Since the revenues were not so great as had been anticipated, a new method of taxation was imposed, one based on the weight of drug sold instead of on potency. When this tactic failed to generate any noteworthy increases to the treasury, the overall tax was boosted once more. Bhang, it was said, was causing indigestion, coughing, melancholy, impotency, insanity, idiocy, and most alarming of all, crime. Behind the rising complaints against the drug was the nuisance, to England at least, of growing Indian nationalism. In 1870, the financial secretary of the government of India added his voice to the growing condemnation of cannabis: "Every lunatic asylum report," he stated, "is full of instances of insanity and crime due to the use of ganja. A sizable quantity of bhang would have to be consumed before any serious effects would be experienced. It was the most potent of the three cannabis drugs, and one might expect that if any of these three would be accused of inducing abnormality, it would have been charas. Moreover, should a situation arise in which some well-to-do user did require special attention, relatives and friends could afford to keep him out of the public eye. Ganja, on the other hand, was potent, not very expensive, and popular Those who enjoyed it usually came from the lower classes. On Oc-tober 10, 1871, the secretary to the government of India issued a direc-tive in which he stated the conditions that had prompted the inquiry and informed the administrators what they should concern themselves with: It has frequently been alleged that the abuse of ganja produces insanity and other dangerous effects. The inquiry should not be simply medical but should include the alleged influence of ganja and bhang in excit-ing to violent crime. On the insanity issue, the government admitted that while there was "no doubt that its habitual use does tend to produce insanity, the total number of cases of insanity is small in proportion of the population, and not large even in proportion to the number of ganja smokers. While local officials continued clamoring that cannabis was ruining the country, British lawmakers contended that total prohibition would only lead to contraband use. The only way to reduce consumption, the government asserted, was to increase the cost of these drugs to consumers. Local administrators refused to be silenced, however, and in 1877 enough pressure was brought to bear upon the cannabis issue that a special task force was commissioned to look into the problem. Once again the government admitted that excessive use of cannabis drugs was harmful, and once again it insisted that the only way of reducing con-sumption was by increasing "the tax on this article as high as it can possibly bear. The policy of Government must be to limit its produc-tion and sale by a high rate of duty without placing the drug entirely beyond the reach of those who will insist upon having it. These officials were drawn primarily from the middle and upper classes, and although sincere in their beliefs about the dangers as-sociated with cannabis drugs, they viewed the issue from the point of view of class distinction. To these observers, it was not that the lower classes were poor and destitute, not that their opportunities for betterment were minimal if not nonexistent, not that they lived in squalor and often had to beg or steal to feed themselves an their families, not that they were placed in insane asylums because of failing health due to inadequate nutrition or disease. By 1890, however, more and more of the English bureaucracy stationed in India were starting to agree with their local underlings and they began to express their feelings in the newspapers. These state-ments could not be ignored or dismissed as the exaggerated claims of ignorant native administrators. Nor could they be brushed aside as the rantings of a rabble of dissidents whose criticism of British policy, what-ever it might be, was their only interest. The authors of these statements were respectable English gentlemen and as such they attracted attention from other respectable English gentlemen. Because these statements were issued by English administrators and not Indians, they received a certain amount of attention in England. The ganja menace, at it was being called, eventually caught the attention of the Temperance League, and one of the leaders of that movement, who also happened to be a member of Parliament, requested Lord Kim-berly, secretary of state for India, to form a commission to inquire into the cannabis issue in India with a view to determining whether cannabis should be prohibited altogether in that country. Kimberly agreed, and on March 16, 1893, he ordered such a commission to be appointed. The committee that was finally chosen was composed of four En-glish and three Indian members. It was to study the method used to cultivate cannabis, the kind of drugs made from the plant, and the effects of their consumption on the moral and social life of the people of India. Another point to which the attention of the Commissioners should be directed is the probability or possibility that, if the use of hemp drugs is prohibited, those who would otherwise continue to use them may be driven to have recourse to alcohol, or to stimulants or narcotics which may be more deleterious. On this score, the commissioners were advised that "absolute prohibition, or repressive measures of a stringent nature, may involve inquisitorial pro-ceedings of an unpopular character, and afford opportunities for the army of blackmail. During this time, it received written and oral testimony from 1193 witnesses from all provinces of India.
