There has been a remarkable shift in culture over the last fifty years. In the old days, good or otherwise, there were painkillers around but people were more inclined just to cope. Yes, they would complain. But society approved of the "stoics", the people who just put up with the pain and got on with their lives. Today, we routinely spend billions of dollars on painkillers and pop them for anything from serious joint pain to hangovers. It's become socially acceptable to self-medicate as needed. Perhaps, by yesterday's standards, this is a form of drug abuse. Indeed, a growing number of people are now addicted to some of the more powerful drugs. But we all seem willing to take the easiest way out, i.e. to take a pill, rather than either tolerate the pain or invest effort in finding a better way of living. As a result, the pharmaceutical industry is one of the most profitable in the US and encourages this cultural shift by a barrage of ads directly targeting you, the consumer. No subtle marketing to doctors who can use their discretion to prescribe the best drug to treat the patient's problems. Patients must have full brand awareness and walk into a consultation ready to demand drugs by name.

Let's take backache and joint pain as an example. As you turn fifty, the risk of osteoarthritis starts to grow and one of the first symptoms is joint pain which includes the spine. The pain can come the moment you get out of bed, then ease off and not return until later in the day. But, you must be careful with the diagnosis. The same symptoms can come from tendonitis which is an inflammation of the ligaments and tendons in a joint. It is most often caused by overuse. The reason for making a clear difference in the diagnosis is that painkillers have no effect on tendonitis. The recommended approach is physical therapy to build up the strength in the muscles around the affected joints. If the overuse comes from repeating the same actions, say while sitting at a keyboard or using a particular piece of equipment, you have to find a different way of doing the same work. A physical therapist can offer advice and guidance. But if the underlying cause is arthritis, painkillers are effective. There is a choice. Tablets allow a gradual build up of the active chemicals in the blood, but drugs are more likely to have adverse side effects. There are some excellent gels and topical creams that deliver the painkiller through the skin directly to the affected parts of the body. They have fewer side effects but need to be reapplied throughout the day.

In addition to the possibility of taking tramadol to relieve moderate to severe pain, you can also consider the use of hot packs. The targeted use of heat relieves soreness and stiffness in joints. There are major advantages to losing those pounds because that reduces the amount of weight the joints must carry. Finally, get advice on shoes to wear while walking and exercising. Using shock absorbers and arch supports can prevent joint pains from worsening. So, buy tramadol to treat a confirmed diagnosis of arthritis and seek detailed advice on how to support your joints and reduce pain by alternative means.

It's almost impossible to separate sex from psychology. When all is working well, self-esteem and confidence are at high levels. When things are not working so well, this undermines confidence and many feel depressed. If the problems persist, the depression can become severe. There are a range of fancy words that are paraded out at this point: impotence, erectile dysfunction, libido, and so on. The precise details of the physical difficulties also vary. A man may find it difficult or impossible to get an erection, or a hard erection may disappear suddenly during sexual activity, or there may be premature ejaculation, and so on. It's convenient to group all the different forms of failure under one label. But this depersonalizes the problem. Instead of seeing it as "your" problem, doctors start talking about general trends and how the majority can be treated. When you want someone to pay attention to your situation, you find people talking about you as if you are not in the room or talking in generalities. So let's avoid all this slightly embarrassed discussion and get down to basics.

In some cultures, men who have sexual difficulties rely on traditional remedies. These substances are called aphrodisiacs - the word coming from Aphrodite who, in ancient Greece, was the Goddess of Love - and they are believed to improve sexual desire and performance. Examples range from herbs, the powdered horns of large animals to preparations made from beetles and insects. In the majority of cases, these have no physical effect on the body but, because they are recommended by respected authority figures in the local society, the affected men usually find them effective. This goes to prove the general rule that, if the mind is willing, the body responds. The medical profession calls this the "placebo effect".

There are three prescription only medications on the market to treat erectile dysfunction. Chemically, they all rely on the same basic active ingredients and work in the same way. Recently, the American College of Physicians asked the Agency for Healthcare Research and Quality to find out whether there was any evidence to show that one was more effective than the other two. There have only been four clinical trials making a direct comparison between the three and 122 trials studying the drugs individually. The conclusion was that the three drugs are broadly similar in their levels of effectiveness and safety. But the majority of men preferred one of the drugs because, in one form, it produces thirty-six hours of sexual potency. In the once-daily form, men taking the drug have levels of response broadly the same as "normal" men who have not been affected by erectile dysfunction. Thus, in terms of convenience and effect, an increasing majority of men prefer to buy cialis. However, this system of recommendation and sale by word-of-mouth, is exactly the same as the process for selling oysters as an aphrodisiac. Merely suggesting that oysters give you great sex sells them. It's the same with drugs. If men are recommended one drug and they have a good experience with it, they may never try the others. Trusting the product to give a known result creates buying habits. In this instance, unlike oysters, cialis has a very precise physical effect which gives sexual responsiveness. Comparing it to an aphrodisiac for marketing purposes is fair. Otherwise, you can trust cialis to work, no matter what others may tell you.

