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Pretreatment with opioids: the effect on thiopentone induction requirements and on the onset of action of midazolam buy cheapest emsam anxiety 504 plan. Identification of the pharmacogenetic determinants of alfentanil metabolism: cytochrome P-450 3A4 discount generic emsam canada anxiety symptoms keyed up. Catalytic role of cytochrome P4503A4 in multiple pathways of alfentanil metabolism order emsam 5mg with mastercard anxiety lost night. Identification of human liver cytochrome p-450 3A4 as the enzyme responsible for fentanyl and sufen- tanil n-dealkylation. Guitton J, Buronfosse T, Desage M, Flinois J-P, Perdrix J-P, Brazier J-L, and Beaune P. Possible involvement of multiple human cytochrome P450 isoforms in the liver metabo- lism of propofol. Hypnotic and anaesthetic action of thiopentone and midazolam alone and in combination. The effect of oxygen on propofol-induced inhibition of microso- mal cytochrome P450 3A4. Effects of single doses of alprazolam and alcohol alone and in combination on psychological performance. Tofisopam, a novel 3,4- benzodiazepine: multiple-dose effects on psychomotor skills and memory. Psychomotor skills during subacute treatment with thioridazine and bromazepam, and their combined effects with alcohol. Effects of psychological performance of the benzodiazepine, loprazolam, alone and with alcohol. Effect of active metabolites of chlordiazepoxide and diazepam, alone or in combination with alcohol, on psychomotor skills related to driving. Effects of single doses of alprazolam and diazepam, alone and in combination with ethanol, on psychomotor and cognitive performance and on automatic nervous system reactivity in healthy volunteers. Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving. Serum chlordiazepoxide, diazepam and thiori- dazine concentrations after the simultaneous ingestion of alcohol or placebo drink. Disposition of clo- tiazepam: influence of age, sex, oral contraceptives, cimetidine, isoniazid and ethanol. Effects of alcohol and flunitrazepam on mood and performance in healthy young men. Comparison of perfor- mance of healthy volunteers given prazepam alone or combined with ethanol. Pharmacokinetic and phar- macodynamic interactions of diazepam with different alcoholic beverages. Decline in chlordiazepoxide plasma levels during fixed-dose therapy of alcohol withdrawal. Reduced concentrations of plasma diazepam in chronic alcoholic patients following an oral administration of diazepam. Human and animal study on elimination from plasma and metabolism of diazepam after chronic alcohol intake. The influence of three antacids in the absorption and clinical action of oral diazepam. The influence of H2 receptor antagonists on the plasma concentration of midazolam and temazepam. Influence of magne- sium and aluminum hydroxide mixture on chlordiazepoxide absorption. Impaired absorption of desmethyldiazepam from clorazepate by magnesium aluminum hydroxide. Changes in the oral absorption characteristics in man of dipotassium clorazepate at normal and elevated gas- tric pH. Steady-state plasma desmethyl- diazepam during long-term clorazepate use: effect of antacids. Effects of end stage renal disease and aluminium hydroxide on triazolam pharmacokinetics. Effect of orally administered miso- prostol and cimetidine on the steady state pharmacokinetics of diazepam and nordiazepam in human volunteers. The action of cispride on gastric emptying and the pharmacodynamics and pharmacokinetics of diazepam. Selection of drugs to treat gastro-oesophageal reflux disease—the role of drug interactions. Differential inhibi- tion of individual human liver cytochromes P-450 by cimetidine. Comparative effects of H2-recep- tor antagonists on drug metabolism in vitro and in vivo. Influence of repeated administration of cimetidine on the pharmacokinetics and pharmacodynamics of adinazolam in healthy sub- jects. Inter- action of cimetidine with triazolobenzodiazepines alprazolam and triazolam. Pharmacokinetic conse- quences of long term coadministration of cimetidine and triazolobenzodiazepines, alpra- zolam and triazolam, in healthy subjects. Bromazepam pharmacokinetics: influence of age, gender, oral contraceptives, cimet- idine and propranolol. The effect of cimetidine on the single dose pharmacokinetics of oral clobazam and