Main Street is feeling pain as the trade war wallops farms, Kansas City Fed says

Weak farm income coupled with reduced spending has stressed the economy in rural America and led to "adverse" ripple effects on Main Street businesses, according to a new report from the Federal Reserve Bank of Kansas City.
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Gabrielle Union Shares The Pain Of Her Struggle With Infertilty

Gabrielle Union seems to be the girl who has everything. She’s got a successful career, she’s got a wealthy, handsome husband, three bonus children and a great Instagram presence. But one thing she doesn’t have is a baby of her own.

In her book We’re Going To Need More Wine, Union revealed that her attempts to get pregnant led to multiple miscarriages. Rounds of IVF didn’t work and finally, she was diagnosed with adenomyosis, a situation akin to endometriosis where the uterine lining grows into the uterine wall, making pregnancy difficult.

Instagram Photo

 

On the Dr. Oz show, Union, often seeming close to tears, said that she wanted to go public with her pregnancy challenges so other women didn’t feel ashamed or defeated by infertility issues.

Watch the interview below:

Union will star as an L.A. police officer on the show LA’s Finest, which will have a 13 episode run on a Charter Communications channel.

PHOTO: PR Photos

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This Author’s Advice for Black Men and Depression: Turn Your Pain into Purpose

Tsanonda Edwards is the author of a book that deals with black men and depression, The extraORDINARY Mr. Nobody: A Beginner’s Guide to Self-Healing, and co-founder of Above It All, a mental-health organization that offers personal, professional and psychiatric rehabilitation programs for children and parents. Although Edwards has a Masters in Human Services, it’s his personal story of battling depression and anxiety that has enabled him to connect authentically with youth and create a blueprint for personal and professional success. Edwards explains why black men face greater mental health challenges and the few steps they can take to turn pain into purpose.

Black Enterprise: Your father committed suicide at a young age and you battled anxiety and depression. When did you realize you could turn this pain into purpose? What are the first steps you took to share your story?

Edwards: I started realizing I could make the pain to purpose transition in college at Morgan State University. I not only found my voice as a writer, but I was also able to hone my abilities as a listener. By listening to my friends in a non-judgmental and empathetic way and then being unafraid to offer my opinion to those who would ask allowed me to see the power in empathy and how that led to healing. The journal entries, years, and numerous stop-and-starts later, my book was born.

If I had to say one event or moment that served as a next-level catalyst for me to share my story, I would have to say my therapy sessions (my therapist Akiami McCoy is incredible!). She did three things that made the book happen: She told me that I wasn’t crazy, she told me that my testimony had power, and then she told me how to publish my book. The biggest power in that is that I actually spoke to a therapist, which is not the most common route for black people, especially black men. It was a 10-year process and I’m thrilled to have it completed.

What holds black men back from sharing their story and seeking treatment?

The first is constantly being told “get over it,” “bounce back,” “no days off,” “stop acting like a woman,” etc. While it’s important to be resilient as our people are known for it (men and women both!), we have to find ways to allow people to come to terms with mental obstacles and embrace ways to cope with them without being told they don’t exist and/or forget about them.

The second thing is fear. Black men have trouble simply going to the doctor. While I do believe we’re actually getting better at identifying issues and seeking help for physical conditions, the stigma surrounding mental health is a real one and it will definitely take time and effort to loosen its stranglehold on the minds of my brothers.

When it comes to supporting men who are battling depression and anxiety, what do you believe is the most underestimated tactic?

Building a true support system. Friends, family, members of your spiritual community, therapists, etc. Again, as men, we’re still expected to be stalwarts and leaders at home, at work, and in the community and rightly so, but depression, anxiety and the like are seen as weaknesses as opposed to mental health barriers that can be embraced and overcome. This often leads men to become “pseudo-actors,” never letting anyone see them sweat. So when you have a true support system that understands the issues you face and are ready to reinforce the efforts we take personally to be our best selves, it speeds up progress.  Yes, it starts with you, but a true support system is priceless.

What is your favorite chapter of your book? 

Chapter 3, ‘A Product of Divorce and Depression.’ I talk about my father’s suicide and his battle with bipolar disorder/manic depression. This chapter pushed me to be open and honest about my own battles with depression. One of my ultimate goals with the book is to let others know that you can lead a happy, successful life despite the mental health issues you face and despite those who are uncomfortable with others having or talking about these issues. Yes, any struggle is a part of you, but it doesn’t define you.

What are three key messages you want people to take away from the book?

  • You are not alone.
  • Your story is valuable. Allow it to be heard and potentially save someone’s life.
  • You’re your own advocate when it comes to personal healing, so be your absolute best you and don’t let others dictate what that looks like.

The post This Author’s Advice for Black Men and Depression: Turn Your Pain into Purpose appeared first on Black Enterprise.

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Red-state governor sticks with Trump on China trade war but warns US farmers can’t take much more pain

GOP Arkansas Gov. Asa Hutchinson urges a quick resolution for the sake of the nearly 48,000 family owned farms in his state.
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Breast Pain Keeps Women From Exercise: Can The Right Bra Help?

Starting at age 14, Katherine Bice used to wear three sports bras when exercising because it was the only way she felt comfortable. Her breasts bounced around a lot, and after just a few minutes, she was in pain. As a result, Bice felt odd, different, and uncomfortable in her …

The post Breast Pain Keeps Women From Exercise: Can The Right Bra Help? appeared first on Women's Health.

