PainScience.com (Paul Ingraham)

@painsci

Highlights and skeptical snark about the science of chronic pain and injury rehab, from publisher Paul Ingraham. + Digressions into astronomy, Roman history, palaeontology, more. Everything is too interesting to focus!

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PainScience.com (Paul Ingraham)@painsci· Jul 11

This comic is satire — but only slightly sillier than some real pillow marketing. NEW POST today, all about what pillows can and cannot do for neck and shoulder pain … www.painscience.com/blog/pillow-...

Satirical black-and-white advertisement for the “Tactical Pillow ZZZ-9000,” drawn in a vintage comic style, with the slogan “Engineered for victory. Delivered by dawn.” Cloud-shaped callouts tout absurd features: “Ergonomic Dominance Core,” “Perfectly aligned or you don’t pay,” “Climate Dominance Fabric,” “Patented Yawn Optimizer,” “Wake up more manly,” “Silently judges your sleep posture,” “Military-grade sleep foam,” and “Reduces sleep inertia by 92.7%” — with fine print confessing “we made this number up.”

PainScience.com (Paul Ingraham)@painsci· Jun 29

#Stretching for #fibromyalgia: abstract versus full text! The abstract for Støve et al. makes it sound like stretching eased fibromyalgia symptoms… but the full text reveals a study so warped that it backfires and actually suggests no effect at all. NEW POST: www.painscience.com/blog/stretch...

ide-by-side meme comparing scientific abstracts to full papers using a pizza. Left panel, captioned “When you just read the abstract,” shows a closed pizza box with a window revealing what appears to be a generously pepperoni-covered pizza. Right panel, captioned “When you read the whole thing,” shows the opened box revealing a cheese pizza with only three pepperoni slices clustered near the centre — implying that the abstract gave a misleadingly favourable impression compared to the full paper.

PainScience.com (Paul Ingraham)@painsci· Jun 26

Study says just 6m of daily home stretching for 6 weeks reduced #fibromyalgia symptoms by ~18%. Not quite “huge” if true, but good, cheap, no major flaws in the abstract, so…should I put that in my anti-stretching pipe and smoke it? Not today. 😏 NEW POST: www.painscience.com/blog/stretch...

Photograph of a woman in “child’s pose” in her living room. Right beside her, a golden lab is in a nearly identical pose, looking bored and sleepy.

PainScience.com (Paul Ingraham)@painsci· Jun 22

This is character Ryland Grace in the novel Project Hail Mary, demanding more painkillers from the computer on the Hail Mary spacecraft. This is not included in the PainSci quote collection for any serious reason, just pure whimsy…but I take my whimsy seriously! 😉

Screenshot of a quote from the novel Project Hail Mary by Andy Weir: “My arm hurts nonstop now. It’s a constant sting. It’s been less than an hour, but the painkillers aren’t doing the job anymore. ¶ ”Computer! Painkillers!“ ¶ ”Additional dose available in three hours and four minutes.“ ¶ I frown. ”Computer: What is the current time?“ ¶ ”Seven-fifteen P.M., Moscow Standard Time.“ ¶ ”Computer: Set time to eleven P.M. Moscow Standard Time.“ ¶ ”Clock set complete.“ ¶ ”Computer: painkillers.“ ¶ The arms hand me a package of pills and a bag of water. I gobble them down. What a stupid system. Astronauts trusted to save the world but not to monitor their painkiller doses? Stupid.”

PainScience.com (Paul Ingraham)@painsci· Jun 17

This quote obviously resonates with a lot of people, but I am going to pull rank: it resonates with me MORE as an independent science journalist. Sometimes I feel like I am mostly earning a living from the customers I haven’t pissed off yet. 😜 More: www.painscience.com/blog/three_w...

Quote: There are three ways to make a living: 👉🏻 Lie to people who want to be lied to, and you’ll get rich. 👉🏻 Tell the truth to those who want the truth, and you’ll make a living. 👉🏻 Tell the truth to those who want to be lied to, and you’ll go broke.

PainScience.com (Paul Ingraham)@painsci· Jun 13

The injured always want to know WHY ME? And 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. Details: www.painscience.com/blog/achille...