N-desmethylclobazam. Influence of cimetidine on oral diazepam elimination with measurement of subsequent cognitive change. Influence of cimetidine on the pharmacokinetics of desmethyl- diazepam and oxazepam. The effect of intravenous cimetidine on the absorp- tion of orally administered diazepam and lorazepam. Effect of single doses of cimetidine and raniti- dine on the steady-state plasma levels of midazolam. Effect of rantidine on the disposition of orally and intravenously administered triazolam. Ranitidine does not impair oxidative or conjugative drug metabolism: noninteraction with antipyrine, diazepam, and lorazepam. Nocturnal doses of ranitidine and nizatidine do not affect the disposition of diazepam. Famotidine, a new H2-receptor antagonist, does not affect hepatic elimination of diazepam or tubular secretion of procainamide. Interaction of diaz- epam with famotidine and cimetidine, two H2-receptor antagonists. Evaluation of omeprazole and lansoprazole as inhibitors of cytochrome P450 isoforms. Pharmacokinetics, metabolism and interactions of acid pump inhibitors: focus on omeprazole, lansoprazole and pantoprazole. Effect of ome- prazole treatment on diazepam plasma levels in slow versus normal rapid metabolizers of omeprazole.
Contra-indications buy emsam 5mg otc anxiety tattoos, adverse effects emsam 5mg with visa anxiety symptoms mayo clinic, precautions – Do not administer to patients with severe renal impairment proven 5mg emsam anxiety symptoms rocking, anuria, hyperkalaemia > 5 mmol/l, hyponatraemia. However, avoid using during the last month of pregnancy (risk of jaundice and haemolytic anaemia in the newborn infant). Dosage and duration – Infantile beriberi 10 mg once daily, until complete recovery (3 to 4 weeks) – Acute beriberi 150 mg/day in 3 divided doses for a few days, until symptoms improve, then 10 mg/day until complete recovery (several weeks) – Mild chronic deficiency 10 to 25 mg once daily Contra-indications, adverse effects, precautions – No contra-indication, or adverse effects with oral thiamine. Clostridium sp, Bacteroides sp) Presentation – 500 mg tablet Dosage and duration – Amoebiasis Child: 50 mg/kg once daily, without exceeding 2 g/day Adult: 2 g once daily The treatment lasts 3 days in intestinal amoebiasis; 5 days in hepatic amoebiasis. Contra-indications, adverse effects, precautions – Do not administer to patients with allergy to tinidazole or another nitroimidazole (metronidazole, secnidazole, etc. In the event of prolonged treatment, do not stop abruptly, reduce doses progressively. Contra-indications, adverse effects, precautions – Do not administer in the event of severe respiratory depression and to patients that risk seizures (e. The neonate may develop withdrawal symptoms, respiratory depression and drowsiness in the event of prolonged administration of large doses at the end of the 3rd trimester. Monitor the mother and the neonate: in the event of excessive drowsiness, stop treatment. In situations of repeated bleeding, it may be helpful to combine tranexamic acid with a non-steroidal anti-inflammatory drug (oral ibuprofen, 1200 to 2400 mg/daily maximum, to be divided in 3 doses for 3 to 5 days) and/or a long-term treatment with oral estroprogestogens or injectable progestogens. Therapeutic action – Antiepileptic Indications – Generalised and partial epilepsy Presentation – 200 mg and 500 mg enteric coated tablets Dosage – Child under 20 kg: 20 mg/kg/day in 2 divided doses – Child over 20 kg: start with 400 mg (irrespective of weight) in 2 divided doses, then increase gradually until the individual optimal dose is reached, usually 20 to 30 mg/kg/day in 2 divided doses – Adult: start with 600 mg/day in 2 divided doses, then increase by 200 mg every 3 days until the individual optimal dose is reached, usually 1 to 2 g/day in 2 divided doses Duration – Lifetime treatment Contra-indications, adverse effects, precautions – Do not administer: • to women of childbearing age. If the treatment is absolutely necessary and if there is no alternative, an effective contraception is required (intrauterine device); • to patients with pancreatitis, hepatic disease or history of hepatic disease. If treatment was started before pregnancy: replace valporic acid with a safer antiepileptic if possible. If there is no other alternative, do not stop valporic acid however administer the