to the disabled or injured person.
Odontoid process
The tooth-like projection from the upper surface of the body of the second vertebra in the neck. Also referred to as the Dens.
OMT
An abbreviation for Osteopathic Manipulative Treatment. The type of manipulation performed by most osteopaths and manual therapists. This usually refers to a low-velocity, low-to-medium-amplitude technique where a joint is carried through its full range of motion with the goal being to increase joint movement and function.
Orthopedic surgery
Surgery of the bony skeleton, tendons, ligaments, and muscles.
Orthopedics
Referring to the specialty of orthopedic evaluation and surgery.
Orthotic
A shoe insert used to control the position of the foot and ankle to create better mechanical stability.
Osteoarthritis
The most common form of arthritis involving the effects of wear and tear on the body’s structures. In the spine this is a degenerative process that includes spondylosis, spurring of the vertebral bodies, and deterioration of the facet joints. Cartilage degeneration is the hallmark of this type of arthritis.
Osteopath
Referring to an osteopathic physician or Doctor of Osteopathy (DO).
Osteopathic manipulative treatment
The type of manipulation performed by most osteopaths. See OMT.
Osteopathic physician (DO)
A physician who has completed a graduate course of medical education at an American Osteopathic Association – approved college of osteopathic medicine. See DO, Osteopath.
Osteophyte
A bony outgrowth, often in response to trauma to a joint or as a result of normal degenerative joint disease. Also known as bone spurs.
Osteoporosis
Decreased bone density which may lead to mechanical failure or fractures due to even minimal physical stress on the bone.
Osteotomy
Literally, it means the cutting of bone.
OT
An abbreviation for Occupational Therapist.
P
P.T.
Physical Therapist.
Pain clinic
A multidisciplinary team approach for treating patients with chronic pain. Education is emphasized, as well as physical conditioning, self-management techniques, decreasing narcotic dependence, and addressing psychological barriers to recovery.
Pain generator
The anatomic structure that is causing pain.
Pain scale
One method for quantifying pain. There are many different types of pain scales. The most common is a 0-10 scale termed the Visual Analog Scale with 10 as the “most severe” pain.
Palmer diversified
A chiropractic technique where the primary adjustive force is the practitioner’s hands. See Diversified Technique.
Paraspinal musculature
The muscles that can be readily palpated on either side of the spinous processes during an examination.
Paraspinal tenderness
Tenderness in the muscles on one or both sides of the spinous processes.
Paravertebral
Adjacent to the vertebral column.
Paresthesia
An abnormal sensation of numbness usually involving tingling or pins and needles, which is typically not painful. It may also include a burning feeling.
Pars interarticularis
It literally means “the part between the articulations.” This is the portion of the vertebra which lies between the upper facet process and the lower facet process. If this section of bone is fractured or not fully fused, it may result in a spondylolysis or spondylolisthesis.
Pars interarticularis defect
A fracture or congenital defect in the bony portion connecting facet joints and the pars interarticularis. This is also called a spondylolysis and may lead to spondylolisthesis.
Passive range of motion
In the spine or extremities, passive range of motion (ROM) is measured in flexion, extension, lateral flexion, and rotation, abduction, adduction, inversion, and aversion. This differs from active range of motion in that the patient uses no voluntary muscle contraction and must be taken through the ROM by the examiner.
Patella
A bone located in front of the knee, commonly referred to as the kneecap.
Patella tendon reflex
The reflex contraction of the quadriceps muscle with tapping of the tendon of the patella. Used to discern indirectly the functioning of the L4 and, to a lesser extent, the L3 spinal nerve functions. Also known as the Knee Jerk Reflex.
PCE
Abbreviation for physical capacities evaluation.
PDR
Physician’s Desk Reference.
Pedicle
That portion of a vertebra which separates the larger, vertebral body in the front from the smaller bony structures toward the back.
Peripheral nervous system
The portion of the nervous system outside the central nervous system.
Peripheral neuropathy
A generalized “slowing” of the peripheral nervous system which is often characterized by decreased sensation in a stocking and glove distribution in the feet and hands. This condition can sometimes be diagnosed with a nerve conduction study.
Pettibon technique
A chiropractic technique which uses complex formulas to ascertain various misalignment angles. Specific manual and instrument adjustments are used to correct these misalignments.