Screenshot of the first page of the full-text PDF for Jandacka et al. with highlighting. It’s too much text for here, but some of the key phrases highlighted: “followed for 1 year using a Fitbit device and a custom mobile application” … “biomechanical variables included ankle, knee and hip kinematics and kinetics during the stance phase” … “identified a lower peak ankle inversion moment, a lower peak ankle external rotation angle and a greater running volume as significant predictors of the onset of Achilles tendinopathy” … “Previous research has highlighted biomechanical factors… however, evidence has predominantly been limited” … “other biomechanical parameters, such as footfall pattern, do not significantly influence the risk of Achilles tendinopathy, challenging common recommendations to alter running footfall pattern.”

PainScience.com (Paul Ingraham)@painsci· Jun 6

People aren’t limited to believing quackery works: the human capacity for wishful thinking is so potent that countless people in history have “sworn by” dangerous snake oils even as they were being slowly destroyed by them. ☠️ Truly “no imposition is too great for the credulity of men” (Thoreau).

Nicely typeset quote, white text in a large attractive font on a blue gradient background: "Nothing more strikingly betrays the credulity of mankind than medicine. Quackery is a thing universal and universally successtul. In this case, it becomes literally true that no imposition is too great too great for the credulity of men." Attributed to Henry David Thoreau

PainScience.com (Paul Ingraham)@painsci· May 29

I highlight a lot of things as I read, but I almost never go back and look at what I highlighted. I finally got around to trolling through several YEARS worth of quotes, and I was rewarded with several gems like this one.

A quotation set in a nice font: "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." Attributed to the Area X Trilogy by Jeff VanderMeer.

PainScience.com (Paul Ingraham)@painsci· May 26

Pain isn’t actually “mild” if it never stops. Persistence can turn a small pain into a nightmare. Duration MULTIPLIES the intensity! But we try to quantify #chronicpain intensity without duration? 🤦🏻‍♂️ www.painscience.com/blog/mild-pa...

A complex line chart comparing pain intensity over time for three conditions—toe stub, tension headache, and chronic low back pain—on a compressed horizontal time scale ranging from seconds to 7 days. The vertical axis shows pain intensity from 0 to 10, the bog standard "pain scale." A red curve for toe stub spikes sharply to just over 8/10 within seconds, then falls quickly to zero by about 10 minutes, creating a small shaded area. An orange curve for tension headache rises much more gradually, peaking at 6/10 after a few hours, then tapers back to zero over a day, creating a much broader shaded area. A blue curve for chronic low back pain begins rises to about 4/10 over a day, and remains fairly steady through several days (and perhaps much longer, it continues off the graph), with minor fluctuations, creating the largest shaded area. The visual emphasizes that although chronic low back pain is lower in intensity than the other examples, its long duration produces the greatest total pain burden. Beneath the chart, summary labels read: toe stub, approximately 2 minutes, peak 8/10, total burden low; tension headache, approximately 6 hours, peak 6/10, total burden moderate; chronic low back pain, continuous, peak 4/10, total burden vast.

PainScience.com (Paul Ingraham)@painsci· May 13

Answer got long-ish, so here's a screenshot. TLDR: stretch syncope is interesting, but only one of several possible causes for post-stretch malaise, and probably not the most likely one.

PainScience.com (Paul Ingraham)@painsci· May 7

“Maybe this pain treatment won’t work any miracles! But…every little bit helps, AMIRIGHT?” Ackshually, not every little bit helps—not even close. First: it may not help even a “little.” Second: even if it does, it may not be a good VALUE… NEW POST, 3m read. www.painscience.com/blog/every-l...

Black-and-white single-panel cartoon in a loose, sketchy pen-and-ink style. Two women sit cross-legged on yoga mats in a simple wellness studio, facing each other and chatting. The woman on the left looks slightly frazzled, with messy hair, motion lines, and one hand raised as she talks while holding a mug in the other hand. The woman on the right listens calmly, holding a water bottle. Around them are a candle, potted plants, rolled mats, shelves with books and bowls, and a small Buddha statue. A wall poster lists numerous wellness activities such as meditation, sound bath, breathwork, journaling, moon ceremony, and digital detox. Caption below: “I never have time to cook a healthy meal or go for a walk! I’m too busy with all my other wellness practices.”

PainScience.com (Paul Ingraham)@painsci· Apr 25

A few highlights from a little holiday in progress. Exercising my zoom lens quite a bit. 🙂

PainScience.com (Paul Ingraham)@painsci· Apr 18

If you want to improve your mood, go for a walk—it can truly work. And maybe pass on “single-session interventions” (discussed in my last post)—because that probably won't work well. It’s an informative comparison. PainScience.com/blog/exercise-actually-moves-the-mental-health-needle.html

Chart comparing effect sizes of exercise vs single-session interventions (condensed CBT etc). Big effect sizes for exercise, not so much for SSI.

