The work presented in this PhD thesis is the result of research carried out at the Center for Sensory-Motor interaction (SMI) at Aalborg University (Denmark) in the period from September 2009 to March 2013. The research was supported by the Danish Research Council for Technology and Production (FTP). During this project five months, between April and August 2011, were spent at Duke University, Durham, NC, USA in collaboration with Dr. Warren M. Grill. This thesis investigates the basic methodology behind the human nociceptive withdrawal reflex (NWR). The aims of this thesis were to investigate this methodology as a potential way of reducing the variability of NWR assessment and, if possible try, to discover methods which could help to reduce this variability. In order to fulfill these aims electrophysiological experiments, advanced mathematical modeling and anatomical studies were applied to investigate the elicitation and recording of the NWR. This thesis contains four chapters. The Introduction presents the reader to the background and motivation for this project and gives a general overview of the PhD thesis. The Methods chapter introduces the used methods and elaborates the background for choosing them. The Results chapter presents and discusses the main findings in this thesis; in addition, all these findings are further elaborated in the original papers. The Conclusions chapter sums up the main findings and the impact on the state of the art, and finally looks at the perspectives towards future studies. The thesis is based on three original papers that all are either published in, or submitted to, peer-reviewed journals. In addition one submitted peer- reviewed paper and several conference abstracts were based on the research conducted in this project.

In this yearbook for 2013 we present you with the latest research on pain management. We start out with knee, pain in persons with intellectual disability, low back pain and pain in cancer and oncology. You will also find a systematic review on pain and function in older people with persistent pain, pediatric pain and the influence of music on dental pain. Acute pain, pelvic pain and many case stories around pain in cancer will be found in this Yearbook. It is our hope that you as the reader will find the information of interest and useful.

DR. GARY SAFF is a native of South Florida where he currently practices as an Interventional Pain Management Specialist. Ivy League trained, he did his pain management fellowship at Memorial Sloan-Kettering Cancer Center. More recently he was the Director of Pain Management services at Cleveland Clinic-Weston and formerly a Director at Columbia University's St. Lukes-Roosevelt Hospital. He holds certificates in the American Board of Anesthesiology, the American Society of Pain Management, the American Board of Independent Medical Examiners, and he is licensed in Acupuncture. Dr. Saff has spent ti me both in the Amazon jungle learning medicine from shamans as well as learning eastern medicine acupuncture techniques. In 2009 he published his first book "What A Pain" A Doctor's Guide to Understanding and Treating Pain. He has also authored another children's book, "Baby Benny's Boo-Boo Book" published in 2011. He has published many articles and has given lectures both nationally and internationally. Dr. Saff is currently in private practice and can be contacted at Integrated Pain Solutions of South Florida at (954) 772-7552 or via the web at www.whatapain.com.

The purpose of this book is to explain some basic fundamental principles in relation to managing your body, spine, and posture for greater health in a very simple and easy manner. It also goes into various techniques one can do to release tightness and compression throughout the body. While self-adjustment is no substitute for the expert knowledge and experience of a health professional, a great deal of benefit can be acquired by simply practicing the set of simple self-healthcare techniques and practices outlined and described in this book. In this book you will learn: - A simple five-step process for self-adjusting. - More about one of the most important and undervalued tissues in the musculoskeletal system- the connective tissue. - Three yoga-style stretches that anyone can do right now to help decompress the spine and prepare for a self-adjustment. - Tools and tips that help to release muscles and connective tissues. - Supplements for a healthier musculoskeletal system. - How to begin retraining your musculoskeletal system for more efficient movements that provide long-term solutions to many pain problems.