minimal effective dose and divide the daily dose. Monitor the newborn (risk of withdrawal syndrome and haemorrhagic disease, not related to vitamin K deficiency). The administration of folic acid during the first trimester may reduce the risk of neural tube defects. Contra-indications, adverse effects, precautions – Do not administer to patients with severe haematological disorders (leukopenia, anaemia), to neonates with hyperbilirubinaemia or raised transaminases. Stop taking zidovudine in the event of severe haematological disorders or hepatic disorders (hepatomegaly, raised transaminases). Contra-indications, adverse effects, precautions – Do not administer to patients with severe haematological disorders (neutropenia, anaemia). Contra-indications, adverse effects, precautions – Do not administer to patients with severe haematological disorders (neutropenia, anaemia), hepatic disorders or intolerance to nevirapine that led to discontinuation of treatment. If the enzyme level reaches 5 times the normal level, stop nevirapine immediately. Remarks – Zinc sulfate is given in combination with oral rehydration solution in order to reduce the duration and severity of diarrhoea, as well as to prevent further occurrences in the 2 to 3 months after treatment. Zinc sulfate must never replace oral rehydration therapy which is essential (nor can it replace antibiotic therapy that may, in specific cases, be necessary). Once a tablet is removed from the blister, it must be dissolved and administered immediately. The addition of clavulanic acid to amoxicillin extends its spectrum of activity to cover beta-lactamase producing Gram-positive and Gram- negative organisms, including some Gram-negative anaerobes. Indications – Erysipelas and cellulitis – Necrotizing infections of the skin and soft tissues (necrotizing fasciitis, gas gangrene, etc. Dosage (expressed in amoxicillin) – Erysipelas, cellulitis child under 3 months: 60 mg/kg/day divided in 2 infusions child 3 months and over: 80 to 100 mg/kg/day divided in 3 injections or infusions (max. Duration – Erysipelas, cellulitis: 7 to 10 days; necrotizing infections: 10 to 14 days; upper genital tract infection: depending on clinical response. Contra-indications, adverse effects, precautions – Do not administer to penicillin-allergic patients, patients with history of hepatic disorders during a previous treatment with co-amoxiclav, patients with infectious mononucleosis. The concentrated solution must be diluted in 500 ml of 5% glucose to obtain a solution containing 0. Then, after improvement, resume amphotericin at the lowest effective dose or on alternate days. Do not use the preparation if there is visible precipitation (the glucose solution is too acid). Attach the filter provided with the vial to the syringe; inject the contents of the syringe, through the filter, into the volume of 5% glucose (50 ml, 250 ml, 500 ml) needed to obtain a solution containing between 0. Dosage and duration – Cryptococcal meningitis, severe histoplasmosis Child over 1 month and adult: 3 mg/kg once daily over 30 to 60 minutes for 2 weeks liposomal amphotericin B, 50 mg-vial in 12 ml G5% Weight Daily dose Volume of suspension Volume required Nb of vials in mg/kg (4 mg/ml) to be withdrawn for administration 4 kg 12 3 ml 5 kg 15 4 ml 6 kg 18 4,5 ml 7 kg 21 5 ml 1 50 ml 8 kg 24 6 ml 9 kg 27 7 ml 10 kg 30 7,5 ml 15 kg 45 11 ml 20 kg 60 15 ml 25 kg 75 2 19 ml 250 ml 30 kg 90 23 ml 35 kg 105 26 ml 40 kg 120 30 ml 3 45 kg 135 34 ml 50 kg 150 38 ml 500 ml 55 kg 165 41 ml 60 kg 180 4 45 ml 65 kg 195 50 ml 70 kg 210 5 53 ml – Cutaneomucous or visceral leishmaniasis Follow the recommended protocol, which varies from one region to another (exact dose, administration schedule, etc. For information, the total dose in children over 1 month and adults is 15 to 30 mg/kg. Contra-indications, adverse effects, precautions – May cause: • intolerance reactions during administration: fever, chills, headache, nausea, vomiting, hypotension; local reaction: pain and thrombophlebitis at injection site; allergic reactions; • gastrointestinal disturbances, disturbances in renal function (raised creatinine or urea levels, renal impairment), hypokalaemia, hypomagnesiemia, elevated liver enzymes; rarely, haematological disorders (thrombocytopenia, anaemia). Change to oral treatment as soon as possible with amoxicillin