The following are basic elements in the process: · Maintain a clear distinction between assessment for the purpose of determining whether there are grounds for reasonable suspicion and conducting an investigation of the report. If it is given, and later the confidence is broken, the child is likely to feel betrayed and trust will be jeopardized. The assessment process is dynamic; that is, it does not stop after a particular number of questions have been asked. It requires active involvement on the part of the mandated reporter to interpret clues, observe non-verbal communication, and develop and test hypothesis. The process of assessment necessitates a willingness and ability on the part of the mandated reporter to inquire further. An assessment can be done in such a way that it naturally evolves into collecting information about neglect and physical, sexual and emotional abuse. It is extremely important not to lead the child to say what they think you want to hear. Assessment With a Verbal Child Two things are noteworthy when interviewing a child who is able and willing to be verbal: first, creating an environment that seems safe to the child; and second, providing opportunities for spontaneous disclosure through verbal and non-verbal messages. If assessing the home environment, ask the child to describe the house and who lives there. Physical Abuse the presence of physical abuse can be evaluated by asking what happens at home when people get angry, drink or take drugs. Sexual Abuse Sexual abuse can be assessed by asking non-leading questions about touching and affection in the family. Particularly in the area of questions about sexual abuse, mandated reporters should use discretion. Detailed questioning about sexual abuse will usually be asked by the investigating agency, such as Child Protective Services. Neglect the two types of neglect are severe neglect and general neglect: · "Severe neglect" means the negligent failure of a person having the care or custody of a child to protect the child from severe malnutrition or medically diagnosed nonorganic failure to thrive. If the child has given information that leads to a reasonable suspicion that he/she is being abused, let the child know you are concerned about what is going on (describe what the child has revealed) and that it is important to get some help now. Do not make any guarantees to the child about what will happen, but let the child know as much as possible. It is helpful to make the referral to the Child Protective Agency while the child can listen. Emotional abuse Emotional abuse is a new addition to the Child Abuse & Neglect Reporting law. It is important to assess abuse based on extreme or persistent behaviors that are consistent with indicators of abuse. A child who is physically abused may be very physically abusive of dolls or other play materials, and have themes of violence or death in his or her play or drawings. Assessment With the Family If the entire family will be meeting with a mandated reporter, the family members may be asked nonthreatening questions about family life similar to those questions asked of a verbal child (see "Assessment with a Verbal Child"). It must be recognized, however, that if abuse is occurring in the family, parents and other family members may not be inclined to discuss this area of concern. Frequently, meeting with the child separately from the parents may be helpful in gathering further information which may be relevant to the abuse situation. These references may indicate that a parent or caretaker is physically abusing a child. Parents sometimes use objects such as belts, bats, pots and pans, or telephone cords to physically punish their children. Some parents who were abused as children may not recognize their behavior as abusive. Other abusive parents may think of their behavior as abusive, and may seek to hide it, making up stories, or getting their children to protect them. The latter are obviously more difficult to assess, but looking at the entire family picture, and interviewing the children alone, may help with data collection. Parents are frequently frightened and angry when the referral is made to the authorities. They may also, either immediately or eventually, feel relief that steps have been taken to protect their children.