In the majority of cases, the grant of a patent captures the chemistry and purpose of a drug and locks it away for the given number of years. This is the monopoly given to the manufacturer who will police the drug market and sue anyone who comes too close for infringing the patent. The very act of protection discourages future research to develop the drug for new and different purposes. Yet, in one or two cases, research does go on. Most of the time, this represent unofficial interests where physicians experiment with off-label uses, or there is just a simple change so that, what comes in multiple doses, may be spread out through an extended release capsule. Only in quite rare cases is the research real and sanctioned by the original manufacturer. So it is with Pfizer and its now famous little blue pill.

In every way, this pill broke the mold. It was a literal game changer. Under development for one purpose, its accidental power to inspire men is now the stuff of legend. But that left Pfizer with an interesting choice. It had already invested millions to develop a drug to help relieve pulmonary arterial hypertension (PAH). Should it just throw all that money away? Although tempting, given the billions of revenue now flowing into its bank account, Pfizer decided to continue developing the drug for PAH. The result is Revatio, the same basic PDE5 inhibitor applied to the arteries in the chest rather than those leading into the penis. It has become a lifesaver. What is interesting is the change of name. Apparently Pfizer did not think patients would believe in the effectiveness of the drug if it continued under it erectile dysfunction name. A whole new brand identity had to be developed.

In a desire to prove the chemistry is applicable to an ever wider range of conditions, there are now trials underway to test whether it is an effective treatment for cancer, multiple sclerosis, strokes and, somewhat surprisingly, some aspects of mental disability. In all cases, the common feature is the ability of the drug to dilate arteries to improve the circulation of blood throughout the body. One of the consequences of improved circulation is a boost to the body's immune system. If blood moves only slowly, it is possible for the immune response to drop quite dramatically, say in the area of a tumor. Hence the current trial to determine whether local administration to cancer of the throat will have beneficial results. Apparently, the early results look promising.

There is something faintly strange about the idea that people will buy viagra as commonly as an aspirin. What had once seemed so uniquely particular to the male need seems to have a potential relevance to almost everyone. Given that there are eleven different forms of PDE in the human body, this gives us the prospect there may be eleven different uses for viagra. Perhaps other drugs are always going to be less flexible. A painkiller, for example, really only has one reason to exist (ignoring the abuse for pleasure). Yet who is making this decision? Who decides a drug only has one use? For all we know, the majority of drugs licensed for use for one purpose may actually have multiple purposes. Ah, wait! That is the problem. If one drug could treat multiple diseases and disorders, there would be no need for multiple different drugs and pharmaceutical companies would make less money. Let us leave it that there shall only be the brand and generic viagra. For any other disorder, there must be a new and expensive drug.

Every day, blogs are created by people of all ages and from all walks of life, but when it comes to blogging, teen writers are truly on the cutting edge of the movement. Because today's teenagers are the first generation of people to have grown up using the internet at every stage of their development, many adolescents have a seemingly innate sense of how to use web technology to express their innermost thoughts and ideas. Older writers often experience a kind of learning curve when they begin to blog, but many young people find that using a word processor and blogging software feels more natural and direct a mode of communication than writing in a diary ever could. One of the reasons why blogs have undergone a kind of explosion in the teen community and are growing by leaps and bounds is the fact that they provide a unique mixture of visibility and anonymity. A teenager can invite friends and peers to read his or her blog with a simple email, thereby winning attention or possibly even praise. Of course, with visibility usually comes the possibility of embarrassment, but the fact that it is possible to blog anonymously with an invented handle or nickname negates a lot of the potential for humiliation. Many a blogging teen lives in fear that a parent or guardian will discover his or her blog, but by publishing under an alias a teenager can spill his or her secrets without fear of being traced. Outside the world of blogging, teen writers often have very limited opportunities to be published. Magazines and journals are often reticent to publish young writers who may not have as much credibility as older writers with a lot of experience and extensive credits to their names. This can discourage adolescents from writing or from seeking chances to publish their work. By blogging, young people can begin to gain a following of readers without first having to win the attention and support of an editor or publisher who may not be very interested in teenaged authors. Between the fact that blogs provide young people with a chance to exercise their impressive technical aptitude, to gain visibility without compromising privacy, and to build a readership for their writing without having to jump through the traditional hoops of the publishing industry, it is little wonder that are so many teenagers with blogs. For some teenagers, blogging is even a very social endeavor that allows them to meet people with similar interests from all over the world. Many a blogging teen has discovered that having a weblog on the internet is a great way to explore self-expression and, often, to win positive feedback from new friends. (Word count 453) PPPPP