The development of generalized sensitization during acute pain conditions plays an important potential role for the transition to and development of chronic pain. Such a phenomenon complicates adequate pain management and challenges current therapeutic modalities. This doctoral thesis aims to investigate the application of quantitative sensory testing in a clinical setting, mainly postoperative pain and chronic pain states. The pathophysiology, extent, and intensity of generalized sensitization, and in particular its relation to clinically relevant patient experiences, i.e. spontaneous pain and pain evoked by daily activities, are still a matter of debate and intensive research. The current thesis has taken on the difficult task of applying standardized quantitative sensory testing to clinical medicine to explore the extent and magnitude of sensory perturbation in a number of important conditions. The thesis is a very impressive and pioneering collection of important pieces of research providing a strong assertion on how pain can be diagnosed and profiled. It comprises an important contribution to the progress of the field and the impact of the studies will pave the way for new explorative studies for the benefit of patients suffering from chronic pain. Going from a purely descriptive way of thinking, the thesis has developed, in an ambience of changing concepts in pain medicine at large, a shift towards a mechanism-based way of thinking. This is the only way to make a step forward in pain medicine both when it comes to understanding the complex pictures presented by pain patients, and to provide clever answers to the complex therapeutic needs of these patients. The scientific work described in this thesis is original, and the findings contribute to new and better understanding of the pain syndromes investigated. This work also provides important information for planning future research. I have known and collaborated with Oliver since the early 1990s, and he is a true pioneer within the research to apply QST in the clinical setting. Therefore, I was extremely honoured when he chose to submit and defend his doctor of science thesis at the Center for Sensory- Motor Interaction, Aalborg University, and I am very much looking forward to our future collaboration and interaction in many years to come.

This book was written by a world-renowned chronic pain specialist and invites the reader into his journey through the medical system with his family and friends and through his emotional and spiritual health once he experienced chronic pain himself. After a fall on ice, his pain spread, and he was diagnosed with many different disorders, operated on, and invited into many different intervention practices. Having had this unfortunate and debilitating experience, the author, Dr. Stuart Donaldson, learned about the best practices and alternative treatments, and he has developed a treatment plan for his chronic pain patients in Calgary, Canada that is based upon his unique and intimate experiences with pain. This book is written for chronic pain sufferers who want to approach their recovery more compassionately, personally, and holistically.

Myofascial pain is the most common pain; it is estimated that 60-70 per cent of all pain is of myofascial origin. There are many common diagnoses - such as sciatica, lumbago, tendinitis, arthrosis, bursitis, tennis elbow, and frozen shoulder - that have a myofascial origin. They are not life threatening, but they abate the quality of life and reduce functional capacity, creating stress and depression. They are also a big sanitary cost and cause for early retirement. There is a regrettable lack of knowledge surrounding myofascial pain and the existing possibilities to cure. With this manual, I try to spread my long experience in treating and curing these pains with my combination method. For the manual techniques, videos are included on the companion DVD to make the study easier.

The success of a neural electrode is often measured by its performance in the selective stimulation of or recording from individual fascicles within a peripheral nerve without damaging the nerve. Neural prostheses are limited by the availability of peripheral neural electrodes that can be used to record the user's intention or to provide sensory feedback through functional electrical stimulation for an extended duration. Improvement in future neural prostheses may be achieved through the availability of multichannel, bidirectional neural interfaces, such as the transverse intrafascicular multichannel electrode (TIME). The aim of this thesis was to investigate the biofunctionality, biostability, and biosafety of the TIME in an animal model that bears a close neuroanatomical resemblance to the human. To this end, four research questions were formulated: 1) Is the pig model neuro-anatomically suitable for the simulation of the actions and reactions of a neural electrode in a large human-sized peripheral nerve? This question was addressed in study 1 in which a comparative morphology study was performed on the median and ulnar nerves of Danish landrace pigs and Gottingen mini-pigs. Nerve specimens were selected at different levels for analysis. The number of fascicles in each nerve was counted, and the fascicle diameters were measured. 2) How selective is the TIME compared to other intrafascicular electrodes, such as the thin-film longitudinal intrafascicular electrode (tfLIFE)? Study 2 was performed to address this question. A comparative stimulation selectivity study was performed in Danish Landrace pigs with the TIME and tfLIFE. Electrodes were implanted in the median nerve, and sequential electric stimulation was applied to individual contacts. The compound muscle action potentials of seven forelimb muscles were recorded to quantify muscle recruitment. 3) Is the TIME biostable and biofunctional for long-term implantation? This question was addressed in study 3 in which the chronic stimulation selectivity of the TIME was evaluated on Gottingen mini-pigs. 4) Does the TIME fulfil the criteria of biocompatibility and chronic stability? Study 4 was conducted to address this question. Immunohistological analysis was conducted on nerve specimens from chronic experiment pigs that had been implanted with TIMEs in study 3.