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Under stress, newborn babies show greater brain response to pain

When newborn babies are under stress, their brains show a heightened response to pain, a new study has found. However, you’d never know it from the way those infants act. The findings show that stress leads to an apparent disconnect between babies’ brain activity and their behavior. Stressed babies may not seem to respond to pain, even as their brain is still processing it.
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Prescription opioids fail rigorous new test for chronic pain

CHICAGO (AP) — A yearlong study offers rigorous new evidence against using prescription opioids for chronic pain.
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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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‘Pain, Trauma, Horror.’ Olympic Swimmer Ariana Kukors Details Alleged Abuse by Coach Sean Hutchison in Emotional Essay

Former Olympic swimmer Ariana Kukors on Friday posted an emotional essay detailing what she calls years of “pain, trauma, horror, and abuse” at the hands of her former coach, Sean Hutchison.

Kukors, now 28, alleges in the essay that Hutchison, who coached her starting from age 13, “groomed” and manipulated her for years, before their relationship eventually turned sexual. After the 2012 Olympics, Kukors writes, she quit swimming and moved in with Hutchison in Seattle.

“I think back on those times now, tearfully asking why no one helped me…why no one stepped in to save me from this monster,” Kukors writes. “It’s still hard to comprehend, but Sean had perfected the art of grooming; I wasn’t even aware I needed saving.”

USA Swimming investigated the alleged relationship between Kukors and Hutchison in 2011, after the publication of a Washington Post article including allegations against Hutchison. Kukors says she was asked just 19 questions throughout the course of the investigation.

“I was scared. I lied. I have never felt more alone in my life,” Kukors writes.

Hutchison’s named was cleared, and he has not been charged with a crime. Hutchison continues to deny that the relationship was at any time inappropriate.

“At no time did I ever abuse Ariana Kukors or do anything with her that was not consensual,” Hutchison said in a statement released by his attorney. “I absolutely deny having any sexual or romantic relationship with her before she was old enough to legally make those decisions for herself. Prior to that time, I did nothing to ‘groom’ her.”

In her essay, Kukors writes that she chose to set the record straight “for the sake of the little girls and boys whose lives and futures hang in the grasp of a horribly powerful and manipulative person,” and, “Because the time for change is now. It’s time to change the way we talk about sexual abuse, the way we respond to sexual abuse, and the way the system understands and prevents sexual abuse. And with all my heart, I hope that each and every abuse victim knows their story matters, it is important, and their voice will be heard whenever and however they choose to use it.”

Kukors’ essay comes just a few weeks after more than 150 former and current Olympic gymnasts detailed abuse by former team doctor Larry Nassar. USA Swimming has had its own brushes with abuse: In 2010, the organization revealed that sexual misconduct allegations were behind many of the lifetime bans handed down by the sport.

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Alexander Polinsky Thanks Sara Gilbert And ‘The Talk’; Says Expressing Past Pain Is Liberating

Alexander Polinsky became a viral news story this week when Nicole Eggert appeared on CBS’ The Talk and co-host Sara Gilbert read a written statement he had sent to the show. Nicole and Alexander have filed police reports against Scott […]
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6 Alternative Therapies Athletes Use to Beat Pain and Boost Their Performance

They sound wacky, but some pros swear by them.

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We Can’t Measure Pain. Is That Fueling the Opioid Crisis?

According to the CDC, 91 people die every day from opioid overdoses—a problem that has become epidemic in proportion and led the Trump administration to try to solve the crisis with everything from declaring it a “public health emergency,” an ad campaign, and a messy attempt to find an opioid czar.

Read more at The Daily Beast.

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http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

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JAY-Z on Saving Marriage with Beyoncé After Infidelity: ‘The Hardest Thing Is Seeing Pain on Someone’s Face That You Caused’

JAY-Z is opening up about how his marriage survived scandal.

In an extensive new interview with T: The New York Times Style Magazine, the famed rapper offered a rare glimpse inside his private world with wife Beyoncé, admitting to past infidelity, revealing his state of mind leading up to the infamous transgression and sharing how the power couple pieced their relationship back together.

“You know, most people walk away, and like divorce rate is like 50 percent or something ’cause most people can’t see themselves. The hardest thing is seeing pain on someone’s face that you caused, and then have to deal with yourself,” he told the outlet. “So, you know, most people don’t want to do that. You don’t want to look inside yourself. And so you walk away.”

JAY-Z never walked away from his own marriage, but it hasn’t always been easy.

RELATED: JAY-Z Confesses His Relationship With Beyoncé Was Not ‘Built on the 100 Percent Truth’

Since 2013, the musician has been dogged by cheating rumors, which were only compounded by the news of his notorious 2014 #elevatorgate squabble with sister-in-law Solange after the Met Gala. Beyoncé more than hinted at marital strife on her 2016 adultery-fueled visual album Lemonade — and JAY-Z finally alluded to being unfaithful on the title track of his latest album, 4:44, released in June.

JAY-Z, 47, told T that therapy helped him look inward.

“I grew so much from the experience,” the rapper (born Shawn Carter) said. “But I think the most important thing I got is that everything is connected. Every emotion is connected and it comes from somewhere. And just being aware of it. Being aware of it in everyday life puts you at such a … you’re at such an advantage.”

The artist — nominated for eight awards at the 2018 Grammys — said he built up walls due to experiences from his childhood.

“You go into survival mode, and when you go into survival mode what happen? You shut down all emotions. So even with women, you gonna shut down emotionally, so you can’t connect ,” he said. “In my case, like it’s, it’s deep. And then all the things happen from there: infidelity …”

JAY-Z acknowledged problems in their relationship informed both Lemonade and 4:44.