They advance individual and institutional knowledge; they directly enhance teaching; and they often powerfully transform both people and law school programs. And of Legal Writing Faculties as a Violation of Both Equal Protection and Professional Ethics, 39 Duquesne L. Professor Durako taught legal writing at Rutgers School of LawCamden, and now teaches legal writing at Stetson University College of Law. Professor Neumann taught legal writing at Hofstra University School of Law for many years. Writing 155 (2001); Jo Anne Durako, A Snapshot of Legal Writing Programs at the Millennium, 6 Leg. Professor Liemer teaches legal writing at Southern Illinois University School of Law. Professor Glassman teaches legal writing at Cleveland State University, Cleveland-Marshall College of Law. Levine, Voices in the Wilderness: Tenured and Tenure-Track Directors and Teachers in Legal Research and Writing Programs, 45 J. In the final analysis, that function will have more cumulative impact on legal education, and therefore, on the future of the legal profession, than almost any other kind of scholarship. Further, we in the academy claim that critiques of other institutions-courts, legislatures, agencies-fulfill a fundamentally important duty of the professoriate. The evaluative process places the criteria, and therefore, the norms of the discipline itself, at issue. Whether the voices are "assimilated" or "rebellious,"140 we need to hear what they have to say. In this Section, we examine and respond to claims used to discount topics in all of these areas. Westbrook notes, "In this way, law professors fulfill a very traditional notion of their duties as public intellectuals-the task of the professor is to improve the polity through criticism. He goes on to say that Pierre Schlag has turned this criticism back onto the legal academy with great success. To withstand logical challenge, claims discounting a particular topic must presume an article in which the author has achieved all the topic would permit. Otherwise, the claim is not addressed logically to the topic but rather to the sufficiency of a particular effort. Myth #1: Legal Writing Topics Do Not Qualify as Scholarship One rationale sometimes offered to support a policy discounting legal writing topics is the sweeping generalization that writing on legal writing topics does not constitute scholarship. Even assuming the possibility of a static and universal definition of "legal scholarship,"142 this assertion cannot sustain reasoned analysis. Recall the topics in categories one and two described above, such as the roles and functioning of the judicial and legislative systems; the doctrine of stare decisis; precedential values and appropriate uses of legal authority; the forms of legal reasoning; the principles of statutory construction; relevant ethical duties of lawyers; the standards of appellate review; and other doctrines relating to appellate practice. Some of them have been well established as subjects of legal scholarship for many years. Llewellyn, Remarks on the Theory of Appellate Decision and the Rules or Canons about How Statutes Are to Be Construed, 3 Vand. Yet, unless the work of these well-known legal scholars is excluded from the category of legal scholarship, no reasoned justification can be advanced to discount all legal writing topics. The only other possible explanation would be that topics count as legal scholarship when Professors Cover, LaRue, Bandes, Schauer, Solan, White, and Winter write about them, but not when legal writing professors write about them. Press 1984) (cited 270 times); the Legal Imagination: Studies in the Nature of Legal Thought and Expression (Little Brown & Co. LaRue, Constitutional Law as Fiction: Narrative in the Rhetoric of Authority (Penn. We also notice that the vast majority of the people who actually teach legal writing are women. The players in this status hierarchy are the faculties and 2005] New Voices in the Legal Academy 37 Certainly no one in the academy would advocate that we decide what is legal scholarship based on the identity of the author.