The Colorado Medical Marijuana Handbook is an essential must have for every Colorado medical marijuana patient, caregiver and dispensary. This handy reference guide touches base on all important topics about medical marijuana, its use in the treatment of illnesses and disease, scientific facts, an independent section on marijuana laws. A section on how to handle interaction with law enforcement, important legal facts about the Patriot Act, Plain View Doctrine, probable cause, reasonable suspicion, and warrantless searches. The guide also looks at state and federal law regarding marijuana and medical marijuana, possession, use and cultivation. Other topics include a complete section on applying for a Colorado medical marijuana ID card, facts on marijuana contaminates and sterilizing medical marijuana. A section featuring over 500 strains of cannabis and each strains recommended medical use and effect. This guide includes the entire text of the Colorado laws, including revised statutes, bills, the Health Department Rules, and more. The Colorado Medical Marijuana Handbook is packed full of useful information and facts covering the highly controversial medical marijuana issue. Compiled by long time California medical marijuana advocate, Michael Malott. Malott was involved with Dennis Peron in the operation of the San Francisco Cannabis Buyers Club, the very first medical marijuana dispensary in US history. He also contributed in the drafting of California's Proposition 215 working with primary author Dennis Peron, which launched the beginning of medical marijuana use not only in California but many states who have used Prop. 215 has precedence and as a model for medical marijuana decriminalization in their state.

Based upon the pioneering work of John E. Sarno, MD, Pathways to Pain Relief offers the stories of seventeen patients who recovered from back pain, sciatica, and other pain disorders which were emotional in origin.... These stories are shared to help people searching for relief from pain and those who support them..... Written by two therapists who worked with Dr. Sarno for over 30 years, and including input from their patients, Pathways to Pain Relief offers ideas and inspiration to explore the emotional circumstances related to the development of pain.... For those who have read Dr. Sarno's work, about 25% find that psychotherapy is essential for success. Pathways to Pain Relief provides greater depth about the emotional and therapeutic aspects of recovery through psychotherapy. These innovative concepts have already produced gratifying results for thousands of patients suffering from psychophysiologic pain disorders.

Pain medicine is a relatively new field of medicine. Although easing pain has been an imperative in medical practice from the beginning of medical care, we know very little about how to effectively treat pain. The last three decades has been close to an explosion of knowledge of the mechanisms, chemistry, and biology of pain but with a slow uptake in translating that knowledge to medical care. There have been some important advances in how to care for pain but the public and most medical practitioners are still unaware. This state of affairs makes it very clear why this important anthology needs to be read. One of the important things we have recently learned about pain is that it is complex. There are many different kinds of pain and there are many different responses to the types of treatments. PainTamers collects the thoughts and perspectives of several people living with pain and several medical experts who practice different types of pain medicine. Pain is complex, as complex as the subject matter. Taken together, the patient stories and the perspectives of the multiple medical practitioners, PainTamers creates a complex weave that mirrors the challenge of understanding pain. You hear from doctors, scientists, psychologists, rehabilitation specialists, massage therapists, acupuncturists, and many patients, and collectively, you begin to appreciate the challenges of living with pain and of helping people manage pain. - Will Rowe, CEO, American Pain Society Helen M. Dearman lives with her husband near Houston, Texas. She has been a chronic pain sufferer since surviving a snow skiing incident in 1975. It wasn't until 1985 that she learned she had fractured her back in three places. "I am not a chronic pain or a chronic pain patient; rather I am a person who has pain. I like to think I define the pain instead of it defining me." http: //SBPRA.com/HelenMDearman

Despite today's historically low maternal and infant mortality rates in the United States, labor continues to evoke fear among American women. Rather than embrace the natural childbirth methods promoted in the 1970s, most women welcome epidural anesthesia and even Cesarean deliveries. In "Deliver Me from Pain," Jacqueline H. Wolf asks how a treatment such as obstetric anesthesia, even when it historically posed serious risk to mothers and newborns, paradoxically came to assuage women's anxiety about birth.

Each chapter begins with the story of a birth, dramatically illustrating the unique practices of the era being examined. "Deliver Me from Pain" covers the development and use of anesthesia from ether and chloroform in the mid-nineteenth century; to amnesiacs, barbiturates, narcotics, opioids, tranquilizers, saddle blocks, spinals, and gas during the mid-twentieth century; to epidural anesthesia today.