or a combination of antibacterials, depending on the indication. Contra-indications, adverse effects, precautions – Do not administer to patients with infectious mononucleosis (risk of skin eruption) or to penicillin- allergic patients. Contra-indications, adverse effects, precautions – May cause: headache, gastrointestinal disturbances, dizziness, neutropenia and transient increase in liver transaminases. Administer at least 3 doses parenterally, then, if the patient can tolerate the oral route, change to an artemisinin-based combination (do not use the combination artesunate-mefloquine if the patient developed neurological signs during the acute phase). Contra-indications, adverse effects, precautions – Do not administer to patients with urethro-prostatic disorders, cardiac disorders, glaucoma. Contra-indications, adverse effects, precautions – Do not administer to penicillin-allergic patients. In severe cases, hypotension, bradycardia, arrhythmia, syncope and cardiac arrest may develop. Duration – Depending on indication and clinical response Contra-indications, adverse effects, precautions – Do not administer to patients allergic to cephalosporins or penicillins (risk of cross-sensitivity). Contra-indications, adverse effects, precautions – Do not administer to patients with allergy to cephalosporins or penicillins (cross-sensitivity may occur) and to neonates with jaundice (risk of bilirubin encephalopathy). Contra-indications, adverse effects, precautions – Do not administer to children under 1 year. In these events, stop treatment immediately; • gastrointestinal disturbances, peripheral and optic neuropathies. If used during the 3rd trimester, risk of grey syndrome in the newborn infant (vomiting, hypothermia, blue-grey skin colour and cardiovascular depression).
Although these interactions are usually undesirable order emsam 5 mg overnight delivery anxiety symptoms vomiting, there have been instances when clinicians have taken advantage of them to successfully treat resistant cases (81) purchase emsam 5 mg amex anxiety 30000. Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability discount emsam 5 mg free shipping anxiety symptoms worksheet. An effect-size analysis of the relative efficacy and tolerability of serotonin reuptake inhibitors for panic disorder. A multicenter investigation of fixed dose fluoxetine in the treatment of obsessive compul- sive disorder. Citalopram 20 mg, 40 mg, and 60 mg are all effective and well tolerated compared with placebo in obses- sive compulsive disorder. Prevalence of mental illness in Germany and the United States: comparison of the Upper Bavarian Study and the Epidemiologic Catchment Area Program. The National Depressive and Manic-Depres- sive Association consensus statement on the under treatment of depression. Concomitant use of selective serotonin reuptake inhibitors with other cytochrome P450 2D6 or 3A4 metabolized medications: how often does it really happen? Pharmacokinetics of selective serotonin reuptake inhibi- tors: clinical relevance. Pharmacokinetics of sertraline and N-demethyl- metabolite in elderly and young male and female volunteers. A review of its pharmacodynamic and pharmaco- kinetic properties, and therapeutic potential in depression and obsessive-compulsive dis- order. A review of its pharmacodynamic and pharmacokine- tic properties, and therapeutic potential in depressive illness. The stereoselective metabolism of fluoxetine in poor and extensive metabolisers of sparteine. The role of cytochrome P-450D6 in the metabolism of paroxetine by human liver microsomes. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabo- lism. Identification of three cyto- chrome P-450 isozymes involved in N-demethylation of citalopram enantiomers in human liver microsomes. A fatal case of serotonin syndrome after combined moclobemide- citalopram intoxication. Postmortem forensic toxicology of selective serotonin reuptake inhibitors: a review of pharmacology and report of 168 cases. Plasma concentra- tions of risperidone and 9-hydroxyrisperidone during combined treatment with paroxetine. Fluvoxamine and fluoxetine do not interact in the same way with the metabolism of the enantiomers of methadone. Selective serotonin reuptake inhibitors and tricyclic antidepressants in combina- tion. Rifampin induced selective serotonin reuptake inhibitor with- drawal