Phalen’s test
A clinical test for carpal tunnel syndrome. The test is performed by pressing the backs of both hands together for one minute. Numbness, tingling, or pain in the thumb, index and middle fingers suggests the presence of carpal tunnel syndrome.
Physiatrist
A medical doctor who has completed residency training in Physical Medicine and Rehabilitation. A specialist in rehabilitation and outpatient non-operative orthopedic musculoskeletal care. Board certification is given by the American Academy of Physical Medicine and Rehabilitation.
Physical capacity evaluation
A test of physical strength and stamina used to determine work restrictions and work tolerance. See Functional Capacity Evaluation.
Physical therapist
Graduate from a university program with a Master of Science or a Ph.D. in physical therapy. Licensed in each state, a physical therapist focuses on biomechanical components of the neuro-musculoskeletal systems with emphasis on functional limitations. Procedures used include manual physical therapy neuro-muscle exercises, posture correction, and home and work place analysis.
Physical therapy
Treatment for musculoskeletal and neurological disorders provided by a licensed physical therapist. Usually involving exercise, electrical modalities, and myofascial techniques.
Piriformis muscle
The piriformis is a muscle deep in the buttocks. Its job is to rotate (think log roll) the leg outward. It also helps to flex the hip. The piriformis lies very close to the sciatic nerve. When the piriformis is tight, it may put pressure on the sciatic nerve and cause some nerve pain.
Piriformis syndrome
Various symptoms involving posterior hip pain localized in the piriformis muscle that may include radiating numbness or tingling down one leg. A small portion of the population has a sciatic nerve which goes through the piriformis muscle, which may be irritated when inflammation occurs within the muscle.
Plantar Fasciitis
The plantar fascia is a tough band of connective tissue that extends from the heel to the base of the toes. It help supports the “arch” of the foot. If the fascia becomes too tight, it may become inflamed resulting in pain in the heel or bottom of the foot.
Plexopathy
Dysfunction of the brachial plexus or lumbar plexus.
Plexus
A network of nerves.
Positional dysfunction
A manual therapy term for dysfunction or pathology when a spinal motion segment is in a particular position.
Post-Concussive syndrome
Any alteration in cerebral function caused by direct or indirect forces transmitted to the head resulting in brief loss of consciousness, light-headedness, vertigo, cognitive and memory dysfunction, tinnitus, difficulty concentrating, amnesia, headaches, balance disorder, nausea and/or vomiting.
Post-Traumatic Stress Disorder
An abnormal amount of psychological stress after some traumatic event. This may occur after an auto accident. The patient may experience anxiety with driving. It is a specific psychological diagnosis.
Posterior
The backside of a bodily part. Opposite of anterior.
Posterior cruciate ligament
There are two cruciate ligaments in the knee. The word cruciate means “cross” and that is what the two cruciate ligaments do. They form a cross or “X” as they pass through the middle of the knee. They go from front to back (or back to front). The anterior cruciate ligament (ACL) starts in the front of the lower leg bone (tibia) and attaches to back of the thighbone (femur). The ACL resists forward slippage of the lower leg bone under the thighbone. The posterior cruciate ligament (PCL) starts in the back of the lower leg bone (tibia) and attaches to the front portion of the thighbone (femur). The PCL resists backward slippage of the lower leg bone (tibia) under the thighbone (femur).
Posterior longitudinal ligament
The ligament along the length of the spine attached to the backside of a vertebral body.
Posterior tibial tendinitis
The tibia is the “shin bone”. Posterior means behind. The posterior tibial tendon sits on the inside of the left, just behind the shin bone. It extends down the leg and wraps under the medial malleolus (the bump on the inside of your ankle) and finally attaches to the inside/bottom of the foot. Tendinitis means inflammation, swelling and pain – so it may hurt anywhere along the tendon’s course.
PPD
An abbreviation for Permanent Partial Disability.
PRN
An abbreviation for Per Required Need.
Progressive resistance exercise
A rehabilitation technique with progressively increasing strength training.
Prolapsed disc
A term often used synonymously with herniated disc the annulus fibrosis becomes disrupted and the inside of the disc material, the nucleus pulposus, extends outward.
Prolotherapy
The injections intended to cause scarring of tissue around joints to reduce ligament hypermobility at a joint area.
Pronated foot
A foot that is extra lax, resulting in excessive roll of the foot and flattening of the arch.
