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Kirchner EM quality 60 mg levitra extra dosage goal of erectile dysfunction treatment, Lewis RD buy 40mg levitra extra dosage erectile dysfunction medicine names, O’Conner PJ: Effect of past gymnastic National Institutes of Health: The practical guide identification, participation on adult bone mass. J Appl Physiol 80(1):226–232, evaluation and treatment of overweight and obesity in adults. Laaksonen DE, Atalay M, Niskanan LK, et al: Aerobic exercise Nazar K, Chwa;bomsla-Moneta J, Machalla J, et al: Metabolic and the lipid profile in type 1 diabetic men: A randomized con- and body temperature change during exercise in hyperthyroid trolled trial. Lin Sports Nelson ME, Fiatarone MA, Morganti CM, et al: Effects of Med 11(2):403–418, 1992. JAMA dependent diabetes mellitus morbidity and mortality study: 272:1909–1914, 1994. Pediatrics Olerud JE, Homer LD, Carrol HW: Incidence of acute exertional 78:1027–1033, 1986. Laufer Y, Dickstein R, Chefex Y, et al: The effect of treadmill Pate RR, Pratt M, Blair SN, et al: Physical activity and public training on the ambulation of stroke survivors in the early health: A recommendation from the Centers for Disease stages of rehabilitation: A randomized study. J Rehabil Res Control and Prevention and the American College of Sports Dev 38(1):69–78, 2001. Lee CD, Blair SN: Cardiorespiratory fitness and stroke mortality Perry AC, Miller PC, Allison MD, et al: Clinical predictability of in men. Jeffrey G Jenkins, MD Ram FS: Effects of physical training in asthma: a systematic Scott Chirichetti, DO review. Rimmer JH, Riley B, Creviston T, et al: Exercise training in a pre- PLAYING SURFACE dominately African-American group of stroke survivors. Snow-Harter C, Bouxsein ML, Lewis BT, et al: Effects of resist- exists; however, in some sports, different options offer ance and endurance exercise on bone minteral status of young their own advantages and disadvantages. Storer TW: Exercise in chronic pulmonary disease: Resistance exer- cise prescription. Szentagothai K, Gyene I, Szocska M, et al: Physical exercise pro- Turf sports (e. Pediatr Pulmonol may be played on either artificial turf or natural grass. Natural grass is generally held to be safer and is asso- Tanji JL: Exercise and the hypertensive athlete. Clin Sports Med ciated with lower rates of significant injury owing to 11:291–302, 1995. Am J Hypertens 2:135–138, among National Football League (NFL) players, 1989. MMWR found that concussions occurred 33% more often on Morb Mortal Wkly Rep 49(17):366–369, 2000. Diabetes Care 15:1800–1810, Powell’s landmark NFL study confirmed these find- 1992. A national athletic injury/illness reporting Wallberg-Henriksson H: Exercise and diabetes mellitus. Exerc system study in 1975 concluded that “artificial turf Sports Sci Rev 20:339–368, 1992. These include turf burns, the common abra- lar disease: How to use C-reactive protein in clinical practice. A study by Cantu et al attributed in large Increased incidence of turf toe, a sprain of the plantar part a dramatic reduction in brain injury-related fatal- capsule ligament complex of the metatarsophalangeal ities from football to the adoption of NOCSAE helmet (MTP) joint of the great toe, is also associated with standards (Cantu and Mueller, 2003). Hyperextension of the MTP is went into effect in 1978 for colleges and in 1980 for the most common mechanism. Blisters are more common owing to increased criteria: the frontal crown of the helmet should sit traction. Ready-made guards are the Hard courts are associated with greater stress on the least comfortable and least protective type. Mouth lower extremities as a result of the reduced shock guards have been required equipment for high school absorbing ability and increased traction between shoe football players since 1962 and for their collegiate and court. Mouth injuries, which at one W ith its energy absorbing properties, clay is more for- time comprised 50% of all football injuries, have been giving to the upper extremities owing to reduced ball reduced by more than half since the adoption of face speed (Nicola, 1997). Cantilevered pads are named for the cantilever bridge that extends PROTECTIVE EQUIPMENT over the shoulder, dispersing impact force over a wider area.