“We were using our art almost like a therapy session,” he said of the music, adding that playing the deeply personal tracks for one another was painful — and “very, very uncomfortable.”

While the A-list pair were working on their respective albums — and a joint album they had previously been working on — emotions were running high.

“We were sitting in the eye of that hurricane,” JAY-Z said. “The best place is right in the middle of the pain. And that’s where we were sitting. And it was uncomfortable. And we had a lot of conversations. You know. really proud of the music she made, and she was really proud of the art I released. And, you know, at the end of the day we really have a healthy respect for one another’s craft. I think she’s amazing.”

Today, it seems, JAY-Z and Beyoncé are doing better than ever. Already parents to 5-year-old daughter Blue Ivy, the couple welcomed twins Rumi and Sir in June.

“It is not a secret that Beyoncé and Jay had huge problems a couple of years ago. It was obvious to everyone that spent time with them,” an insider told PEOPLE this summer. “There was always tension in the air, but they both worked very hard to get to the place where they are now … They are very excited about adding babies to the family. Jay was great during Beyoncé’s pregnancy and continues to be great. He loves being a dad and Beyoncé seems very happy.”


PEOPLE.com

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Louis C.K. says he misused his power and ‘brought pain’

NEW YORK (AP) — With his career imploding over allegations of sexual misconduct, comedian Louis C.K. confessed Friday to masturbating in front of women and expressed remorse for wielding his influence “irresponsibly.”
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I Call My Pelvic Pain Doris — And She Makes My Life Hell

“Doris is not only a grumbling battle ax but also the voice of reason.”

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Your 5 threenager pain points, solved for good

by

Laura Falin

posted in Life

Those of us who have parented a preschooler have been there at some point. You’re at the playground, it’s time to go, you give them the five-minute warning, and when you actually try to leave…there is wailing and crying and gnashing of teeth. They may throw themselves prostrate on the ground. You may end up hauling a child to the car while they alternate between going limp and thrashing violently and you may swear to them that the next time you take them to the park will be when they’re 23.

No? Just me?

There’s a reason we call preschoolers “threenagers” — they’re going through some of the same stuff at both points in their life. They’re trying to figure out how to be independent and do what they want to do…while still needing you to set boundaries and help them. I like to think of it as the “Go away and leave me alone, Mom…wait, where are you going? Come back! I need youuuuu!!” phase.

So. To help you survive without losing your own mind, here are a few tips — starting, of course, with the playground.

1. How to leave the playground without a meltdown.

I love this suggestion from Mama Instincts for getting your child ready to leave the park (or the library, or the zoo, or anywhere else). Preschoolers don’t really have a concept of time. Heck, without my cell phone, I don’t either. So instead of giving them a warning based on how much time they have left, give them one based on how many things they get to do. “We need to go soon. What is the one thing you’d like to do most before we leave?” They get a sense of control, and they know when it’s time to leave.

2. How to go shopping without a meltdown.

Well, a very specific meltdown, that is. I’m afraid I can’t help you with all of them…but I can help with the very particular meltdown that comes when your threenager wants you to buy toys you don’t plan on buying. Give them your cell phone, let them take a picture, and then “text” it to Santa. The kids feel better knowing that a “no” today might not be a “no” forever…and you have a resource at Christmas when you can’t remember which LEGO set it was they were losing their minds over. You can also send the pictures to family members who might need gift ideas.

3. How to eat out without a meltdown.

This BabyCenter article has some great information on how to take your kids out to eat. I think it’s important to do. Kids need to know how to behave at a restaurant, but at the same time, you don’t want everyone else who’s spending their hard-earned money on a nice dinner to have to listen to twenty minutes of shrieking. I like the suggestion in the BabyCenter article to go early. You’ll be seated and served quicker, and since restaurants are usually less crowded then, you won’t feel as stressed if your child does make noise or gets down and wanders around.

4. How to leave the house without a meltdown.

Preschoolers have a sixth sense that tells them when you’re in a hurry. And then, of course, they insist on tying their own shoes which everyone knows takes 45 minutes and they begin by putting them on backward and…well, you know the drill. As much as you can, have everything ready to go ahead of time. If you’re going to school, have backpacks and lunches loaded up and at the ready. Lay out clothes. Find shoes (oh, goodness…the shoes…!) ahead of time if you can. I know. This doesn’t always work because life gets in the way. But it really helps when you are able to do it.

5.) How to avoid having your OWN meltdown.

So far, we’ve dealt with how to help your preschooler avoid meltdowns. But if I’m being honest, sometimes I’m the one melting down. The Rubber Band Method has been around for a while now, and it’s a great way to use visual cues to help you stop, take a breath, and reset. If you don’t catch yourself in time, there are also ways to make up and repair the damage after you yell at the kids. The Reformed Idealist Mom has a post detailing how to use the Rubber Band Method to help you connect with your kids…and to help you when you slip up. There’s also an effective mindfulness technique where you deconstruct your overwhelm into smaller, manageable parts.

Preschoolers are one of my favorite ages so far. They’re funny and curious and so full of energy…but they’re also maddening and stubborn and easily frustrated. I promise — you got this.

Do you have any advice for parenting preschoolers?

Images by iStock

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Vulvodynia: The Pain Down Below

Imagine experiencing burning, stinging, and stabbing sensations in your vulva constantly or when there’s pressure or contact. Either way, this condition – known as vulvodynia – can affect every aspect of your life.

Michelle Living knows this all too well. She realized something was really wrong in 2003 when she had sudden spasms in her pelvic floor that made her stop in her tracks and grab ahold of something. Shortly after this, she experienced a scary moment when she discovered that she could barely insert a tampon. In 2004, she finally received the diagnosis of vulvodynia, which she had never heard of before.