Pronation
Pronation means to rotate (the hand or forearm) so that the surface of the palm is downward or toward the back; or in the foot to turn the sole of the foot outward so that the inner edge of the foot bears the weight when standing. In the foot, if someone “over-pronates” they are more flat footed. This can lead to foot pain as well as knee pain, shin splints, achilles tendinitis, posterior tibial tendinitis, Piriformis syndrome, and plantar fasciitis.
Prone
Lying in a face-down position.
Protruded Disc
A contained disc herniation, sometimes called a bulging disc.
Provocative maneuver
A physical exam test which attempts to reproduce pain through movement, mobilization, pressure over a structure, or other means.
PTSD
An abbreviation for Post Traumatic Stress Disorder.
Pubic symphysis pain
The pubic symphysis is the joint in the front of the pelvis where the two pelvic bones meet. Sometimes due to trauma or systemic inflammation the pubic symphysis may become painful.
Q
Q.H.
An abbreviation for “every hour.”
Quadrant
One of four regions (for example in the abdomen), used for descriptive and diagnostic purposes. For example: right upper quadrant, left lower quadrant, etc.
Quincke needle
A type of needle used for spinal injections.
R
Radicular
Of or pertaining to a nerve root exiting the spinal cord.
Radicular pain
Pain caused by a radiculopathy or radiculitis.
Radicular symptoms
Sensations such as pain radiating down arms or legs. Symptoms may involve motor or sensory dysfunction
Radiculitis
Inflammation of a nerve root causing symptoms of pain in the distribution of that root.
Radiculopathy
Dysfunction of a nerve root that can cause (1) numbness or tingling in a specific pattern corresponding to that nerve root or (2) muscle weakness in the muscles supplied by that nerve, or (3) loss of reflex associated with that nerve.
Range of motion (ROM)
The range of movement of a joint or a spinal area that is measured and compared to normal. Restrictions in the range of motion of a joint or spinal area indicates some type of dysfunction.
Reconditioning
A supervised exercise program designed to promote physical conditioning through strength, flexibility, and increasing aerobic capacity.
Referred pain
Pain that originates in one part of the body, but is felt in another part of the body.
Reflex dystrophy
See Reflex Sympathetic Dystrophy.
Reflex sympathetic dystrophy
A clinically determined syndrome characterized by burning, atrophy, hypersensitivity, temperature changes in the affected area, and decreased range of motion. The cause is usually trauma. This has recently been renamed Complex Regional Pain Syndrome.
Reflexology
A therapy which connects various regions in the sole of the foot with different body parts. The theory is that life energy, or chi, is channeled through these zones.
Restriction
A term to describe limitation of movement of vertebral sections.
Retrolisthesis
A term which refers to a vertebral body which has moved backwards relative to the vertebral body below.
Reversal
A radiographic term which describes a spinal curve which has been reversed to the opposite direction, e.g., the reversal of the normal lordotic curve of the cervical or lumbar spine.
Rheumatoid arthritis
A common type of inflammatory arthritis believed to be a result of an autoimmune process which primarily affects the joints of the hands and feet as well as the cervical spine. It can also affect all other joints in the body. It is characterized by pain, stiffness and swelling in the joints.
Rhizotomy
The cutting or burning of a nerve root. See also Neurotomy.
Rhomboid major muscle
A skeletal muscle on the back that connects the shoulder blade (scapula) with the vertebrae of the spinal column. It acts together with the rhomboid minor (a similar but slightly smaller muscle) to keep the scapula pressed against thoracic wall and to pull the shoulder blades together (a process called scapular retraction). The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. Other muscles that perform this function include the serratus anterior and pectoralis minor.
Roentgenometrics
A chiropractic technique which involves the study of x-rays by biomechanical analysis and measurement, using markers on static spinal views or acetate overlays on bending views.
Rolfing
A manual therapy technique creates by Ida Rolf used to correct posture and integrate structure. The technique involves manual soft tissue manipulation to balance the body in the gravitational field. The 10 sessions are often completed in sequence followed by an integrating session.
ROM
Abbreviation for Range of Motion.
Roos test
A test for thoracic outlet syndrome in which the shoulder is abducted to 90 and the shoulder joint is externally rotated. The fingers are then rapidly flexed and extended. If this test elicits arm pain, vascular thoracic outlet syndrome may be implicated. The pulse is also monitored.
ROS
Short hand medical terminology for “Review of Symptoms.” A review of systems is a standard checklist of questions that a doctor asks you to make sure that nothing is being missed.
