I am a science writer in Vancouver, Canada, and a chronic pain patient myself since 2015.1 I am not a medical expert, but I am an expert “translator.” It’s my job to explain and cite expert opinion and solid science.
I was a Registered Massage Therapist for a decade2 and worked with many patients with chronic pain, but I left that profession because it was too polluted with pseudoscience for my tastes.3 For several years after that I was the assistant editor of ScienceBasedMedicine.org,4 working closely with their world class team of physicians, while building PainScience.com up to be a sister site.5
My goal is to make PainScience.com a credible source in an era of rampant medical misinformation, despite my own unimpressive credentials. I do this in many ways:
- Extensive citations to the scientific evidence. PainScience.com has a huge bibliography and more than seven thousand footnotes spread across 234 articles and books. I live in PubMed.
- Citations are often substantially annotated, and always linked to the original source for easy verification.6
- I also systematically update my citations, correct errors, and log changes.
- The site has a blog, but it is not “just a blog” — an important distinction. Not that there’s necessarily anything wrong with blogs.7
- Opinion, speculation, and uncertainy are always clearly identified. All knowledge is provisional, and I am extremely cautious about declaring what I think I know about pain.
- I constantly seek input from a substantial network of expert clinicians and researchers.
- Rather than trying and failing to be “unbiased,” I disclose my bias clearly and minimize all possible conflicts of interest.8 I do not profit from recommending or advertising any product or service. All site revenue comes from book sales and donations.
- There is no false balance here: my job is not to tell “both sides of the story” when one side is too far out in left field. But for legit controversies, I am quick to explain “who disagrees and why” (an important guiding principle I picked up from Dr. Harriet “The Skepdoc” Hall).
- Although I am not a medical expert and will never claim to be, obviously I have picked a few things up after 24 years of workaholic independent study. 😉
Some personal stuff
I am pushing fifty now, married for almost twenty years. I grew up in the Canadian north, and I’ve lived in Vancouver since 2000.
I am an amateur athlete, mostly as an ultimate Frisbee player,9 but probably for not much longer: at my age, I would be struggling with the intensity even if I didn’t have some health issues.
I am unusually short; I was given growth hormone as a child, grew like crazy for a year, and then basically stopped at 5’3" — my first “interesting” encounter with health care.
A few other details:
- Keen tech hobbyist since I was about six years old, and mostly an Apple guy since the early 80s.
- Dog lover and cat lover (but currently deprived of either).
- Consumer of great deal of science fiction and fantasy.
- My favourite non-pain subjects are paleontology, astronomy, and classical history.
- My personal blog, Writerly, is where I write about everything that isn’t the science of pain.
Me & my lovely wife, who shall remain nameless. (This small picture is probably her only Internet presence — she’s an offline kind of lady.)
Major influences, mentors, and acknowledgements (a hopelessly inadequate summary)
Dr. Lorimer Moseley, Diane Jacobs, PT, and Jason Silvernail, DPT, are particularly responsible for teaching me some vital lessons about neurology.
I was a part of the editorial team at Science-Based Medicine from 2010 to 2016. Everyone there, but especially Drs. Steve Novella, Harriet Hall, and David Gorski, was generous and supportive, and taught me how to think about health care. I continue to correspond with several of the SBM editors and contributors.
Blogger-massage-therapists Alice Sanvito, Todd Hargrove, Laura Allen, Ravensara Travillian — out of literally dozens of other worthies — have all routinely given me invaluable ideas, advice, perspective, and so on.
Chiropractic apostate Sam Homola, DC has particularly been an inspiration and a resource; Eyal Lederman’s writing has taught me much. Anti-quackery activist Dr. Stephen Barrett has offered various kinds of support over the years. Psychologist and massage researcher Dr. Christopher Moyer has contributed expertise and comments to PainScience.com many times over the years.
I left massage therapy because the profession is an embarrassing mess
I love massage, but the profession of massage therapy has a deeply pseudoscientific character overall, defining itself mostly in opposition to science-based or “mainstream” health care, where rejection of science is actually celebrated by many practitioners, probably a majority. My practice was busy and fun; I enjoyed my work and adored my clients. But I wasn’t comfortable in a profession so conflicted about science. It was getting awkward. I didn’t want to spend the rest of my career explaining to scientists and engineers and doctors that I was one of the pro-science massage therapists.
I wrote about these concerns and was threatened with professional censure by the regulatory body that licenses massage therapists. They effectively demanded that I stop blogging. I quit the profession instead. You can read the whole bizarro-world story on ScienceBasedMedicine.org: Why I Quit My Massage Therapy Career. Or you can listen to me talk about it in an interview for the Body of Evidence podcast.
Other therapists who share my feelings have remained in the profession, fighting to modernize the profession, and my hat is off to them — I do what I can to support them with my writing and publishing.
Flaky stuff: a history of fascination with alternative medicine, vitalism, and “internal” martial arts
Most of my critics assume that I must be ignorant of all things alternative, magical, spooky, and flaky. In fact, my “street cred” in this area is quite solid — so much so that I find it fairly embarrassing today. Back in the day, I tried and believed practically everything alternative medicine has to offer. I bought it hook, line, sinker for years, and had a chip on my shoulder about mainstream medicine to boot.
