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Remember that too-good-to-be-true study of Pain Reprocessing Therapy back in 2022? It hasn’t been replicated, but it has been extended : more of the same, five years on. There is now a 5-year follow-up report on the long-term durability of that trial’s freakishly good results for chronic back pain — an unusually long follow-up window for a psychological pain intervention trial. Don’t mix up your…
Melatonin could plausibly help people with chronic musculoskeletal pain, presumably by improving sleep . Unfortunately, a new review of 23 trials ( Wu ) shows that it doesn’t get the job done. It might improve their sleep slightly, but that does not appear to translate into pain relief. The headline result is honest: no better than placebo. And you should probably look no further, because the…
I have long been critical of platelet-rich plasma (PRP) — injections of your own concentrated blood, still supposedly “ regenerative ” despite piles of underwhelming evidence. In July I posted about an interesting new trial that was, predictably, “ a credible negative for PRP .” As always, “ negativity ” about PRP is a complaint magnet. Usually it’s just “ it worked for me ,” but sometimes I get…
Someone once tried to defend reiki practitioners on my Facebook page , and I surprised some of my skeptical allies by standing up for her — not because I think reiki works, but because I don’t think the people who do reiki are “evil,” or even very different from me . Different, sure, but not very different. Reiki is “aura massage,” usually branded as either reiki or the strangely named…
And it sounds like good news, but I’m not so sure. The salamander is not easily impressed. Singh et al . is a sweeping new super-review of many kinds of exercise for many kinds of pain: a mighty review of 157 other reviews , based on almost 2800 trials, and over 220,000 study subjects. So it’s a big boy. The authors conclude that exercise modestly reduces pain for most conditions — with the…
This post is about an actually good study of nature sounds for fibromyalgia — seriously! It is possible. There aren’t even any major asterisks on that.  * Gungormus and Pérez-Mármol did a fine job. “Nature sounds are good for pain” is one of those ideas that many people just want to believe, and to hell with the evidence. If a study seems to back it, no matter how superficially, they’ll…
[ Image caption: Scene of the crime? Cricks often strike overnight — so pillows get both credit and blame. ] Sleeping badly and hurting are entangled: poor sleep is linked to worse neck pain, and better sleep to improvement. Anything that helps you sleep is probably part of the neck-pain picture — a bad pillow can interfere with that, and a good one won’t. But what’s a “good pillow,” other than…
A new trial from Taiwan with a respectable design and a believable result has compared platelet-rich plasma (PRP), corticosteroids (CS), and a saline placebo for shoulders in the agonizing freezing stage of frozen shoulder . Steroids won handily, and that’s worth knowing — but I see this study as more of a bad news story for PRP than good news for steroids. Fashionable, fancy PRP couldn’t even…
On the heels of another round of my stretch “negativity,” today I’m reporting on a new study ( Støve et al .) that challenges my notorious anti-stretching bias, and offers fibromyalgia patients a smidgen of hope. The study reports that a mere six minutes of daily home stretching for six weeks reduced fibromyalgia symptoms by a little over 18%. Not exactly “huge” if true, but it’s good, and cheap,…
Recently I posted about how you can make a living by “ telling the truth to people who want to hear it ,” but you’ll go broke if you try that with people who don’t … and it’s hard to tell the difference. I also mentioned that I often lose subscribers because I eventually publish something that triggers them. Fresh example! I lost two paying members when I posted that “ stretching doesn’t always…
Just a heads up that I have rewritten half of my recent post, “ Stretching doesn’t always feel good .” This significant rejiggering was 100% powered by reader comments, all from folks with fibromyalgia and hypermobility/EDS: “It just hurts too much. Usually too sore!” “I hit the end range of my joint miles long before I feel any stretch.” The post did mention both conditions, but only as potential…
Every time I’ve ever published anything that undermines bad beliefs about stretching — and there are plenty of those to undermine — I get a fresh batch of reactions like this: “But stretching feels so good!” And for as long as I’ve been writing about how stretching is not a pillar of fitness (since circa 2005), I have been softening the blow by acknowledging that, yes indeed, it really does feel…
Sometimes I feel like I am mostly earning a living from the customers I haven’t pissed off yet. 😜 This charmingly quotable wisdom nugget was recently shared by John Gruber , so you may well have come across it already, but it’s worth a look again while thinking about the messy and fiercely disputed “truths” of biology and healthcare: There are three ways to make a living: Lie to people who want…
The injured always want to know why me? Science rarely has a satisfying answer, but today it can tell you at least this much: Achilles tendinitis probably causes gait glitches, and not the other way around, according to a big new Czech study with a better-than-average design. Jandacka et al gave us some precious “prospective” evidence: that is, they followed 900 thoroughly measured adults (runners…
People don’t limit themselves to merely believing that absurd but harmless quackeries are actually effective medicine: the human capacity for wishful thinking is so potent that countless people throughout history have sworn by dangerous snake oils even as they were being slowly destroyed by them. “That’s how you know it’s working” is an easy rationalization. Consider this the next the time you…