PainScience.com (Paul Ingraham)@painsci· Apr 14

I’ll say this much for the idea of single-session therapy: one and done is sure cheaper and more accessible than many sessions of more traditional talk therapy! But neither is a good value if the job doesn’t actually get “done.”

Comic of a standard psychiatry scene with the psychiatrist talking to the patient: “These psychotherapy sessions will help us uncover the root of your problem, but I warn you... We’re going to be delving deep... deep... DEEP into your savings account.”

PainScience.com (Paul Ingraham)@painsci· Apr 9

“Pain is inevitable. Suffering is optional.” 😮 O rly? That famous quote from Haruki Murakami contains both genuine wisdom and great potential for abuse in the context of #chronicpain. It’s not a useless idea, of course, but it is highly problematic for pain patients — and it does infect pain care.

The “this is fine” meme: a cartoon dog seated and drinking a beverage from a mug while surrounded by flames and smoke.

PainScience.com (Paul Ingraham)@painsci· Apr 7

Exercising while sleeping less than 7 hours per night might do more harm than good: a study linked that pattern to biological signs of premature aging! And vice versa: slowed biological aging with more sleep. 😮 LOL, I’d never work out again if I stuck to days when I had more than 7 hours sleep!

Screen shot of highlighted abstract for paper titled "Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study."

PainScience.com (Paul Ingraham)@painsci· Apr 7

A perspective you don’t see every day. We've gotten photos like this from some probes over the years, but it’s been decades since the last time a human snapped a picture like this — and we have better cameras now! Credit: NASA, Artemis II mission. images.nasa.gov/details/art0...

As the Artemis II crew came close to passing behind the Moon and experiencing a planned loss of signal, they captured this image of a crescent Earth setting on the Moon’s limb. The edge of the visible surface of the Moon is called the “lunar limb.” Seen from afar, it almost looks like a circular arc – except when backlit, as in other images captured by the Artemis II crew. In this photo, the dark portion of Earth is experiencing nighttime, while Australia and Oceania are in the daylight. In the foreground, the Ohm crater is visible, with terraced edges and a flat floor interrupted by central peaks. Peaks such as these form in complex craters when the lunar surface is liquified on impact, and the liquefied surface splashes upward during the crater’s formation.

PainScience.com (Paul Ingraham)@painsci· Apr 3

We Bury The Dead is an arty, poignant…zombie film? With physio! Many horror fans hate it for being “boring,” but it’s exactly what I want out of that genre: genuine, emotionally mature human drama in a crazy context. And then there was the #physiotherapy scene. 🙂

A movie poster for <em>We Bury the Dead</em> starring Daisy Ridley: a lone figure stands on a post-apocalyptic road holding an axe, facing an advancing zombie against a blood-red smoky sky, with wrecked cars and bodies scattered around; tagline reads "Volunteers needed."

PainScience.com (Paul Ingraham)@painsci· Apr 2

New study concludes “grit” may protect us from depression and stress caused by pain. That’s grit as in “true grit” (a movie I coincidentally just watched, the 2010 one): “passion and perseverance for long-term goals despite adversity.” Not very compelling data, but the framing is interesting.

PainScience.com (Paul Ingraham)@painsci· Mar 24

This observational study showed that pain catastrophizing — assuming the worst about pain — partially explains why some people with PTSD have worse back pain outcomes … and even more so in men.

Screenshot of highlighted abstract of scientific paper by Yamin et al., titled "Catastrophizing contributes to the association between posttraumatic stress symptoms and pain outcomes in individuals with chronic low back pain: Differential effects as a function of sex."

PainScience.com (Paul Ingraham)@painsci· Mar 23

A tsunami of IT band syndrome updates! 🌊 For a tsunami of new e-book customers from a bulk sale. I made a special effort to make sure the content is all current for all those new readers: ~20 updates + this new cover + major audio version upgrade. Details: www.painscience.com/blog/tsunami...

E-book cover image for The Complete Guide to Iliotibial Band Syndrome AKA Runner's Knee by Paul Ingraham, with a close-up photo of a runner's lower leg and knee against a warm orange background. Subtitle: 'A deep dive into the science, the nature of the beast & every possible treatment option. For both patients and professionals.