syndrome in a patient treated with sertraline. Effect of selective serotonin reuptake inhib- itors on the oxidative metabolism of propafenone: in vitro studies using human liver micro- somes. Inhibition of phenytoin hydroxylation in human liver microsomes by several selective serotonin reuptake inhibitors. Lack of effect of citalopram on the steady state pharmacokinetics of carbamazepine in healthy male subjects. Paroxetine and amitrip- tyline augmentation of lithium in the treatment of major depression: a double-blind study. Tolerability of com- bined treatment with lithium and paroxetine in patients with bipolar disorder and depres- sion. Paroxetine affects metoprolol pharmacokinetics and pharmacodynamics in healthy volunteers. Dose-response evaluation of the inter- action between sertraline and alprazolam in vivo. Ayahuasca preparations and serotonin reuptake inhibitors: a potential combination for severe adverse interactions. Treatment of depression with associated anxiety: compari- sons of tricyclic and selective serotonin reuptake inhibitors. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. Seizure risk associated with psychotropic drugs: clinical and pharmacoki- netic considerations. Is therapeutic drug monitoring a case for optimizing clinical outcome and avoiding interactions of the selective serotonin reuptake inhibitors? Therapeutic drug monitoring of selective serotonin reuptake inhibitors influences clinical dosing strategies and reduces drug costs in depressed elderly patients. A double blind, placebo-controlled study of citalopram with and without lithium in the treatment of therapy- resistant depressive patients: a clinical, pharmacokinetic, and pharmacogenetic investiga- tion. Traditional antipsychotics are thought to act by exerting effects principally on the dopamine neurotransmitter system (1). The traditional antipsychotics became known to many as neuroleptics based on their frequent effects of substantially slowing movement (1). Atypical antipsycho- tics, designed in laboratories to provide psychotic symptom relief without movement problems, affect other neurotransmitter systems (2), and present other potential concerns. Interactions involving antipsychotics (a) make side effects of the antipsychotics more pronounced, (b) render the antipsychotics less effective, and (c) affect the metab- olism of other medicines, and prolong their effects and side effects Both older and more recently developed varieties of antipsychotics are known for their manifold side effects on numerous organ systems. Interactions have forensic sig- nificance when efficacy and/or side effects are heightened by the coprescription of med- icines that affect antipsychotic metabolism. Drug interactions involving antipsychotics warrant particular scrutiny in the elderly, the brain-damaged, those on other psychotropics, and those with a history of special sensitivity to antipsychotics. Given the severe conditions for which antipsychotic prescribing is reserved, inter- actions also have forensic relevance when an antipsychotic is no longer effective because of the medicines prescribed along with it. In these cases, the greatest forensic significance of the drug interaction is the relapse of the root illness, rather than drug side effects. Before we explore how these interactions manifest themselves in criminal and civil case scenarios, an appreciation for the neurochemistry involved is necessary. Messages pass through the nervous system, from cell to cell, by these chemical neurotransmitters (3). Psychosis and other psychiatric maladies occur when the delicate equilibrium of each of these micro- scopic neurochemical transmitters is disrupted. The chemical imbalance causes chain reactions that result in the development of symptoms or outwardly visible behaviors. Antipsychotics impact a number of neurotransmitters and regulatory systems in the body. Like other psychotropics, antipsychotics exert their effects on receptors of these neurotransmitters, receptors that normally catch and relay the transmitting neuro- chemical that has been released by the nerve cell nearby. In addition to directly blocking dopamine transmission at D2 receptors, anti- psychotics have antihistaminic and antiadrenergic effects (4).