Living calls the diagnosis a bit of a rude awakening. She was devastated, as she was getting married in four months and had been dismissed by the dermatologist who diagnosed her. The dermatologist basically ignored her crying and just gave her a short print out and sent her home without any other information. She came close to cancelling her wedding, and felt hopeless.

More on vulvodynia

According to the National Vulvodynia Association (NVA), vulvodynia occurs in women of all ages and doesn’t discriminate. Additionally, the NVA cites research studies which found that as many as 16 percent of women in the U.S. suffer from this condition at some point in their lives. Most women start noticing symptoms between the ages of 18 and 25.

Unfortunately, receiving a diagnosis isn’t always easy. Dr. Pamela Morrison, a physical therapist who has treated vulvar pain/pelvic floor muscle dysfunction for the last 17 years, says that up to 10 years ago, a patient was seen by an average of 10 or more doctors prior to getting a proper diagnosis and effective treatment. With increased awareness, patients now only have to see one to three healthcare providers before being properly diagnosed, though this depends on location and proximity to knowledgeable providers.

Most women are initially told they have recurrent yeast infections, when in fact these infections don’t exist and their treatment can worsen the pain.

The exact cause of vulvodynia is unknown, mostly because there hasn’t been enough research. What is known, however, is that it is not an infection or a sexually transmitted disease, the NVA says.

Some women first notice the pain when they try to insert a tampon, have their first gynecologic exam, or when they first attempt to have sex, says Dr. Paul Nyirjesy, professor of Obstetrics and Gynecology at Drexel University College of Medicine and Director of the Drexel Vaginitis Center, but they tend to be the minority. “More commonly, they’ve been doing fine, then something acute (which often sounds like a yeast infection) happens, and they are left with the chronic pain,” he says. “I think of it as a triggering event, which can include yeast infections, skin conditions like lichen sclerosus, or vaginal atrophy (the changes that occur with menopause); there are probably a bunch of various things that can start it.”

Indeed, the NVA says one or more of the following may cause the condition:

  • An injury to, or irritation of, the nerves that control sensation in the vulva
  • An abnormal response of vulvar cells to infection or trauma
  • Genetic abnormalities that make cells overreact to inflammation
  • A localized hypersensitivity to Candida (yeast)
  • Weakness or spasm in the pelvic floor muscles

Treatment

The bad news is there isn’t a well-studied, evidence-based approach to treatment, says Dr. Nyirjesy, so each expert has his or her approach that’s been developed over the years. And of course, every woman is different.

The good news is that Dr. Nyirjesy considers vulvodynia a very treatable problem. “More than 90 percent of the women we see end up feeling much better,” he says. Because the treatment approaches used haven’t undergone the rigors of a placebo-controlled study, it’s hard to know whether it’s the treatments that worked or if the problems resolved on their own. “Since most of our patients have had problems for years before getting to us,” Dr. Nyirjesy says, “I personally believe it’s the treatments that get them better.”

Dr. Nyirjesy tends to start conservatively and works his way up, with an initial approach of using a compounded cream that has Gabapentin/Amitriptyline/Baclofen in it. Patients use this for about six months, with about 70 percent improving. If this doesn’t work, the next step is trying oral Amitriptyline or Gabapentin. If the patient has elevated pelvic floor muscle tone, Dr. Nyirjesy is a big advocate of physical therapy. When nothing else works for localized vestibulodynia – when the pain is in the tissue surrounding the vaginal opening – he does a vestibulectomy with vaginal flap advancement. The success rate of this surgery ranges from 60-90 percent, the NVA says.

On the horizon, the MonaLisa Touch laser may be helpful; Dr. Nyirjesy has been using it for about a year with more refractory patients with some success.

A multi-disciplinary approach seems to be favored. This is what Living has found to be true for her. Her treatment has been a journey of patience. The first thing she tried after diagnosis was seeing a chiropractor to work out the tension in her groin and thighs, but this didn’t help. Two and a half years after diagnosis, Living found a pelvic floor physiotherapist who treated her entire body and did internal pelvic floor work. It was slow progress, but she improved.

Around this time, she started taking amitriptyline orally, which took the edge off the pain. Along the way she discovered that different foods were irritants. Later on, she added Yamuna Ball rolling exercises. She also started low-level laser or light therapy (LLLT), which changed her life. She eventually rented a unit to use at home. She’s also used the compounded cream, tries to take care of her overall body health, and lives as low stress a life as possible.

“I don’t think that any of these treatments on their own would have gotten me to this point,” says Living, “[as] it was the combination of treatments that worked best for me.”

Effect on life

Because vulvodynia is invisible, women who have it might look fine on the surface, when in reality they’re in incredible pain.

Living is now at the point where vulvodynia is a factor in her life and she still makes decisions with it in mind, but it no longer controls her entire life. She describes it as being very isolating, especially since it’s such a sensitive and personal topic. Even wearing clothes was hard because they caused pain, and menstruating was awful. “Vulvodynia made it hard to have a job, have a social life, and even hard to be a good mom sometimes,” says Living. “Having [it] is very hard on a marriage.”

Because it’s treatable, there are different approaches to try, and it’s not worth suffering in pain, don’t hesitate to get another opinion if you’re not being helped. There isn’t always a quick, easy answer, Dr. Nyirjesy says. Six months of working with someone is a good length of time to decide whether you’re on the right track.