Ineffective treatments are often prescribed long after being spanked by science. Alternative medicine famously never gives up on anything, no matter how grim the evidence. Medicine usually does away with obsolete ideas, but it can be painfully slow, even when the evidence is strong. Doctors may carry on prescribing clearly bad medicine for many years after medical guidelines start discouraging it.…
I highlight a lot as I read, but rarely review what I’ve highlighted. I finally got around to trolling through several years worth of quotes, and was rewarded with several gems like this: Nothing that lived and breathed was truly objective — even in a vacuum, even if all that possessed the brain was a self-immolating desire for the truth. Area X Trilogy, Jeff VanderMeer I was going to just drop…
The last post, about pain duration , may have been badly corrupted as seen in your RSS reader, depending on when it was fetched. The problem was a complex graph generated programmatically, which did not play nicely with my content management system. 😠 I got it sorted out with some difficulty in stages over about 3 hours. If you did not get the tidied up RSS version, hit the link above to read it…
People talk about pain intensity all the time, healthcare professionals ask about it, and studies focus on it. We do our best to quantify it, with mixed results, because the traditional pain scale is a one-dimensional measurement of a multi-dimensional, highly subjective experience — there is no objective pain-meter . There are a lot of reasons why people don’t like to try to put a number on their…
Is a story about being “abused” at a chronic pain clinic believable? Yes — all too easily believed, unfortunately. The Mayo Clinic’s Pain Rehabilitation Center (PRC) program is a well-known, decades-old interdisciplinary pain rehab program that officially aims to help people “cope” with their serious chronic pain, to function and live better in spite of it, primarily with cognitive behavioural…
People like to defend their favourite health and wellness practices by saying that “every little bit helps.” This is often intended to disarm and evade any skepticism by conceding the obvious: “Sure, it’s not going to work any miracles! But … every little bit helps, amiright? ” The first problem ( explored in 2022 ) is that the “little bit” part may just be wrong: it’s not a little bit of help,…
Today I stumbled across two new scientific reviews of the same thing — cannabis for neuropathic pain — with different conclusions about more or less the same data. I thought I’d have some good nerdy fun comparing and contrasting them. If nerdy fun is a non-starter for you, here’s the zero-nuance bottom line: surprise surprise, cannabis does not work well for neuropathic pain, if at all. There’s…
Causality inference is a potent defining feature of human intelligence that serves us well in many situations. Our ability to suss out how things work is largely based on this “one weird trick” that our brains can do. Flick the switch, light turns on … probably causally related! [ Image caption: “Thinking at Hell’s gate” , by innoxiuss , CC BY 2.0 ] touch fire 👉🏻 get burned throw rock 👉🏻 break…
If you want to improve your mood, go for a walk — because it can truly work — and maybe pass on the single-session interventions (“condensed CBT + more”) featured in my last post . Exercise for depression and anxiety just got a resounding endorsement from an unusually large new meta-meta -analysis — yes, that’s two metas, meta 2 . I don’t normally write about pure psychology, but this study is…
What if just one class could do roughly the same job as a full eight-session course of cognitive behavioral therapy (CBT) for chronic pain? A single dose of the medicine? So efficient! That’s the enticing goal of Empowered Relief , “a two-hour intervention that provides individuals with essential pain relief skills.” It’s a branded, pain-focussed version of the generic concept of a “…
There is still no evidence that stretching will make you live longer, despite what you may have heard — even if you heard it from a trusted source. This idea is the result of a classic example of muddling correlation and causation. Steven Novella, in a recent post for ScienceBasedMedicine.org, made it clear that “ the data is in, exercise is good for you .” He particularly emphasized that it…
We Bury The Dead [IMDb] is an arty, poignant … zombie film? With a physio scene! Many horror fans hate this film for being “boring,” but it’s exactly what I want out of the genre: genuine, emotionally mature human drama in a crazy context. And then there was the physiotherapy scene. 🙂 Daisy Ridley plays a physical therapist … someone begs her for shoulder help … she reluctantly goes to work, and…
[ Image caption: “Thinking at Hell’s gate” , by innoxiuss , CC BY 2.0 ] “ It worked for me .” Almost everyone, sooner or later, feels like they got some blessed relief from a remedy of dubious value — something that’s not supposed to work according to the science, something “alternative,” maybe something straight out of the folk medicine of people from the other side of the world. Perhaps it was…
Way back in the 2000s, I published a snarky, skeptical article about a popular massage technique. That article was junk. 🗑️ It was basically correct junk, but a poor piece of science communication — not thorough, meticulous, or classy. I was mostly preaching to a small choir of skeptics and enraging professionals invested in that technique. It was also a reckless full-frontal assault on a…
I’ve finished publishing a tsunami of iliotibial band syndrome e-book updates for a tsunami of new customers from a bulk sale . Whenever I have a big wave of new readers like that, I pull out all the stops to make sure the content is current. There are about 20 significant updates, plus a major audio version upgrade, plus this here rebooted e-book cover: Ilio-what now? A quick primer: IT band…
This is the “your muscles look nasty without massage” meme being shared widely on social media (origin unknown): [ Image caption: I wonder what AI prompt was used to generate this image? Make one of them look like a burn victim? 🙄 ] It is, of course, horrible nonsense, pure marketing/propaganda. It inflates the perceived value of magic hands, and tries to make not getting regular massage seem…