When we view this complex phenomenon from a perspective that seeks to account for the equally complex experience of pain purchase 40mg levitra extra dosage impotence uk, we realize that the contin- uing profusion of positive and negative emotional responses elicited by lan- guage combines to create an emotional state levitra extra dosage 40 mg with visa erectile dysfunction underlying causes, which will be positive if the positive responses outweigh negative ones and negative if the opposite is true. An emotional state is like a porridge that is sweetened with honey and seasoned with salt. It not only has its own characteristic in response to the sum of the ingredients, it absorbs any further additions. Thus, at some point, additional experiences can tip the balance and change an individual’s emotional state from positive to negative or vice versa. An emotional state can also change the positive/negative impact of an additional experience (adding more sugar intensifies sweetness). This understanding of emotional states joined with that of pain as an unpleasant emotion allows us to see how a negative emotional state can inten- sify the experience of pain and vice versa. On the other hand, a positive emo- tional state can reduce the experience of pain and vice versa. Thus, patients suffering chronic pain often have comorbid depression, which, in turn, intensi- fies the pain. Depression arising from non-pain-related events can also have a deleterious effect on pain. Personality In order to explain the pain phenomenon, our theory must locate these biological/behavioral/learning/cognition principles firmly within a framework that also explains the impact of personality differences. Our theory of personality, which arises from the basic behavioral princi- ples we reviewed above, defines personality as the sum of three different learned repertoires of behavior. First, our personality is a creation of our exten- sive and complex repertoire of language-cognition responses. This repertoire contains subrepertoires that differ from individual to individual and acts (think- ing, planning, communicating) that arise from these individualized subreper- toires. Second, our personality is shaped by the emotional responses we have learned to pair with various stimuli. Third, our personality includes our sensory- motor responses to conditioned stimuli, some of which are so complicated (making pottery) that they comprise repertoires themselves. The Psychological Behaviorism Theory of Pain Revisited 31 Thus, what we call ‘personality’ is the behavioral manifestation of our con- ditioning and our learning our basic behavioral repertoire. Our theory holds that biological conditions (normal or abnormal) mediate the translation of learned experiences (past or present) into basic behavioral repertoires and that biological factors come into play again to influ- ence our ability to sense (recognize) and respond to current lessons and to retain what we have learned. At any given time, an individual’s behavior will affect the current environment, making changes that will affect future behavior in an ongoing interaction. This theory of personality, thus, unifies what we know about the actions of biological and emotional variables with basic principles of learning and conditioning. Pain Behavior Pain, of course, affects and is affected by personality repertoires. Beginning again with the language-cognition personality repertoire, it becomes clear that differences in emotional responses to words and phrases (language) play a large role in creating the differences we see in how individuals perceive and react to pain. In the case of pain arising from cancer, for example, a patient who associates ‘cancer’ with ‘death’ is likely to exhibit or report more suffer- ing than a patient who associates ‘cancer’ with ‘cure’. Expanding this relation- ship to the more complex language repertoire that oversees each individual’s language labeling ‘style’ (pessimistic, optimistic), let us hypothesize that a pessimistic individual will exhibit or report more suffering than an optimistic individual from an equally painful condition. The second behavioral repertoire, an individual’s set of learned emotional responses to various stimuli, obviously plays a role in determining if that person’s emotional state is positive or nega- tive, especially if the responses are accompanied by a series of reinforcers and directive stimuli. As noted above, the emotional state sets the stage for pain, either highlighting or diminishing its effect and how that effect is manifest. Finally, the sensory-motor repertoire will determine how an individual expresses pain behavior. A person given to flamboyant actions will likely exhibit more extreme pain behavior than a person whose sensory-motor reper- toire comprises only reserved actions. The Social Environment The social environment is a macrocosm in which all of the factors that are important for pain investigation on an individual level exert a similar bidirec- tional influence on pain on a cultural level. The biological level, for example, corresponds to those elements of the social environment that simply exist – the climate or geography – and which may or may not be altered by members of the Staats/Hekmat/Staats 32 society.