Rotated
An osteopathic, chiropractic, or manual treatment term which refers to a spinal vertebral segment which is rotationally out of position with respect to the vertebra below. The term rotated may apply to misposition of other skeletal parts.
Rotator cuff impingement
Compression of any of the rotator cuff or tendonous fibers at the shoulder joint underneath the supraspinatus tendon.
S
Sacral
See Sacrum.
Sacroiliac joint
Referring to the area where the sacrum and ilium bones form a joint.
Sacrum
The base of the bone support for the spine. It is made up of the S1 through S5 vertebrae, which fuse to form a triangular shaped bone
Scalene
Three anterior neck muscles which attach between the back of the first six cervical vertebrae and the first and second ribs. This muscle group allows for bending and rotating the neck.
Scapula
The large, flat, triangular bone which forms the backside part of the shoulder. Also referred to the shoulder blade.
Schmorl’s node
A bone defect in the upper or lower margin of the body of the vertebra. It may be traumatic, developmental, or degenerative in nature.
Sciatic nerve
The major nerve supplying motor and sensory functions to the legs. This is the largest peripheral nerve in the body. This nerve later divides to form the tibial and peroneal nerve. It arises from the L4, L5, and S1-S3 spinal nerves. It emerges from the lumbar spine and sacrum into the gluteal region through the sciatic notch. It is the largest diameter nerve in the body.
Sciatic notch
A notch between the sacrum and the ilium. The sciatic nerve travels through this region.
Sciatica
A description of pain and/or numbness associated with inflammation of the sciatic nerve, usually due to compression of the spinal nerve between fifth lumbar (L5) and first sacral vertebrae(S1). It is often the result of a herniated nucleus pulposus at the L4-5 or L5-S1 levels.
SCM
An abbreviation for Sternocleidomastoid Muscle.
Scoliosis
An abnormal lateral curvature and/or rotation of the spine. May be idiopathic, anatomic (as with a short leg) or functional (as with muscle spasm) in etiology.
Secondary gain
An external benefit which arises from an illness such as monetary gain or attention. See Malingerer.
Segmental dysfunction
Refers to vertebral segments which are not moving normally in relation to one another.
Segmental instability
Motion of a spinal motion segment which significantly exceeds normal range of motion for that segment so that further over-stretching of the supporting soft tissue may occur.
Selective nerve root block
Injection of an anti-inflammatory and local anesthetic onto the sleeve surrounding a spinal nerve. This can be done for both therapeutic and diagnostic purposes to determine if a spinal nerve is causing pain. Also known as a Spinal Nerve Block.
Self-mobilization
Exercises by a patient to help move restricted joints.
Sensory deficit
A decrease in one or more types of sensation noted on physical exam.
SEP
A diagnostic technique called Somatosensory Evoked Potentials used to detect a sensory radiculopathy or significant myelopathy.
Shiatsu
A style of acupressure/massage therapy that stimulates points along meridians and focuses on balancing “chi”. See acupressure and acupuncture.
Shoe lift
An orthotic to correct a short leg or an abnormal or less than ideal postural position of a lower extremity part. See Orthotic.
Short leg syndrome
Pain symptoms arising from a difference in length between the lower extremities. Short leg syndrome may cause musculoskeletal-type symptoms which can be corrected with a shoe lift.
SI dysfunction
A mechanical abnormality of the sacroiliac joint which alters normal movement.
SI joint
See Sacroiliac Joint.
Skin rolling
A physical examination technique in which the thumb and fingers are used to grasp the paravertebral skin and roll this tissue from inferior to superior. The ease of displacement of both skin and subcutaneous tissue is evaluated, as are the thickness of the skin and pain symptoms. Also a manual treatment technique used to break up scar tissue.
SOAP
An acronym for a standard record keeping method of patient visit: Subjective, Objective, Assessment, and Plan.
Soft cervical collar
A soft neck collar made of foam rubber covered with fabric which provides support and limits movement of the neck.
Soft tissue
Muscles, tendons, ligaments, cartilage, connective tissues and other non-bony structures of the musculoskeletal system.
Somatic dysfunction
An osteopathic term meaning an alteration in the normal function of a joint.
Somatosensory evoked potentials
An electrical test used to determine the integrity of the sensory pathways in the spinal cord. Also termed SSEP.
Soto hall test
A physical exam test in which the chin is brought to the chest, with the patient flat on their back. Pain will be felt at the site of the lesion in spine abnormalities. Classically used to screen for spinal meningitis and to clarify spinal related pain.