Remember, there’s a light at the end of the tunnel. “There was a time when I didn’t feel life was worth living because there was so much pain,” Living says. “And now I love life and I can even say that I am thankful for the experience as it made me the person I am today (although if given the choice I would never have chosen to walk that road). I am not completely pain-free all the time from vulvodynia, but I have very little pain most of the time and often enough, none.”

The post Vulvodynia: The Pain Down Below appeared first on Women's Health.

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Vulvodynia: The Pain Down Below

Vulvodynia: The Pain Down Below

Imagine experiencing burning, stinging, and stabbing sensations in your vulva constantly or when there’s pressure or contact. Either way, this condition – known as vulvodynia – can affect every aspect of your life. Michelle Living knows this all too well. She realized something was really wrong in 2003 when she had sudden spasms in her pelvic floor that made her stop in her tracks and grab ahold…

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Readers Have Their Say … On Pain And Who Stands To Gain In Drug Market

Letters to the Editor is a periodic KHN feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.


Surgeons AWOL In The ER

While performing surgeries simultaneously is supposedly justified on the grounds of teaching residents and fellows, it wasn’t always this way (“Double-Booked: When Surgeons Operate On Two Patients At Once,” July 12). The surgeon was expected to stay and oversee and advise the resident as they worked. The real reason surgeons double- and triple-book in teaching hospitals — and the hospitals let them — is that it jacks their income into the stratosphere. That is one way teaching hospitals attract and keep some of the more talented (if somewhat avaricious) surgeons. I have been a hospital and medical group executive for over 40 years.  I know this is true.

— Richard V. Stenson, Forest Grove, Ore.
MHA, MBA, FACHE, FACMGA


The Other Side Of The Opioid Crisis

Chronic migraines forced me to go on disability after 15 years of working as an RN in the NICU. I tried every medication suggested by my neurologist. The only medication that had any effect was gabapentin. Every day I read a new article about the abuse of an alternative to opioids, like gabapentin (“New On The Streets: Drug For Nerve Pain Boosts High For Opioid Abusers,” July 6). A new medication to vilify, restrict and cross off the list of alternatives to opioids. While I understand there is the potential of abuse for gabapentin, there is for all medications. In the efforts to fight the “opioid epidemic,” those of us who live with chronic pain have been ignored. Don’t be surprised if next time you break your leg, they give you an aspirin.

— Kristine Bell, Calgary, Alberta, Canada


Hammering Home The Message

There’s no better proof your recent video carries the drug lobby’s message than the PhRMA CEO’s two-word compliment: “Nailed It.” We take exception to the video (“Middlemen Who Save $ $ On Medicines — But Maybe Not For You”), which we think confuses the roles of drug companies, wholesalers, drugstores, payors and pharmacy benefit managers (PBMs).

First, payors (employers, unions, government, health plans), not PBMs, decide what to do with the rebates that PBMs negotiate on their behalf. While PBMs are typically directed to pass through 90% of rebates, an increasing number of payors choose to have all rebates passed through. This is a transparent negotiation between PBMs and their clients. Likewise, it’s incorrect to say “consumers don’t see the savings” from rebates. Payors use rebates to reduce premiums, deductibles and copays for consumers.

Second, the video confuses the roles of PBMs, wholesalers and drugstores. Wholesalers and drugstores are the ones that buy and resell drugs. Whether those industries “pocket the difference” or include a “mark-up” is a question for them, not PBMs.

Third, the video confuses the role of drug companies (which set prices) and PBMs (which negotiate discounts off those prices). PBMs have no control over whether “prices for some drugs keep going up.”

It’s also a non sequitur to say PBMs favor competing drugs with higher rebates and discounts “instead of the cheaper drug.” By definition, the drug with the lowest net cost is the cheaper drug. In any case, 90% of the claims PBMs administer are generics, which involve no rebates at all.

Rising drug prices make coverage harder to afford for payors. Benefit design is not the cause but the effect. Payors try to cope by raising deductibles to continue offering coverage. It’s surprising that an established news organization would peddle such a misinformed video that so closely mirrors drugmaker talking points.

— Mark Merritt, Washington, D.C.
President and CEO of Pharmaceutical Care Management Association

Shaky Logic?

A recent KHN article (“5 Ways White House Can Use Its Muscle To Undercut Obamacare,” July 24) reports that various reputable entities suggest that Obamacare’s subsidized exchanges are “stabilizing.” But, a subsidy is money that bolsters that which is “unstable” by virtue of its being incapable of standing on its own. Are “Obamacare” exchanges requiring smaller and smaller subsidies, as time goes on, while delivering more and better coverage and care? Only then would “stabilizing” be an accurate description of their health and prospects.

— Larry Powers, Philadelphia


You Get What You Pay For

I am grateful for the attention Kaiser Health News brought to the extremely high sticker price of Spinraza. When assessing the cost of rare-disease drugs, one must look closely at the benefits the drug provides, and unfortunately the article (“Drug Puts A $ 750,000 Price Tag On Life,” Aug. 2) vastly undersold Spinraza’s benefits.

By any metric, Spinraza is a major breakthrough for spinal muscular atrophy (SMA) patients. In addition to the data you cited, over 70 percent of the infants saw a four-point or greater increase in The Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders score, another motor-skills gauge. And it cut the risk of death or permanent ventilation by 50%. Infants dosed before symptom onset show even more profound benefits, with many hitting motor milestones when expected and some even walking. The data also show Spinraza benefits patients on ventilators.

You state, “It was tested only on children, most under age 2, though it was approved for pediatric and adult use.” However, over half the patients in the pivotal trials were ages 2 to 12. The drug showed incredible benefit in these patients as well — a four-point difference in the Hammersmith motor function score compared to placebo. This a meaningful change in these kids’ lives. And because the drug worked in two different patient populations, it would be unethical to withhold it from older patients.