Surgical (“laminotomy purchase levitra extra dosage 40 mg otc impotence 1,” “plate generic 40mg levitra extra dosage fast delivery what is an erectile dysfunction pump,” or outcome of most ablative procedures. Pain relief is “paddle”) leads offer the advantages of a lower inci- achieved in more than 95% of patients. Require maintenance (eg, refilling of infusion pumps, replacement of stimulation system battery packs) Have the potential for device-related complications The indications for PNS are similar to those for SCS General indications for augmentative therapies are except that the distribution of pain should be limited similar to those for other neurosurgical pain treat- to the territory of a single peripheral nerve. Dots also represent the most common location of needle insertions during RIT. The pilot group consisted of 30 intradiscal electrothermal annuloplasty (IDET). These Thirty patients were reported to have a significant patients have failed previous conservative care, pain improvement and return-to-work ratio after >° °° 61 PIRIFORMIS SYNDROME DIAGNOSTIC TESTS AND PHYSICAL EXAM FINDINGS SYMPTOMS distention of the joint capsule, whereas the subse- Although CT guidance has been used for this proce- quent analgesia is due to the local anesthetic effect. This allows the posteroinferior aspect of the joint to be clearly differentiated from the inaccessible anterior, which moves cephalad on the image. Using sterile technique, a local anesthetic skin Conservative treatment may begin with nonsteroidal wheal is placed at the site previously marked. Unfortunately, no ligaments and capsule into the joint by advancing it prospective studies have been done evaluating the about 5–10 mm, usually by angling the needle tip efficacy of physical therapy and bracing in SIJ dys- slightly laterally to follow the natural curve of the function. The desired result is Because repeated injections are not recommended as thickening of ligaments or muscle attachments to a long-term treatment plan, this has resulted in the stabilize a “hypermobile joint. Craig PAIN Psychological Perspectives PAIN Psychological Perspectives Edited by Thomas Hadjistavropoulos University of Regina Kenneth D. Craig University of British Columbia LAWRENCE ERLBAUM ASSOCIATES, PUBLISHERS 2004 Mahwah, New Jersey London Copyright © 2004 by Lawrence Erlbaum Associates, Inc. No part of this book may be reproduced in any form, by photostat, microform, retrieval system, or any other means, without the prior written permission of the publisher. Printed in the United States of America 10987654321 We dedicate this volume to those who mean the most to us: Heather, Nicholas, and Dimitri —T. Contents Contributors ix Preface xi An Introduction to Pain: Psychological Perspectives 1 Thomas Hadjistavropoulos and Kenneth D. Craig 1 The Gate Control Theory: Reaching for the Brain 13 Ronald Melzack and Joel Katz 2 Biopsychosocial Approaches to Pain 35 Gordon J. Wright 3 Pain Perception, Affective Mechanisms, and Conscious Experience 59 C. Richard Chapman 4 Social Influences and the Communication of Pain 87 Thomas Hadjistavropoulos, Kenneth D. Craig, and Shannon Fuchs-Lacelle 5 Pain Over the Life Span: A Developmental Perspective 113 Stephen J. Chambers vii viii CONTENTS 6 Ethnocultural Variations in the Experience of Pain 155 Gary B. Rollman 7 Social Influences on Individual Differences in Responding to Pain 179 Suzanne M. Williams 9 Psychological Interventions for Acute Pain 245 Stephen Bruehl and Ok Yung Chung 10 Psychological Interventions and Chronic Pain 271 Heather D. Williams 11 Psychological Perspectives on Pain: Controversies 303 Kenneth D. Craig and Thomas Hadjistavropoulos 12 Ethics for Psychologists Who Treat, Assess, and/or Study Pain 327 Thomas Hadjistavropoulos Author Index 345 Subject Index 371 Contributors Gordon J. Asmundson Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada Stephen Bruehl Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee Christine T. Chambers Department of Pediatrics, University of British Columbia, Centre for Community Child Health Research, Vancouver, British Columbia, Can- ada C. Richard Chapman Pain Research Centre, Department of Anesthesiology, Univer- sity of Utah, Salt Lake City, Utah Ok Yung Chung Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee Kenneth D. Craig Department of Psychology, University of British Columbia, Van- couver, British Columbia, Canada Amanda C. Thomas’ Hospital, London, United Kingdom Shannon Fuchs-Lacelle Department of Psychology, University of Regina, Regina, Saskatchewan, Canada Steven J. Gibson National Ageing Research Institute, Parkville, Victoria, Australia Heather D. Hadjistavropoulos Department of Psychology, University of Regina, Re- gina, Saskatchewan, Canada ix x CONTRIBUTORS Thomas Hadjistavropoulos Department of Psychology, University of Regina, Re- gina, Saskatchewan, Canada Joel Katz Department of Psychology, York University, Toronto, Ontario, Canada Victoria L.