Spasm
A painful involuntary, sustained contraction of a muscle, due to irritation.
SPECT
An acronym for Single Photon Emission Computed Tomography, a nuclear-radiographic technique. Often used to detect presence of fractures or other bone abnormalities.
Speed’s test
A clinical test used to check for inflammation of the biceps tendon (called biceps tendonitis. To perform the test, the patient’s elbow is flexed (or bent) 20 to 30 degrees with the palm up. The patient has their arm straight out in front like they are holding up a tray. The examiner pushes the patient’s arm down while palpating the patient’s biceps tendon over the anterior aspect of the shoulder. Pain with this maneuver suggests biceps tendonitis.
Spinal Cord
The extension of the central nervous system which extends from the brain stem to the cauda equina and is surrounded by the spinal canal. This acts as a conduit for information to and from the brain as it relates to the rest of the body.
Spinal fusion
A surgical procedure to form a bony bridge between two or more spinal vertebrae to eliminate movement over painful or unstable spinal segments. Spinal fusion can also occur at birth or as a result of the aging process.
Spinal instability
Abnormal or excessive motion in a vertebral segment with respect to the vertebrae above and/or below it.
Spinal motion segment
A unit of the spine, including the two adjacent vertebrae, the intervertebral disc, the facet joints, all the interconnecting ligaments, two intervertebral foramen, and the nerves and vessels emerging there from the spinal canal.
Spinal nerve
One of 31 right and left paired peripheral nerves which connect with the spinal cord.
Spinal nerve block
Injection of an anti-inflammatory and local anesthetic on to the sleeve surrounding a spinal nerve. This can be done for both therapeutic and diagnostic purposes to determine if a spinal nerve is causing pain. Also known as Selective Nerve Root Block.
Spinal nerve root
See Nerve Root.
Spinal stenosis
Narrowing of the central spinal canal that contains the spinal cord and/or cauda equina. This can be caused by congenital conditions, abnormal development or degenerative changes of the disc and/or facet joints or ligaments.
Spinal subluxation
A term used in chiropractic to describe the alteration of the normal dynamics between adjacent vertebrae, which may result in motion, muscular or neurological dysfunction.
Spinous process
A projection of bone which extends from the junction of the two laminae projecting off the back of the vertebra.
Spondylitis
An inflammatory condition of the spine.
Spondyloarthritis
An arthritic condition of the spine. It is related to spondylosis.
Spondyloarthropathy
A form of inflammatory arthritis which typically involves the spine, especially the sacroiliac joints.
Spondyloarthrosis
Arthrosis of the synovial joints of the spine. This usually refers to degenerative joint disease.
Spondylolisthesis
Forward or backward displacement of one vertebra in the relation to the adjacent vertebra below. Depending on the amount of the displacement, spondylolisthesis may require surgical intervention to fuse the spine.
Spondylolysis
A defect or fracture of the pars interarticularis, on one or both sides. This condition is often associated with spondylolisthesis.
Spondylopathy
Any disease process or disorder of the vertebrae.
Sprain
Trauma to the joint capsule or ligaments, causing pain and impairment of joint movement, depending upon the degree of severity of injury to the ligaments.
Spray and stretch
A manual technique for the treatment of trigger points and tender points within muscle.
Spurling’s sign
A physical examination procedure test in which the patient’s head is rotated sideways and extended backwards, while gentle compression is applied to the top of the head. The test is used to determine if neural foraminal narrowing is compressing the exiting spinal nerve. A positive test involves pain, numbness, or paresthesia extending into the arm below the elbow. Also called Foraminal Compression Test.
SSEP
Somatosensory Evoked Potentials. This is a neurodiagnostic test to evaluate sensory nerves.
Static intersegmental subluxation
A chiropractic describing term a malposition of vertebrae detected on static palpation testing.
Stenosis
In the spine, this can refer to a narrowing of the vertebral canal (central spinal stenosis), the bony foramen through which a spinal nerve passes (foraminal stenosis), or the lateral passage where a nerve descends to prepare to exit the spine (lateral recess or sub-articular stenosis).
Step defect
A spinal fracture noted at the front side of the vertebral body.
Sternoclavicular joint
The joint between the upper portion of the sternum and the clavicle.
Sternocleidomastoid muscle
An anterior neck muscle which attaches at the sternum and collarbone and then at the mastoid process of the skull. It is often injured in whiplash injuries.