With respect to the cost to develop the drug, Ionis Pharmaceuticals, the developer of Spinraza, has spent over a billion dollars over 30 years developing the novel class of drugs Spinraza is a part of (antisense oligonucleotides). This is Ionis’ first commercial success. Implying development started in the early 2000s with public money does not tell the whole story. Without Ionis’ decades-long efforts, Spinraza would not exist.

— Nate Uhl, Greenwood, Ind.

[Editor’s note: The FDA provides this “drug trial snapshot” and summary review to detail who participated in the clinical trials that led to the approval of Spinraza and provide information about whether there were differences among sex, race and age groups.]


Benefits Vs. Risks

We would like to clarify a few points in “Denial, Appeal, Approval … An Adult’s Thorny Path to Spinraza Coverage” (Aug. 2). Kaiser Permanente is strongly committed to providing safe and effective care for our patients based on the patient’s clinical condition, physician expertise and evidence-based research. At this time, there is no published clinical evidence that nusinersen benefits adults with spinal muscular atrophy (SMA). While the Food and Drug Administration did approve nusinersen (Spinraza) for adults, the clinical trials tested nusinersen only in children up to age 15. This puts the responsibility of doing the research on the efficacy of nusinersen on health plans and delivery systems, while potentially exposing patients to side effects and harm.

Kaiser Permanente physicians have prescribed the drug for patients whose age and clinical condition indicate they are most likely to benefit from the treatment based on medical evidence. We encourage the FDA to re-examine its drug approval process to ensure that pharmaceutical companies have actually conducted research on the appropriate populations to prove their drugs are safe and effective.

— Dr. Sameer Awsare, Campbell, Calif.
Associate Executive Director, The Permanente Medical Group

[Editor’s note: Kaiser Health News is unaffiliated with Kaiser Permanente.]


Cutting To Heart Of The Data

Of course — if you demonize the cardiac surgeons with high death rates, then those surgeons will improve their rate by turning away patients who are likely to die (“Calif. Hits Nerve By Singling Out Cardiac Surgeons With Higher Patient Death Rates,” July 17). Those patients will die without surgery, but at least the reported numbers will improve! It happened in New York and will happen in California in proportion to how much demonization goes on.

— Dr. Bruce Bodner, Taunton, Mass.


What Readers Want: More Digging

When telling a story and someone says, “Obamacare was too expensive,” don’t stop there. You need to dig into why the person is saying that. We need to know whether:

  1. The person has income too low to be eligible for a tax credit to help pay for the plan and thus would have had to pay the full price.
  2. The person has income too high to be eligible for a tax credit to help pay for the plan and thus would have had to pay the full price.
  3. The person is eligible for a tax credit to help pay for the plan but they looked at bronze plans and decided the deductible was too high to be worth it. They weren’t aware they were eligible for a cost-sharing reduction with a silver plan.
  4. The person is eligible for a tax credit to help pay for the plan, looked at both bronze and silver plans, considered cost-sharing reduction if eligible and it still was more than they could afford.

These are different problems and we need to know which it was.

— Mary Schneckenburger, Litchfield, Maine


Poster Child For The New 90s

Your story “How To Put The ‘Non-Age’ in Nonagenarian” (June 26) is a big deal! When I was 97, I was writing plays and producing them. Since my 90s, I’ve been writing books and have published five books. I dance, but I have to hold onto my walker. I travel every year to somewhere warm … and my memory is excellent. I take each day as it comes and find enjoyment in simple pleasures. I enjoy a good laugh and good conversations — my daughter says I’m very funny and should do sit-down comedy! I find life very interesting — even at my age. (I am going to be 103 on my next birthday.)

— Estelle Craig, Toronto


Kaiser Health News

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News Brief: Underwear of the Future Could Help Prevent Back Pain

The wearable device reduces strain on the back during lifting or leaning, which can help stop the pain before it starts
Articles | Smithsonian

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New Spine Stimulation Device Provides Pain Relief

High-frequency therapy helps block pain signals better than low-frequency treatments, study finds
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
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Strong Women, Strong Backs: Everything You Need to Know to Prevent, Treat, and Beat Back Pain

Strong Women, Strong Backs: Everything You Need to Know to Prevent, Treat, and Beat Back Pain


From the bestselling author of the "Strong Women" series-an indispensable resource for a strong and pain-free back. In this accessible guide, trusted women’s health author and exercise physiologist Miriam E. Nelson presents the information every woman needs to know to maintain a healthy back. Complete with clear explanations, practical advice, and lively anecdotes from women who have benefited from this simple and effective program, this book reveals: – The most common causes of back pain in women – How stress and other emotional factors play a key role – A straightforward exercise program to improve flexibility, strength, and aerobic fitness-designed specifically for women – What you need to know to create a back-friendly home and office – Explanations of the medical options available-and how to know when they might be necessary
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Strong Women, Strong Backs: Everything You Need to Know to Prevent, Treat, and Beat Back Pain

Strong Women, Strong Backs: Everything You Need to Know to Prevent, Treat, and Beat Back Pain


From the bestselling author of the Strong Women health series, an essential program for a strong, healthy, pain-free back and a toned midsection. In this accessible guide, trusted women’s health author and exercise physiologist Miriam E. Nelson presents the essential information every woman needs to know to maintain a healthy back. Complete with clear explanations, practical advice, and lively anecdotes from women who have benefited from this simple and effective program, the book discusses: – the major causes of back pain in women; – how stress and other emotional matters play a key role; – a straightforward exercise program to improve flexibility, strength, and aerobic fitness-designed specifically for women; – advice for creating a back-friendly home and office; and – explanations of the medical options available-and how to know when they might be necessary.
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Augusta Pain Center Receive Tribute & Medicine Assistance by Charles Myrick of ACRX

ACRX Recognition Gallery: American Consultants Rx
http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.