We do not intend to pay dividends on our common stock so any returns will be limited to the value of our stock. We currently anticipate that we will retain future earnings for the development, operation and expansion of our business and do not anticipate declaring or paying any cash dividends for the foreseeable future. Any return to stockholders will therefore be limited to the appreciation of their stock. Our principal stockholders and management own a significant percentage of our stock and will be able to exert significant control over matters subject to stockholder approval. Our executive officers, directors, and 5% stockholders together beneficially own a significant percentage of our voting stock. These stockholders may be able to determine the outcome of matters requiring stockholder approval. For example, these stockholders may be able to control elections of directors, amendments of our organizational documents, or approval of any merger, sale of assets, or other major corporate transaction. This may prevent or discourage unsolicited acquisition proposals or offers for our common stock that you may feel are in your best interest as one of our stockholders. Our reported financial results may be adversely affected by changes in accounting principles generally accepted in the U. We prepare our financial statements in conformity with accounting principles generally accepted in the U. A change in these policies or interpretations could have a significant effect on our reported financial results, may retroactively affect previously reported results, could cause unexpected financial reporting fluctuations, and may require us to make costly changes to our operational processes and accounting systems. Our revenue to date has been primarily derived from research and license agreements, which can result in significant fluctuation in our revenue from period to period, and our past revenue is therefore not necessarily indicative of our future revenue. Our revenue is primarily derived from our research and license agreements, from which we receive upfront fees, contract research payments, milestone and other contingent payments based on clinical progress, regulatory progress or net sales achievements and royalties. Significant variations in the timing of receipt of cash payments and our recognition of revenue can result from significant payments based on the execution of new research and license agreements, the timing of clinical outcomes, regulatory approval, commercial launch or the achievement of certain annual sales thresholds. 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If any of our existing or future collaboration partners fails to develop, obtain regulatory approval for, manufacture or ultimately commercialize any product candidate under our collaboration agreement, our business, financial condition, and results of operations could be materially and adversely affected. Once we are no longer an emerging growth company we will be subject to additional laws and regulations affecting public companies that will increase our costs and the demands on management and could harm our operating results. However, as an emerging growth company we may take advantage of exemptions from various requirements such as an exemption from the requirement to have our independent auditors attest to our internal control over financial reporting under Section 404 of the Sarbanes-Oxley Act of 2002 as well as an exemption from the "say on pay" voting requirements pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010. Once we are no longer an emerging growth company, we will be required to comply with these additional legal and regulatory requirements applicable to public companies and will incur significant legal, accounting and other expenses to do so. If we are not able to comply with the requirements in a timely manner or at all our financial condition or the market price of our stock may be harmed. We will remain an emerging growth company until the earliest of (1) December 31, 2020, (2) the last day of the fiscal year (a) in which we have total annual gross revenue of at least $1. We cannot predict when we will no longer be an emerging growth company at this time. Sales of a substantial number of shares of our common stock by our existing stockholders in the public market could cause our stock price to fall. Sales of a substantial number of shares of our common stock in the public market could occur at any time. These sales, or the perception in the market that the holders of a large number of shares intend to sell shares, could reduce the market price of our common stock. Moreover, holders of certain shares of our common stock have rights, subject to certain conditions, to require us to file registration statements covering their shares or to include their shares in registration statements that we may file for ourselves or other stockholders. We have registered all currently reserved shares of common stock that we may issue under our equity compensation plans and intend to register in the future any additional reserved or issued shares of common stock. These registered shares can be freely sold in the public market upon issuance, subject to volume limitations applicable to affiliates. Future sales and issuances of our common stock or rights to purchase common stock, including pursuant to our 2015 Plan, could result in additional dilution of the percentage ownership of our stockholders and could cause our stock price to fall. We expect that significant additional capital may be needed in the future to continue our planned operations, including conducting clinical trials, commercialization efforts, expanded research and development activities and costs associated with operating a public company. To raise capital, we may sell common stock, convertible securities or other equity securities in one or more transactions at prices and in a manner we determine from time to time.