Sternum
The breast bone. It articulates with the clavicle and the cartilage of the first through the seventh ribs.
Steroid
A potent anti-inflammatory drug which can be given orally in tablet form, intravenously, intramuscularly, or into a joint, a tendon sheath or other tissues.
Straight-leg raise
A physical examination maneuver typically used to determine if a low back spinal nerve is under tension. The patient is lying on his/her back or in a sitting position, and the leg is raised.
Strain
Trauma to the muscle or tendons as a result of violent contraction or excessive stretching.
Subacromial impingement
Also known as “Swimmer’s Shoulder” or “Thrower’s Shoulder”, occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space. The acromion is a part of the shoulder blade that meets with the clavicle (collar bone). Together they form an arch, and some of the rotator cuff tendons pass beneath this arch. As you raise your arm, the space under the arch may get tighter which pinches those tendons. If this continues, it may result in pain, weakness and loss of movement at the shoulder.
Subacute
Between acute and chronic. Further defined by some to mean the time period six to twelve weeks into the healing process. Defined by others by the level of inflammation and symptoms.
Subarachnoid space
The space below the arachnoid membrane which is filled with spinal fluid. The arachnoid membrane is a layer enclosing the brain and spinal cord, just below the dura.
Subjective
A finding on any exam that is reported by the patient and is dependent on patient report for its reliability.
Subluxation
In chiropractic terms, subluxation refers to an abnormal joint movement beyond normal range of motion, producing neurological effects. In medical terms, an incomplete or partial dislocation of a joint.
Subluxation complex
A chiropractic term relating to the various components of a spinal subluxation. These components include spinal kinesiopathology (abnormal spinal position or movement), myopathology (abnormal muscle function), neuropathology (abnormal nerve function), histopathology (abnormal soft tissue function), and pathophysiology (resultant degenerative processes.
Subscapularis muscle
The scapula is the shoulder blade. The “sub-scapularis” lies under the shoulder blade – or on the underside of the shoulder blade. The subscapularis turns the arm inward. It also works to prevent dislocation of the shoulder.
Subtalar joint
This is a joint in the ankle between the heel bone (calcaneous) and the talus – a bone that connects to the lower leg. This joint allows the arch to collapse a little when you walk – a process called pronation.
Supartz™ injection
A brand name for a solution of hyaluronate. It is like an artificial joint fluid that is used to cushion the knee joint. In patients with significant knee arthritis, Supartz can be injected into the knee, and in some people it may decrease pain for a period of time or to delay the time for knee surgery.
Superior
Position of an anatomical part which is above or higher than another anatomical part.
Superior Ilium
One of the bones of each half of the pelvis. It is the top and widest part of the pelvis. See Ilium.
Supination
Supination means to rotate (the hand or forearm) so that the surface of the palm is upward or toward the front; or in the foot to turn the sole of the foot inward so that the outer edge of the foot bears the weight when standing. In the foot, if someone “over-supinates” there foot is very stiff and rigid.
Supraspinatus muscle
The shoulder blade is a triangular shaped bone. It sits like an inverted triangle with the point aimed toward the floor. It’s one of the major bones that make up the shoulder joint. The medical term for the shoulder blade is the “scapula.” You can feel that bone on yourself. You can actually feel a ridge of bone that runs near the top of the shoulder. That ridge is called the spine of the scapula. The ridge separates two major muscles of the shoulder. The one above the shoulder is called the supraspinatus. It is one of the four muscles that make up the rotator cuff, and it is the most commonly injured.
Supraspinatus tendinitis
Inflammation of the supraspinatus tendon, found at the top of shoulder blade/lower neck region.
Supraspinatus tendon
The tendon attaching the supraspinatus muscle to the anatomy of the shoulder joint.
Supraspinous ligament
A ligament which attaches to and continues over the spinous processes.
Surface EMG
A graphic record of micro-voltage present in muscles in static or active contraction as measured by sensors placed upon the skin.
Swayback
Excessive forward curve of the spine, including excessive lumbar lordosis and traumatic kyphosis. See lumbar lordosis.
Sx
Abbreviation for “symptoms” or “subjective” pain complaints.
Sympathetic dystrophy
See Reflex Sympathetic Dystrophy.
Sympathetic nervous system
One of the two divisions of the autonomic nervous system which effects heart rate, blood pressure, and blood flow to the skeletal muscles, perspiration, dilation of the pupils, and depression of gastrointestinal activity.