The American Consultants Rx discount prescription cards are to be given free to anyone in need of help curbing the high cost of prescription drugs.

Due to the rising costs, unstable economics, and the mounting cost of prescriptions, American Consultants Rx Inc. (ACRX) a.k.a (ACIRX) an Atlanta based company was born in 2004. The ACRX discount prescription card program was created and over 25 million discount prescription cards were donated to over 18k organizations across the country to be distributed to those in need of prescription assistance free of charge since 2004.

The ACRX cards will offer discounts of name brand drugs of up to 40% off and up to 60% off of generic drugs. They also possess no eligibility requirements, no forms to fill out, or expiration date as well .One card will take care of a whole family. Also note that the ACRX cards will come to your organization already pre-activated .The cards are good at over 50k stores from Walgreen, Wal mart, Eckerd”s, Kmart, Kroger, Publix, and many more. Any one can use these cards but ACRX is focusing on those who are uninsured, underinsured, or on Medicare. The ACRX cards are now in Spanish as well.

American Consultants Rx made arrangements online for the ACRX card to be available at http://www.acrxcards.com where it can also be downloaded. This arrangement has been made to allow organizations an avenue to continue assisting their clients in the community until they receive their orders of the ACRX cards. ACRX made it possible for cards to be requested from online for individuals and organizations free of charge. Request for the ACRX cards can also be made by mailing a request to : ACRX, P.O.Box 161336,Atlanta,GA 30321, faxing a written request to 404-305-9539,or calling the office at 404-767-1072. Please include name (if organization please include organization and contact name),mailing address,designate Spanish or English,amount of cards requested,and telephone number.

American Consultants Rx is working diligently to assist as many people and organizations as possible. It should be noted that while many other organizations and companies place a cost on their money saving cards, American Consultants Rx does not believe a cost should be applied, just to assist our fellow Americans. American Consultants Rx states that it will continue to strive to assist those in need.

These Jane Pain Lingerie Ads Are Not What They Seem

Unconventional lingerie marketing is everywhere these days, but a new campaign for Argentinian fashion brand Jane Pain has done it in a completely fresh way.

In the clever ads, devised by the agency Conill Saatchi & Saatchi USA, sexy optical illusions are created by placing underwear over the bend of a knee, an armpit and an elbow.

plain jane

A photo of the actual body part used accompanies the ad, along with the line, “If it can make your armpit [or knee or elbow] look sexy, imagine what it can do in the right place.”

lingerie

This is not the brand’s first foray into edgy advertising. Back in 2012, Jane Pain’s provocative campaign featured double-take-inducing photo editing that made models appear a lot more exposed than we’re used to seeing in print ads.

What do you think of the provocative campaign? Sound off below!

lingerie

— This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

Style – The Huffington Post
FASHION NEWS UPDATE-Visit Shoe Deals Online today for the hottest deals online for shoes!

Vegan Diet Might Ease Diabetic Nerve Pain

Study found those who followed it lost average of 15 pounds, had improved blood flow to feet
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
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More Babies Born to Mothers Addicted to Pain Meds

Also rising are costs to treat infants’ withdrawal symptoms, study says
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

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Steroids No Better for Sciatica Pain Than Placebo, Study Finds

But taking prednisone was tied to small improvements in ability to perform daily activities
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

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American Consultants Rx Charity Donation To Pain Management & Treatment Center By Charles Myrick

ACRX Recognition Gallery: American Consultants Rx
http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.

The American Consultants Rx discount prescription cards are to be given free to anyone in need of help curbing the high cost of prescription drugs.

Due to the rising costs, unstable economics, and the mounting cost of prescriptions, American Consultants Rx Inc. (ACRX) a.k.a (ACIRX) an Atlanta based company was born in 2004. The ACRX discount prescription card program was created and over 25 million discount prescription cards were donated to over 18k organizations across the country to be distributed to those in need of prescription assistance free of charge since 2004.

The ACRX cards will offer discounts of name brand drugs of up to 40% off and up to 60% off of generic drugs. They also possess no eligibility requirements, no forms to fill out, or expiration date as well .One card will take care of a whole family. Also note that the ACRX cards will come to your organization already pre-activated .The cards are good at over 50k stores from Walgreen, Wal mart, Eckerd”s, Kmart, Kroger, Publix, and many more. Any one can use these cards but ACRX is focusing on those who are uninsured, underinsured, or on Medicare. The ACRX cards are now in Spanish as well.

American Consultants Rx made arrangements online for the ACRX card to be available at http://www.acrxcards.com where it can also be downloaded. This arrangement has been made to allow organizations an avenue to continue assisting their clients in the community until they receive their orders of the ACRX cards. ACRX made it possible for cards to be requested from online for individuals and organizations free of charge. Request for the ACRX cards can also be made by mailing a request to : ACRX, P.O.Box 161336,Atlanta,GA 30321, faxing a written request to 404-305-9539,or calling the office at 404-767-1072. Please include name (if organization please include organization and contact name),mailing address,designate Spanish or English,amount of cards requested,and telephone number.

American Consultants Rx is working diligently to assist as many people and organizations as possible. It should be noted that while many other organizations and companies place a cost on their money saving cards, American Consultants Rx does not believe a cost should be applied, just to assist our fellow Americans. American Consultants Rx states that it will continue to strive to assist those in need.