That’s why most people believe they have “thrown out” The same can be said for back pain emsam 5 mg free shipping anxiety symptoms muscle tension. Find the source of the their backs or suffered the injury because of a singular problem and all the “downstream” issues end up disappearing occurrence buy line emsam anxiety symptoms mimic heart attack. The activity may have triggered Back Pain Type #2: the pain cheap emsam 5mg with visa anxiety symptoms zoloft, but it was the long months or years of uneven Tissue-Based Back Pain muscle use that actually created the condition that made the pain possible. When a physical dysfunction or condition persists uncorrected, the various tissues in your body—namely your Back Pain Type #1: muscles, tendons, and ligaments—get overworked incredibly Nerve-Based Back Pain quickly. Under these kinds of conditions, your soft tissues Once the physical dysfunction and/or condition exists, can tolerate enormous usage completely pain free. When you have a muscle or bone that is a hair’s length straining those soft tissues virtually every second of your away from a nerve, it doesn’t take much for either of them to waking day. If you’re sitting treatments fail, work only temporarily, or have inconsistent in a chair under these conditions, your muscles, tendons, and results is because most treatment approaches focus on the ligaments have to work overtime to compensate for your latter steps of this process. This quickly becomes excess usage (the go away temporarily, but all such relief measures don’t address “too much” problem we mentioned previously) and your the underlying causes of the pain. For example, surgery may claim to “correct a herniated disc,” but it does nothing to address the physical dysfunctions Why Didn’t My Doctor Tell Me About This? This is why a number of people who get back You may be wondering why your doctor never told you surgery end up getting repeat back surgery. One disc gets about muscle imbalances; trigger points; the excess, “fixed,” only to have another become damaged a year or two deficiency, and stagnation; and the mind-body-diet concepts. If you suffer a heart attack, for instance, because of a blocked artery, doctors will focus on opening that artery (either with surgery or medication) and give little attention to why the artery became blocked in the first place. Then, to help you avoid another blocked artery, they’ll prescribe drugs, rather than investigate the “why” behind your condition. Most of our medical professionals work very hard for their credentials, and they tend to work equally as hard in their practices. It takes an enormous amount of time and effort just to stay current with all the advances in the medical world, including new drugs, new treatments, and new technologies. Unfortunately, insurance companies put enormous time- management pressures on doctors. They only have a few minutes to make you feel better—and a few minutes are nowhere near enough to identify the underlying causes of your pain, let alone develop a comprehensive treatment plan. At the same time, pharmaceutical companies are creating billions of dollars’ worth of profit each year, and so the focus is not on prevention, but instead on how to sell more drugs and what new drugs can be developed. And while the typical doctor’s visit isn’t long enough to really solve a back-pain problem, it is long enough to prescribe the latest and greatest pill—a pill that may temporarily reduce pain but doesn’t get rid of the underlying causes of the pain, and that is usually not without serious negative side effects. When the underlying causes of back pain aren’t addressed, you end up right back in the doctor’s office a few months later with the exact same problem you had previously. In a misguided attempt to symptoms, and the solutions they favor usually include save money, insurance companies feel like they’ve succeeded pharmaceuticals or surgery. This costs insurance companies more in the long help you avoid another blocked artery, they’ll prescribe drugs, run, but they’re so used to thinking about short-term profits rather than investigate the “why” behind your condition. Most of our medical professionals work very hard for their Fortunately for you, there are other approaches to credentials, and they tend to work equally as hard in their resolving back pain that do not rely on surgery or potentially practices. Most doctors and the medical Unfortunately, insurance companies put enormous