Symptom magnification
The reporting of symptoms by a patient which are greater than would be expected. See Malingerer, Secondary Gain.
Synovial fluid
The lubricating fluid within the joints.
Synovial membrane
The normal lining of a joint, which becomes inflamed when traumatized or arthritic.
Synovitis
Inflammation of the synovial membrane.
T
T1 weighted image
An MRI technology for imaging of fat tissue as a bright signal and water as a dark signal. This is particularly helpful in the lumbar spine, as many of the structures are outlined by fatty tissue and show up dark against the bright fat signal.
T2 weighted image
MRI technology for the imaging of fluid, water, or fat as a bright signal.
Talus
The talus is a critical bone of the ankle joint. It connects the leg and the foot. The talus joins the ankle joint and is responsible for the upward and downward movement (dorsiflexion and plantarflexion) of the ankle. In addition, it joins the heel bone (the calcaneus) where it is responsible for the majority of the inward and outward movement (inversion and eversion) of the foot. Injuries of the talus can affect both the ankle and subtalar joint and affect multiple planes of movement of the foot and ankle.
TBI
An abbreviation for a “Traumatic Brain Injury.”
Temporal
Toward the temples; the side of the skull.
Temporal bone
A bone on both sides of the skull at its base, which contains the ear canal.
Temporomandibular dysfunction (TMD)
Dysfunction of the temporomandibular joint. May result in headaches, jaw pain and contribute to neck pain.
Temporomandibular joint (TMJ)
The jaw joint between the mandible and the articular surface of the temporal bone. This joint allows opening and closing of the jaw, as well as numerous other movements. The joint contains a disc.
Tender point
A specific area of tenderness within a muscle which does not refer pain to other body parts. It is commonly seen in fibromyalgia. Sometimes considered a latent trigger point.
Tendinitis
Inflammation of a tendon.
Tendon
Primarily the fibrosis non-contractile connective tissue attaching muscles to bones.
Tendon reflex
A physical exam technique which evaluates the integrity of the neurologic function of the muscle being tested.
TENS
Transcutaneous Electrical Nerve Stimulation. A form of electrical treatment used to block pain perception.
Tension headache
A headache caused by excessive contraction of cervical muscles.
Tensor fascia lata
A hip muscle which extends from the outer lip of the iliac crest (the top of the pelvis at the waist line) to a thick band of connective tissue that extends down the outter thigh to the knee (called the iliotibial band). It’s primary function is in walking and it is heavily used in horse riding, hurdling, and water skiing.
Teres minor
One of the four muscles of the rotator cuff of the shoulder. It works in tandem with the infraspinatus to turn the arm bone inward (called internal rotation of the shoulder). It is not commonly injured like other rotator cuff muscles.
Thecal sac
Another name for the area within the dura.
Therapeutic exercise
Instructing a patient in body mechanics, exercise to increase strength or range of motion, and general conditioning and flexibility.
Therapeutic massage
Deep or light pressure applied to the musculoskeletal system for the purpose of muscle relaxation, myofascial release, or increasing local blood flow and lymph flow.
Thompson technique
A chiropractic technique using a mechanical drop mechanism with an adjusting table, requiring less adjustive force.
Thoracic
Pertaining to the chest or thorax.
Thoracic outlet syndrome
TOS. Compression of the neurovascular bundle in the shoulder, collarbone and neck (usually irritation of nerves within the bundle). The compression may cause decreased or abnormal blood flow into the arms, often associated with certain overhead positions of the arms. Symptoms include paresthesia, numbness, pain in the arm and hand, and weakness in the hand.
Thoracic vertebrae
The twelve vertebrae which connect the ribs and form the back wall of the thorax.
Thoracolumbar junction
The region of the twelfth thoracic vertebra and the first lumbar vertebra. This is the region where the relatively less flexible mid-back spine (due to the rib cage) joins with the more mobile low back.
Tinel’s sign
This test is commonly used to look for carpal tunnel syndrome in the wrist. It is performed by tapping over the nerve. If positive, the tapping will cause tingling or pins and needles along the normal pathway of that nerve.
Tinnitus
Ringing in the ears or in the head due to nerve damage, over dosage of certain drugs, or excessive contraction of the small intricate muscle of the inner ear. Tinnitus can result from trauma.