Labor pain is not merely a physiological response, but a phenomenon that mothers and physicians perceive through a historical, social, and cultural lens. Wolf examines these influences and argues that medical and lay views of labor pain and the concomitant acceptance of obstetric anesthesia have had a ripple effect, creating the conditions for acceptance of other, often unnecessary, and sometimes risky obstetric treatments: forceps, the chemical induction and augmentation of labor, episiotomy, electronic fetal monitoring, and Cesarean section.

As American women make decisions about anesthesia today, "Deliver Me from Pain" offers them insight into how women made this choice in the past and why each generation of mothers has made dramatically different decisions.

Indispensable for both the trainee and experienced professional, this is the only truly comprehensive account of the major role of the neurosurgeon in the diagnosis and treatment of chronic pain. The elite panel of contributors were chosen due to their expertise and international reputations. The result of their achievement covers the whole spectrum from criteria for patient selection and the details of operative techniques, to the risks, complications, and expected outcomes for a wide variety of anatomic, ablative, and augmentative neurosurgical procedures in treating chronic, intractable pain. The neurosurgeon will find here chapters on the latest neuroaugmentative advances utilizing electrical stimulation and implantable drug infusion systems as well as a useful section providing algorithms and guidelines for the evaluation and treatment of specific pain syndromes. Over 100 photographs and exquisite line drawings - many specifically commissioned for this book - enhance the text. Invaluable for acquiring the critical judgement and clinical skills necessary to apply the procedures involved.

Yes, today she feeds the goose that lays the golden eggs But her life once read like a mystery, because for forty-five years she had spasms of the face and neck, her head would ring and, most baffling of all, she had an ache deep in her chest like she was having a heart attack. Unbeknownst to her family, she lived with depression from the age of ten, until finally ending up in a psychiatrist's little crash pad shortly after having a beautiful little girl. From here she began a quest to try to do herself in-she tried six times Then it finally became apparent she was living with chronic pain, and a sublime head injury that kept her from accomplishing her quest of a nursing career. Then, in 2002, at the age of fifty-four, she finally threw up her arms and became willing to do whatever it took to get her life back. She began the twelve-step process of recovery that would open her life to healing. She soon found herself, strangely, thanking God for her affliction. Then, one day in June of 2002, she decided to live. Today she still has the pain but no longer suffers. Now it is a blessing to have lived, because her life has become part of one very big, ongoing miracle, a miracle of which you, the reader, are a part.

This is the complete study guide to the pain management board review book Beyond Pain. This guide is designed to work in synchrony with the board review book and assess the user's mastery of the information contained in Beyond Pain. The study companion contains questions in multiple formats which correspond to each of the 38 chapters of the original board review book. Together, Beyond Pain and this Study Companion are an extremely useful tool in promoting active learning and in assuring complete mastery of the information needed to pass the Pain Management Board Certification Exam as administered by the ABA.

Until recently, it was thought that the adult brain is modifiable only during early stages of ontogenesis. However, neurophysiological and neuroimaging studies now indicate that the mature human brain is under certain conditions capable of substantial neuroplastic changes. The concept of plasticity is complex and can be applied to all levels of neural organisation from molecular to systemic level of neural networks. Neuroplasticity reflects the ability of human brain to alter the pattern of neural activation in response to previous experience, and recent findings indicate that the effects of experience can lead to both structural as well as functional reorganisation. This book presents current research in the study of neural plasticity in chronic pain.

Papers and presentations from conferences held by the International Network on Personal Meaning. Articles are included from luminaries such as Howard Gardner, Harold Koenig, Sal Maddi, Jordan Peterson, Donald Meichenbaum, Crystal Park, Paul Wong, Kirk Schneider, and Bernard Weiner. Freshly edited and typeset, this book contains a broad range of essays on meaning and spirituality. The Positive Psychology of Meaning and Spirituality contains a number of must-have essays on topics from suffering, death, and grieving to meaning, spirituality, and virtues.