time- schools that train them focus only on eliminating diseases. They only have a few And since most forms of back pain aren’t technically diseases, minutes to make you feel better—and a few minutes are many medical doctors aren’t familiar with these alternative nowhere near enough to identify the underlying causes of approaches. At the same time, pharmaceutical companies are creating It’s Not Your Fault billions of dollars’ worth of profit each year, and so the focus is not on prevention, but instead on how to sell more drugs If you’re thinking, “What’s the matter with me? Don’t be hard on And while the typical doctor’s visit isn’t long enough to yourself. You didn’t notice because your body made the really solve a back-pain problem, it is long enough to changes without you being aware of them. You may have prescribe the latest and greatest pill—a pill that may experienced some aches and pains, but who hasn’t, right? When the news is now that you’re taking a proactive approach to your underlying causes of back pain aren’t addressed, you end up condition, you’re going to learn what you need to know to right back in the doctor’s office a few months later with the take better care of your own body, get rid of the pain, and exact same problem you had previously. Remember, we all have these imbalances, and the sooner you identify and address them, the sooner you’ll be on your way to freedom from pain. Your Mind and Your Diet: Two Other Potential Sources of Back Pain While problems in the body tend to be the ones most doctors and health care professionals focus on, the mind and the diet play a much bigger role than most realize. In fact, I personally feel, and more and more research is suggesting, that these other areas may be keys to improving back pain. It’s quite easy to have issues with “too much,” “too little,” and blood circulation or body energy that’s “too slow” because of your emotional and dietary life. Remember, we all have these imbalances, and the sooner you identify and address them, the sooner you’ll be on your way to freedom from pain. Your Mind and Your Diet: Two Other Potential Sources of Back Pain The Mind: While problems in the body tend to be the ones most doctors and health care professionals focus on, the mind and How Emotions Cause the diet play a much bigger role than most realize. In fact, I personally feel, and more and more research is suggesting, that Physical Pain these other areas may be keys to improving back pain. It’s quite easy to have issues with “too much,” “too little,” and blood circulation or body energy that’s “too slow” because of Most of us have been conditioned to believe that if we feel your emotional and dietary life. But what we may not Don’t forget to watch my three-part video series realize is that sometimes the hidden cause of physical pain can “Why You’re Still in Pain. We can experience too much stress, anxiety, trauma, sadness, anger, and emotional pain, and too It’s free and you can find it on my website at: little relaxation, stress relief, joy, fun, security, and calm. We often experience physical symptoms of pain or discomfort because of anger, fear, anxiety, sadness, or other negative emotions. These types of emotional stressors don’t need to be catastrophic or provoke mental illness to trigger a chain of events leading to back pain. It’s important to recognize that in these cases, the pain is not imaginary or “in your head. In fact, an extensive study conducted by Stanford University on more than 3,000 employees at the Boeing Corporation found that emotions and psychological factors were the biggest indicators of back pain. You have only to imagine stepping off a bridge to feel your stomach fly up into your throat and your muscles tense. This mental thought can trigger a chain of physical reactions, including dramatic fluctuations in blood pressure, breathing rates, oxygen levels, and more. So you can see the effect your mind can have on your body, particularly if you’re thinking stressful thoughts many times throughout the day. Your muscles tighten and, if you remember from the last chapter, tight muscles cause problems. They inhibit circulation, constricting blood vessels so the blood doesn’t flow through your body like it should and creating muscle imbalances. Without adequate blood flow, the cells in your body become slightly oxygen deprived.