Yet, because not much is divulged verbally about their backgrounds or interior lives, people highlighted in this way are able to "preserve their mystery and with it their dignity" (Hochhдusler 2013, 25). Petzold is adamant, moreover, about differentiating between his own views and those of the character he created. Citizens tended to live in their own bubble: a private space to which they often withdrew (Schenk 2015, 12). That kind of symbolic positioning is alien to him, for it tends to encourage entrenched viewing habits. Petzold explains on the Barbara website that when people discover symbols, they readily decode them. Yet that is inescapable when films merely confirm expectations-when, for example, yet another narrative film ties up loose plot ends or induces viewers to identify with its protagonists. Petzold, on the other hand, thwarts expectations as a matter of principle-first of all, those of his actors (he usually works with them in ensemble fashion). Everyone, including Petzold, was surprised at the lively colors in many of the photos and at the cheerfulness the photos conveyed. Returning by train to her town after the hotel stay-where Jцrg had provided her with the final details of the escape plan-Barbara suddenly sees two young couples next to two motorcycles at the edge of a wide meadow. Dressed in lively colored clothes, they spontaneously wave to the train passengers. When Barbara arrives in town by bus, Officer Schьtz is with the doctor Andrй, upstairs in a building close to the bus stop-that is, he has an ideal surveillance position. Later, when he observes her from his car in front of her lodging, he and Barbara have exchanged positions: he is now at street level, while she is upstairs. In a sense, she too is now spying on him, since she often looks out the window to see if he is still there. Only once is she able to chase him away: when she plays Chopin on her newly tuned piano. Officer Schьtz is ready to mete out punishment whenever Barbara returns from an out-of-town trip. Upon both returns to the town, Stasi officer Schьtz is already waiting for Barbara in order to subject her rented room to a thorough search. But worse than the search of her room is the search of her body-that is, the body scan to which she is subjected both times by a female Stasi agent. In the forest, moreover, she meets Jцrg, the person whom the Stasi, so to speak, could easily label the "bad wolf. That Stella ran away from Torgau several times and that she was desperate not to return there is understandable. Whether Barbara, on the other hand, could have a better life in the West is debatable. By the same token, the attitude toward work that Andrй and Barbara share clearly motivates their personal relationship. To explain it with a love story, such as the one with Jцrg, 346 German Culture through Film would not have sufficed. This short episode clearly has diegetic value: the music can still be heard the next day, when Barbara starts to work in the hospital. A thief who had been hanged recently is lying on a dissecting table, surrounded by doctors. But the left arm in the painting turns out to be the reproduction of the right arm that the doctors see in the anatomy book in front of them. Once again, Andrй, who never denies being an unofficial Stasi coworker, baffles her with his humane disposition. At the end of the film, Barbara thwarts expectations-this time those of the Stasi officer who had been convinced that she would not come back. Like the journeys of many literary travelers, hers too turns into an arrival at her starting point.
Great Stinging Nettle (Stinging Nettle). Evista.
Source: http://www.rxlist.com/script/main/art.asp?articlekey=96654
In the southwest, the sudden increase in Mexican immigration to the United States around 1910 set off yet another round of ethnic con-frontation. The more resentful of these foreigners Americans became, the readier they were to attribute other negative characteristics to the Mexican. The fact that the Mexicans were Catholics made their situation even more touchy since Protestant America consid-ered Catholicism a religion of dark superstition and ignorance. The stereotype of the Mexican was that of a thief, an untamed savage, hot-blooded, quick to anger yet inherently lazy and irresponsible. When revolution broke out in Mexico in 1910, it was inevitable that the fighting would spill across the Rio Grande. When Pancho Villa at-tacked the tiny outpost at Columbus, New Mexico, in 1916, the attitude toward the Mexicans worsened considerably. When the 1930s devastated the American economy, the Mexicans bore the brunt of the scapegoat mentality in the southwest. Everything about them was abhorrent to many Americans, and there was a file:///I /drugtext/local/library/books/marihuana/11. The Mexicans were censured for almost everything they did or failed to do, including smoking marihuana. Marihuana, in fact, be-came the pretext for vexing the Mexicans just as opium had been the pretext for vexing the Chinese years before. During the conference, Finger unexpectedly rose from his seat to plead that cannabis be put on the list with opium and other narcotic drugs to be censured on a worldwide basis. House Ways and Means Committee, which also met in 1911 to hear proposals