Dick EA purchase 60 mg levitra extra dosage fast delivery erectile dysfunction 4xorigional, Patel K discount levitra extra dosage 40 mg with visa erectile dysfunction surgery, Owens CM, et al (2002) Spinal ultrasound anatomy in the neonatal clubfoot. Cahuzac JP, Navascues J, Baunin C, et al (2002) Assessment nographic screening in infants with isolated spinal straw- of the position of the navicular by three-dimensional mag- berry nevi. J Neurosurg Spine 98(3):247–250 netic resonance imaging in infant foot deformities. Tortori-Donati P, Rossi A, Biancheri R, et al (2001) Mag- atr Orthop B 11(2):134–138 netic resonance imaging of spinal dysraphism. Pirani S, Zeznik L, Hodges D (2001) Magnetic resonance Reson Imaging 12(6):375–409 imaging study of the congenital clubfoot treated with the 60. J Pediatr Orthop 21(6):719–726 netic resonance imaging of the pediatric spine. Pekindil G, Aktas S, Saridogan K, et al (2001) Magnetic Orthop Surg 11(4):248–259 Trauma and Sports-related Injuries 19 2 Trauma and Sports-related Injuries Philip J. The aim of this chapter is to give the reader an understanding of the factors affecting the nature 2. The site of fail- ure will usually be at the weakest point within the structure, this varies with the age of the patient and obviously differs depending on the forces applied. This is the junction tant from the site of trauma due to transmitted forces, between mature and growing bone, i. Chronic overuse injuries are particularly thus usually either apophyseal avulsions or Salter- important in the young athlete. Repetitive mental differences in the young skeleton and that strain is a common mechanism for sports-related of the mature adult, which lead to disparate patterns injury and occurs as a result of forces large enough of injury from the same degree of force. With each cycle the tissue weakens until eventu- ally the force applied is larger than the tissue toler- P. These Department of Radiology, The General Infirmary at Leeds, forces are usually complex as a result of differing Leeds, LS1 3EX, UK sports and patient biomechanics, although they will 20 P. Imaging Passive compressive forces result more in damage to osseous structures and are particularly seen in Management of paediatric trauma requires close a ssociat ion w it h h ig h i mpac t c ycl ic a l i nju r y (i. The clinical history is vital, immature patient injury again usually occurs at the since the mechanism will usually predict the likely site of growing bone. The diaphysis of long is best assessed with US, while stress fractures may bones as in the very young can be the site of injury be missed on plain film and require radionuclide as the bone itself has differing mechanical proper- scintigraphy. In the adolescent, osteochondral inju- ties making this the weakest point. In older patients ries are commonly encountered and these require fusing epiphysis similarly no longer represents the cross-sectional imaging, usually with MR. Special weakest point in the chain and compressive forces consideration should be given to the young athlete can result in stress injury to the diaphysis. Changes who is more likely to suffer from chronic overuse can be seen within joints and are normally seen in syndromes. The patterns of injury may be predicted association with compressive or rotational (twisting from the type of sport, with lower limb injuries often and varus/valgus stress) forces. Within joints osteo- arising from football and basket ball, upper limb chondral injury occurs much more commonly than in baseball and swimming, and overuse injuries in internal or ligamentous disruption except where swimming, gymnastics and throwing sports. Common examples of such muscles are the biceps in the upper limb or the 2. In the musculoskeletally immature patient the apophysis represents the weakest point 2. As the patient approaches maturity an increase in incidence of musculotendi- The biomechanical properties of growing bone may nous junction injuries will become apparent as the lead to incomplete, greenstick fractures, which are apophyses begin to fuse. Immature bone is more porous In general the type of force and the age of the and less dense than adult bone due to increased patient tend to determine the site at which that fail- vascular channels and a lower mineral content. The periosteum is thicker, more elastic and are skeletally mature presenting with calf muscles less firmly bound to bone, so it will usually remain tears. The nature of the force will be very similar in intact over an underlying fracture.