Sexual Pain Common After Childbirth, Study Finds

C-section and certain assisted vaginal births linked to more long-term problems
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

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Almost 1 in 5 Americans Plagued by Constant Pain, Survey Suggests

Older people, women more likely to struggle on daily basis, researchers note
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

Save up to 50% at Walgreens

Health Tip: Pain in the Foot?

See a doctor if you have symptoms of arthritis
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

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Healing Pain and Injury

Healing Pain and Injury


Renowned osteopathic physician Dr. Maud Nerman demonstrates how a wide range of symptoms-including unexplained headaches, anxiety, back or neck pain, weight gain, low sex drive, constant fatigue, asthma, chronic pain, or memory loss-can stem from the body’s inability to recover after an injury or trauma. Healing Pain and Injury identifies three key steps to regaining health after injury or trauma: Removing injury shock Restoring motion Controlling inflammation Based on over 30 years of successful treatment of patients with seemingly intractable conditions, Dr. Nerman’s innovative approach enables readers to harness their body’s remarkable healing ability in order to reclaim their health and their lives. When injury or illness befalls you, your body is your greatest ally, constantly fighting to restore balance and health to every part of you. But sometimes it needs the right kind of help. In Healing Pain and Injury, osteopathic physician Dr. Maud Nerman provides a revolutionary approach to understanding and treating pain and injury. Rejecting the view that the patient is a collection of symptoms to be dissected, she illustrates how problems in one area or system of the body can reverberate in a distant system or structure. Dr. Nerman weaves together personal stories from patients, three decades of experience, the healing tradition of osteopathic medicine, and recent scientific discoveries to explain why the body’s interconnectedness is often the key to recovery and how you can understand the clues it provides. The way in which we heal from injury is also critical. The body heroically attempts to recover, but if the healing process is delayed, interrupted, or incomplete, chronic illness can result. Dr. Nerman shares insight into the processes that create chronic illness-how they develop, what makes them persist, and what you can do to reverse them, even months or years later. She explains in detail how the body works to heal itself and offers a multitude of ways that

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The Secret Circus of Pain and Degradation

The Secret Circus of Pain and Degradation


When a circus sets up camp outside their small town, Amy and Paula are immediately drawn to its exotic allure. However, this is not your typical spectacle of acrobatics, wild animals and zany circus clowns. The two young women are surprised to find trapeze artists wearing nothing but thongs and tattoos, and an equestrian act with human females as ponies, complete with bridles, harness and tails fixed to rumps that bear the marks from a trainer’s whip. Even the clowns have contrived to lose most of their clothing. Had this circus camped inside the town limits, it would have been shut down as an offense to the public morals in their small-minded community. But for the naivePaula and Amy, the unusual circus is a titillating adventure and they hunger to see more. After the main show, Amy and Paula are given a handbill for a special late-night performance that sounds too enticing to ignore: “Explicit and revealing enactments of the most depraved and terrifying human appetites. Witness the truly debauched excesses of famous emperors, kings and queens through history. Also presenting the unexpurgated reenactment of Scenes from the Inquisition.” Though the shocking performances are beyond the girls’ wildest imaginings, they tap into secret sexual fantasies they both share. Bondage, whips and riding crops abound, and, as advertized , the reenactments portray the most depraved scenes of female ravagement for gawking eyes to relish. Little do the two realize that the mesmerizing ringmaster has a talent for hypnotism, and before the night is over, they will find themselves performing degrading acts under the man’s skillful manipulation. After a long and bewildering night, Amy and Paula awaken in the morning with vague recollections of being dumped in a wagon. Kidnapped and bound, the two jostle about in a circus cart as they are carried off to a new life and the grueling training that life requires. This sexy and adventurous duo will soon become professional, performing submis

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Tennova Pain Management Center Receive Tribute & Medicine Assistance by Charles Myrick of ACRX.wmv

Cast: Charles Myrick

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Vimeo / Charles Myrick’s videos
Special News Bulletin-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

Topical Issues in Pain 4

Topical Issues in Pain 4


This fourth volume contains further ground-breaking and highly relevant work. Taking on the placebo and nocebo phenomenon, pain management and muscles and pain the volume yet again promotes the forward thinking and cutting edge work of the Physiotherapy Pain Association. In Part 1 a number of internationally renowned clinicians and researchers have come together to produce the first published attempt to broadly address and critically appraise the placebo and nocebo phenomenon from a clinical perspective for physiotherapists. The information and the way the material is presented should fascinate as well as challenge readers to think and work differently. Understanding the placebo fully requires a radical shift in thinking about human recovery mechanisms and the way in which treatments can be triggered to work at their most efficient. Part 2 takes on three more pain management topics the integration of pain management approaches and techniques for individual therapists working with individual patients or in out-patient settings; information giving for patients and addressing the taxing problem of improving fitness in patients with chronic pain related incapacity. The last part is devoted to some major issues surrounding the relationship of muscles to pain. Many current beliefs about the role of muscles come under scrutiny and some are constructively challenged by new proposals. Perhaps the most exciting aspect of the work presented here is that physiotherapy, if it fully integrates the information provided into clinical practice, should be increasingly recognised as the central and essential component of modern management of musculoskeletal pain states. The Topical Issues in Pain series derives from the work, study days and seminars of the Physiotherapy Pain Association and is written by clinicians for clinicians. Each volume reviews the literature and presents best practice in a lively and understandable text. All clinicians will benefit from the straightforward ad

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