PainScience.com (Paul Ingraham)@painsci· Mar 21

This is the “your muscles look nasty without massage” meme being shared around (source unknown). It is, of course, horrible nonsense, pure marketing or propaganda. It inflates the perceived value of magic hands, and tries to make NOT getting regular massage seem dangerous.

Two side-by-side posterior views of a human body rendered as anatomical muscle illustrations on a black background. The left figure, labeled “REGULAR MASSAGES,” shows smooth, orderly, and relaxed-looking muscle fibers with clear definition and symmetry. The right figure, labeled “NO MASSAGES,” shows a more chaotic, rough, and strained appearance with exaggerated texture and irregularity in the musculature. Bold caption text at the bottom claims that regular massages improve muscle tone and reduce tension compared to no massages.

PainScience.com (Paul Ingraham)@painsci· Feb 19

Twenty stretching experts pooled their expertise for an ambitious consensus paper. The clickbait headline for this would be “The Great Stretching Myth: 20 Scientists Reveal What Actually Works — and What Doesn’t.” And it doesn’t work for much! NEW POST, 3m read: www.painscience.com/blog/stretch...

Screenshot of a scientific paper’s abstract page showing the title “Practical recommendations on stretching exercise: A Delphi consensus statement of international research experts” with a list of 20 authors including Konstantin Warneke, Ewan Thomas, Anthony J Blazevich, and others, and a list of “highlights” containing 8 bullet points, which are as follows: Consensus was reached in providing uniform definitions for static stretching, dynamic stretching, and proprioceptive neuromuscular facilitation. Stretching is recommended to improve range of motion, both acutely (single session) and chronically (long-term training), although alternative interventions (e.g., resistance training) are available. Stretching acutely and chronically reduces muscle stiffness, but it is questionable whether this is a desirable goal. Stretching seems largely inefficient as a post-exercise recovery strategy. Stretching does not reduce overall injury risk. In some cases, it may reduce the risk of muscle injuries but with the possibility that it may be compensated for with more bone and joint injuries. Stretching may produce small effects on chronic strength gains and muscle hypertrophy but requires high doses and is much less effective than resistance training for this effect. There are potential benefits of stretching for the cardiovascular system, but more research is required before clinical recommendations can be issued. Stretching does not promote relevant postural changes.

PainScience.com (Paul Ingraham)@painsci· Feb 7

An updated red flag for a rare type of back pain… Cauda equina syndrome (CES) is caused by compression of the horsetail-looking end of the spinal cord. It is a fairly rare kind of back problem, and sometimes very serious. And the classic red flag for it…ain’t great! 🧵

Posterior view anatomical illustration showing lumbar and sacral nerve roots descending through the spinal canal as the cauda equina. The red nerve bundle is labeled ‘central herniation’ at the L5-S1 level, with annotation indicating it ‘affects S2,3,4’ nerve roots. The illustration demonstrates how a central disc herniation can compress multiple sacral nerve roots simultaneously.

PainScience.com (Paul Ingraham)@painsci· Jan 28

I need a word for the PAIN of having the perfect snarky comment to take down some smug putz on social media … but you can’t use it because you have promised yourself to always, no matter what, “keep it classy.” *sigh*

Grumpy cat meme: a very grump cat with the caption: “Social media? I like antisocial media better.”

PainScience.com (Paul Ingraham)@painsci· Jan 22

Days of mist and fog in Vancouver. And it has just a little colour right now.

PainScience.com (Paul Ingraham)@painsci· Dec 6

So that’s the first moon I’ve seen in Vancouver in a month — appropriately shown with clouds. It has been a particularly grey and rainy month here, even by Vancouver standards. OR HAS IT? ”Moon, clouds, Sundial app, and getting corrected by ChatGPT” paulingraham.com/moon-clouds-...

PainScience.com (Paul Ingraham)@painsci· Nov 25

Ozempic works for arthritis. And probably other pain. Am I dreaming? Too good to be true? Nope. This is the real deal, actual good news we can have some confidence in. Free summary, lots of nerdy details for members only: www.painscience.com/blog/ozempic...

PainScience.com (Paul Ingraham)@painsci· Nov 16

Just updated my list. Did a little homework, learned that public libraries are mostly not great for this … but university libraries are quite good, though you do have to be able to actually get to one.

PainScience.com (Paul Ingraham)@painsci· Nov 13

This screenshot went wild on social media a while back. That is some *chef's kiss* irony! Nature took down the paywall on this (ancient) article—no doubt because of the flood of traffic! Just a bit more about this, and tips on how to get full text papers: www.painscience.com/blog/inacces...