Tissue texture abnormality
An osteopathic term describing a palpable change in the tissues that is associated with somatic dysfunction.
TMD dysfunction
See Temporomandibular Dysfunction.
TMJ syndrome
See Temporomandibular Dysfunction.
TOS
An abbreviation for Thoracic Outlet Syndrome.
Transverse ligament of the atlas
A strong ligament passing over the odontoid process of the atlas.
Transverse process
The lateral bony process (vertebral process) projecting from the side of the vertebrae.
Trapezius
A large, flat, triangular muscle on each side of the upper back that serves chiefly to rotate the scapula and assist in turning one’s head.
Traumatic Brain Injury (TBI)
A blow or jolt to the head or a penetrating head injury that disrupts the function of the brain.
Trigger point (TP)
A taut, palpable spot in muscle that is painful to touch and refers pain to another body area.
Trochanteric Bursitis
Inflammation of the trochanteric bursa surrounding the hip joint.
Tx
An abbreviation for “treatment”.
U
Ulnar nerve
The ulnar nerve provides sensory function to the pinky and ring finger. It takes its name from the ulna, one of the bones of the forearm, in close proximity and along which the nerve is located.
Ulnar neuropathy
A lesion of the ulnar nerve which can cause numbness in the fourth and fifth fingers. This can be confused with a radiculopathy from the eighth cervical (C8) nerve root.
Ultrasound
High-frequency sound that is applied as a therapeutic heat treatment in physical therapy rehabilitation.
Uncovertebral joint
The joints in the lower cervical spine from the second to the seventh cervical vertebrae (C2-C7). These are formed by the side projections on the rim of the vertebral bodies. They are independent of the disc and facet joints. Also known as the Joints of Luschka.
Upper cervical dysfunction
A restriction or abnormal movement of the top two vertebral joints in the neck following a neck injury. A common cause of headaches.
V
V sign
A radiographic sign seen on a lateral x-ray view which may represent a torn or stretched transverse ligament.
VAS
Visual Analog Scale. A pain scale in which the patient records pain from 1 to 10, with 10 as the most extreme pain.
Vascular headache
A headache caused by excessive dilation of the arteries in the brain and its dural coverings. See Migraine Headaches.
Ventral
Pertaining to the front part of the human anatomy.
Vertebra
One of the twenty-four (24) bones that make up the spine. There are three types: cervical (seven in number), thoracic (twelve), and lumbar (five), with each section possessing unique characteristics. The sacral vertebrae are fused in one bone.
Vertebrae
The plural of vertebra.
Vertebral
Of or pertaining to the vertebrae.
Vertebral body
The front portion of the vertebra which forms the vertebral column when stacked on another vertebra. The disc of the vertebral joint is found between adjacent vertebral bodies.
Vertebral subluxation complex
See Subluxation Complex.
Vertigo
Dizziness with a sensation of spinning.
Viscosupplementation
This generally refers to the injection of hyaluronic acid into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. See also Supartz injection.
W
Waddell’s test
A series of five tests to assess whether a patient is faking or exaggerating their pain responses. Three of five must be positive for the test to be significant.
Whiplash injury
A sprain or strain syndrome of the cervical spine caused by a hyperextension-hyperflexion or acceleration – deceleration injury. This most commonly occurs in car collisions.
WNL
An acronym for “within normal limits.”
Work hardening program
A rehabilitation program involving gradually progressive work-related activities performed with good body mechanics in an attempt to prepare that person to return to work.
Y
Yeoman’s test
A clinical exam test to determine if a person has SI (sacro-iliac) joint pain. To perform the test, the patient lies on their stomach. The examiner uses one hand to stabilize the pelvis while the other hand lifts the leg off the table. If the patient has pain over the buttock, it may suggest SI joint pain. If the pain is in the front of the thigh, it may suggest nerve pain from stretching the femoral nerve. Back pain may indicated pain coming from the lumbar spine.
Yergason’s test
This is a clinical exam used to evaluate for inflammation of the biceps tendon (called biceps tendonitis). To perform the test, the patient’s elbow is bent to 90 degrees with the thumb up. The examiner grasps the wrist, and resists the patient from trying to turn the palm up and bend the elbow further (at the same time). Pain with this maneuver indicates biceps tendonitis.
Z
Z-joint
An acronym for zygapophyseal joint.
Zygapophyseal
Of or pertaining to the facet joints.
Zygapophyseal joint
Same as facet joint.