Depending on their training, mental-health professionals are often either strongly in favor of, or firmly opposed to, the use of psychoactive medications such as Prozac, Ritalin, and Valium. Drugs and Clients: What Every Psychotherapist Needs to Know advocates a balanced perspective, presenting the advantages and disadvantages of many common psychoactive medications. It also focuses on how non-prescription psychoactive drugs such as alcohol, antihistamines, caffeine, cocaine, marijuana and nicotine affect the clients therapists treat on a daily basis. From alcohol to caffeine to Zoloft, therapists need to understand how these substances work, the nature of the risks and benefits, and how a drug or medication's presence, or absence, affects the process of psychotherapy. Drugs and Clients addresses the confusing and highly complex subject of psychopharmacology as it applies to psychotherapy in a clear, hands-on, practical style that makes it accessible to all mental-health professionals.

It has been enormously satisfying to prepare the third edition of Anesthetic and Obstetric Management of High-Risk Pregnancy because it fulfills the need for close communication between two specialties, anesthesiology and obstetrics. This relationship is necessary not only to take care of the sick parturient, but also to deliver a healthy baby. New developments in obstetrics and in obstetric anesthesia necessitated this third edition. Most of the contributors to this edition are new, and they have provided information on the latest approaches, as well as updated information. In addition, Chapter 13, "Critical Care Anesthesia for High-Risk Parturients," is completely new. Like earlier editions, the third edition includes contributions from an international team of experts in the field of obstetric anesthesia and obstetrics. I thank all the authors for their va- able contributions. The authors have expressed their own opinions and recommendations, which do not necessarily reflect my own views. I also wish to thank Ms. Elizabeth Kiernan for her endless help in completing the new edition. I sincerely hope this edition will further reinforce the concept of the team approach for taking care of the high-risk parturient.

The new edition of this popular atlas offers complete, concise, step-by-step visual guidance on the diagnosis of pain syndromes commonly encountered in clinical practice. Vivid illustrations depict the physical symptoms and anatomy of each pain site, and diagnostic images demonstrate key findings from MRI, CT, and conventional radiography. A bonus CD-ROM - featuring all of the illustrations from the text - enables you to incorporate visuals depicting Dr. Waldman's preferred approaches directly into your electronic presentations. Avoid potential pitfalls in diagnosis and treatment of pain syndromes by referring to "Side Effects and Complications" sections in each chapter. Ensure proper reimbursement with comprehensive coverage of insurance coding information. Quickly and easily find the information you need thanks to highly templated chapters that explore signs and symptoms, physical findings, laboratory and radiographic testing, treatment options, clinical pearls, and diagnostic codes for each pain syndrome. Accurately diagnose and treat common pain syndromes by following a step-by-step approach that progresses from signs and symptoms through physical findings, laboratory and radiographic testing, treatment options, clinical pearls, and diagnostic codes. Effectively apply the latest pain management techniques and approaches with 20 new chapters covering Supraorbital Neuralgia, Charlin's Syndrome, Vail's Syndrome, Hyoid Syndrome, Subacromial Impingement Syndrome, Thrower's Elbow Syndrome, and Triangular Fibrocartilage Tera Syndrome - to keep you abreast of the conditions presenting in today's pain management practice. See, identify, and diagnose patients' pain issues with help from clinically relevant illustrations that connect pain syndromes to clearly labeled anatomic illustrations. Line drawings, clinical photographs as well as x-rays, CTs, and MRIs, helping you to confirm your diagnoses and confidently implement pain management techniques. Access the complete text and illustrations online at Expert Consult, fully searchable. Reinforce your knowledge with 20 new pain syndromes added in which the pieces of the puzzle (signs and symptoms) don't quite fit the simple diagnosis. A quick reference for any physician who handles diagnosing and managing patients with pain.

A book for midwives who would like to explore how best to help women cope with pain and fear. This book contains information about the physiological and psychological functions of pain; cultural influences on the experience of labour pain; elective caesareans, which are supposedly a simpler alternative; advantages and drawbacks of using pharmacological pain relief; information and ideas on how to transform labour pain into an experience of strength and power. While the book provides information on a very wide range of pain relief options and the emphasis is on maternal choice, it also presents many convincing arguments for normal physiological birth. It can therefore make a contribution to helping reduce the rate of unnecessary caesareans and help midwives improve rates of maternal satisfaction. Forewords by Dr Trudy Stevens and Dr Helene Vadeboncoeur.