for federal antinarcotics legisla-tion, were presented with arguments regarding whether cannabis should be outlawed domestically. There is no drug in the pharmacopoeia today that would produce the pleasurable sensations you would get from cannabis, no not one- absolutely not a drug in the pharmacopoeia today, and of all the drugs on earth I would certainly put that on the list. Schief-felin concurred with Fauns, although he felt that Fauns had overstated the case. West and Plaut were the more convincing speakers and cannabis was not even included in the subsequent debate over national restric-tions on narcotic drugs. Unable to secure national support to outlaw cannabis, various state legislatures moved on their own to prohibit its possession unless pre-scribed by a physician. Yet, references in the newspapers to the adoption of these laws clearly show that the marihuana was relatively unknown, even in states with considerable Mexican populations. In Texas, for instance, the Austin Statesman explained to its readers that "marihuana is a Mexican herb and is said to be sold on the Texas Mexican border. To the legislators of Maine, Vermont, Massachusetts, and New York, a narcotic was a narcotic, whatever its name. Cannabis was considered a narcotic and therefore was accorded the same status as opium, morphine, heroin, and codeine, file:///I /drugtext/local/library/books/marihuana/11. Devotees of hashish are now hardly numerous here to count, but they are likely to increase as other narcotics become harder to obtain. But the Mexican connection was to outshadow these groups by far in future laws enacted against marihuana. The main border crossings were El Paso, Texas; Nogales and Douglas, Arizona; and Calexico, Califor-nia. The immigrants who passed through these points of entry usually took up temporary residence on the outskirts of these towns, and the Mexican ghetto or barrio became a common sight in parts of the southwest. At first the newcomers were welcomed, especially by the wealthy landowners and the railway companies. So valuable a labor commodity were the Mexicans that big business pressured Congress to exclude them from the literacy test and head-tax payments that had been written into the Immigration Act of 1917. Small businessmen also reaped dollars from the newcomers, and as late as 1930 they fought all attempts to restrict Mexican immigration. You can sell them higher priced articles than they intended to purchase when they came in. Their low standards of living and morals, their illiteracy, their utter lack of proper political interest, the retarding effect of their employment upon the wage scale of the more progressive races, and finally their tendency to colonize in urban centers, with evil results, combine to stamp them as a rather undesirable class of residents. Business interests countered that the Mexicans were the most preferable of all the cheap labor available and were more suited than American whites at working at menial tasks. Caught in the middle, the Mexicans became the scapegoats for the economic conflict between business and labor.
Rather than any piece of cloth or handful of seeds, however, the evidence takes the form of an inscription containing the symbol for marihuana, along with the adjec-tive or connotation meaning "negative. Taoism was essentially a "back to nature" philosophy which sought ways of extending life. Anything that contained yin, such as marihuana, was therefore regarded with contempt since it enfeebled the body when eaten. Only substances filled with yang, the invigorating principle in nature, were looked upon favorably. The hallucinations thus produced were highly valued as a means to achieving immortality. Meng Shen, a seventh-century physician, adds, however, that if anyone wanted to see spirits in this way, he would have to eat cannabis seeds for at least a hundred days. And on more than on occasion, the waywardness of segments of the Chinese population was denounced by the authorities. They enter the chamber of love in an intoxicated condition; their passions exhaust their vital forces; their cravings dissipate their essence; they do not know how to find contentment with themselves; they are not skilled in the control of their spirits. They devote all their attention to the amusement of their minds, thus cutting themselves off from the joys of long life. For these reasons they reach only ove half of the hundred years and then they degenerate. The Chinese experiment with marihuana as a psychoactive agent was really more of a flirtation than an orgy. Those among the Chinese who hailed it as the "giver of delight" never amounted to more than a small segment of the population. According to Japanese legend, there were once two women who were both weavers of hemp fiber. During market days, which were held only periodically, it was customary for Japanese women to dress in their best clothes, and as the day approached, the two women began to weave new dresses for the occasion. The woman who worked quickly had her dress ready on time, but it was not very fashionable. Her neighbor, who worked slowly, only managed to get the unbleached white file:///I /drugtext/local/library/books/marihuana/1. Since she had to go to market, she persuaded her husband to carry her in a large jar on his back so that only her neck, with the white undyed hemp strands around it would be visible. In this way, everyone would think she was clothed instead of being naked inside the jar. On the way to the market, the woman in the jar saw her neighbor and started making fun of her coarse dress. The woman was so ashamed as she stood naked before everyone that she buried herself in the earth so she would not be seen and she turned into an earthworm. And that, according to the Japanese, is why the earthworm has white rings around its neck. Another ancient Japanese legend tells of a soldier who had been romancing a young girl and was about to bid her farewell without giving her so much as his name, rank, or regiment. Unbeknownst to her mysterious lover, she fastened the end of a huge ball of hemp rope to his clothing as he kissed her farewell. By following the thread, she eventu-ally came to the temple of the god Miva, and discovered that her suitor had been none other than the god himself. Just as hemp could be dyed to any color, so too, according to an ancient Japanese saying, must wives be willing to be "dyed in any color their husbands may choose. As already mentioned, in China evil spirits were banished from the bodies of the sick by banging rods made from hemp against the head of the sickbed. In Japan, Shinto priests performed a similar rite with a gohei, a short stick with undyed hemp fibers (for purity) attached to one end. Invaded from both land and sea, it has seen many conquerors and has witnessed many empires come and go.
Sometimes, even after the original injury or disease process has healed, sensitized pathways continue to send signals to the brain. These signals feel just as real and sometimes worse than the pain caused by the original injury or disease process. Imagine an old television set or computer screen on which the same image is continuously projected. In the same manner, after the original source of pain is healed or no longer present, chronic pain patients may continue to feel pain. Although this is an over simplification of what may happen in chronic pain, it helps explain the basic concept. As mentioned earlier, chronic low back pain is defined as back pain that lasts longer than three months. During the evaluation of chronic back pain, it is important to rule out any injuries or disease processes that could place you at risk for further injury if not treated or addressed. Clarification of the diagnosis is a key step in creating a pain management program. A good patient history and a thorough physical examination by a well-trained clinician are the most important aspects of the evaluation. Serious injuries and illnesses can often be diagnosed or ruled out based on the history and physical examination alone. However, lack of a definite diagnosis does not necessarily mean more testing is needed. Needless tests do not add anything to what your health care provider has already discovered in his or her physical examination. Many times, the exact cause of the pain is still not well defined at the end of the evaluation. Nevertheless, an evaluation is successful if it has ruled out those processes that could place you at risk if not treated. Treatments for chronic back pain can vary greatly depending on the type and source of the pain. If a treatable source of the pain is found, then the underlying process should be treated. When the underlying cause is either not known or not treatable, then the symptoms are treated. The goals of the treatment are to reduce pain, improve quality of life and increase function. These categories include physical therapy, medications, coping skills, procedures and complementary medicine treatments. Your health care provider will tailor a program involving a combination of these general options which best addresses your needs. Active therapies which you can continue on your own, such as exercise and strengthening, usually have the most permanent and long lasting effects. Exercise and strengthening are designed to increase stability and strength around the structures in the back that are being stressed. Exercises are tailored specifically to your abilities and the type of back pain being addressed. Both non-narcotic and, rarely, narcotic pain medications may be used in the treatment of chronic back pain. Nerve stabilizing drugs (antidepressants and antiseizure medications) are used to treat nerve-mediated pain. All these medications have different potential side effects and interactions and should be carefully monitored by your health care professional. For this reason, learning appropriate coping skills for dealing with anxiety, depression, irritability and frustration can be invaluable. Visiting a trained pain specialist, psychologist or psychiatrist greatly enhances the treatment of chronic back pain. You should discuss the potential risks and benefits of any procedures considered with your health care provider. Complementary medicine also provides a variety of treatments often helpful in the treatment of chronic pain. These treatments include acupuncture, dry needling, nutrition, magnets and many others. It is important for you to discuss these treatments with your health care provider.
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