My skepticism today is more credible for having left that world behind. Despite all my motivated reasoning in one clear direction, I found the appeal of science and medicine irresistible over time, despite their many problems. That was more than 20 years ago now.
I did this kind stuff for 20 years: semi-mystical martial arts. I was insufferably earnest about it. And I moved on.
But for 20 years before that, reaching back into my early teens, I was an artsy humanities nerd and hippy, dismissive of science to a fault and interested in just about anything you can find in a New Age bookstore.
I practiced taijiquan and qigong seriously for twenty years, and participated in a number of other martial arts, such as aikido.
I was also exposed early in life, way back in the mid-80s, to some of the world’s foremost experts in the idea of vital “energy” and traditional Chinese medicine — Jock McKeen and Bennet Wong, the remarkable founders of Haven, analogous to the Esalen Institute. Jock and Ben and Haven influenced me strongly right through the 90s, but after that I started to move decisively in new directions where their ideas were less relevant and more questionable.
Creating this website has been an education much like a university degree
I respect academic accomplishment immensely — and yet the effort I’ve put into this website is not just comparable to the effort required to earn a degree, but undoubtedly greater. You can do a lot of independent study in 20 years, and I have. There are about two million words of original articles and tutorials here — roughly 10–20 books worth — with a large, well-maintained and carefully annotated bibliography.
For many years, all this it was driven by interactions with clients, and everything I wrote was for clients. Later, interactions with experts and readers from around the world became more important. Countless times it is my readers who have suggested something I never would have thought of, or reminded me of something I should have.
So, the total educational value of publishing this website is unique and incalculable.
The personal touch: my own sports injuries and pain problems (and my wife’s)
I write a lot about sports injuries, so it would be nice if I had some significant experience with athletics, eh? And I do: I have had perhaps more than my fair share of direct, painful, and highly educational experiences with some of the athletic injuries I write about, especially iliotibial band syndrome.
Me playing ultimate in the sun a few years ago.
I had always been “prone” to aches and pains, which is really why I started this website. But that tendency was a pain puppy humping my leg compared to the Cerberus of suffering that has been mauling me since 2015. I graduated to the pain big leagues: serious chronic pain, fatigue, and exercise intolerance plus many other bizarre symptoms, all unexplained, making me a fibromyalgia patient. In 2022, I started Project Try Everything, a newsletter about a 2-year mission to truly “try everything” to recover.
In 2010, my wife had a particularly horrendous car accident while travelling alone in Asia. I learned a great deal about injury rehab from her experience — a thin silver lining.
- I started out helping people with chronic pain and now I have it myself. See Project Try Everything: A 2-year mission to truly “try everything” to recover from unexplained pain & illness.
- 2000–2010, RIP. Although it’s not much of a credential, please note that my training was unusually long and rigorous for that industry: a 3-year, 3000 hour program with demanding certification exams. Somewhat less that what a physical therapist would do, but getting close.
- Sciencebasedmedicine.org [Internet]. Ingraham P. Why I Quit My Massage Therapy Career; 2019 February 22 [cited 19 Feb 23]. PainSci Bibliography 52363 ❐
- See my bio on ScienceBasedMedicine.org.
- The idea of “science”-based medicine has been a major influence on me, and it’s why I don’t just study and write about the science of pain and injury, but also science and research itself, the history of science and medicine, and critical analysis, epistemology, and cognitive distortions. See Why “Science”-Based Instead of “Evidence”-Based? The rationale for making medicine based more on science and not just evidence… which is kinda weird.
- Many websites have seriously flawed footnotes/citations that are effectively just for show: credibility theatre. For instance, just linking to sources seems like a small and obvious thing, but it’s astonishing how many websites still don’t take advantage of this most basic feature of the world wide web. But there are many other common problems with citations, and I work hard to avoid them all. See 13 Kinds of Bogus Citations: Classic ways to self-servingly screw up references to science, like “the sneaky reach” or “the uncheckable”
Dismissing PainScience.com as “just a blog§” has always been a common strategy for people who are bothered by my criticisms of pseudoscience and quackery, but it’s always wrong in at least two ways:
- it’s actually not a “blog” (or not just a blog anyway),
- and it wouldn’t matter if it was.
All information should be judged mainly on its own merits, not the publication format (or anything else). But anyone who calls my site a “blog” isn’t actually familiar with it, or apparently with blogging. PainScience.com has a blog/newsletter, but even after many years it still only accounts for a fraction of the content on the site, a barnacle on the belly of a whale: PainScience.com is primarily a Wiki-like library of deep-dive articles, evolving resource pages, and explainers, not (just) a series of dated, ephemeral “posts” that usually stagnate after publication. The PainScience.com blog is mostly just highlights and “director’s commentary.”
Not that there’s anything inherently wrong with blogs!
Yes, of course, 97% of blogs back in the Blogging Era — now almost as ancient as the Pleistocene — were terrible, and that is what gave blogs a bad name. Health was one of the worst categories, with a serious Dunning-Kruger Effect (Wikipedia) problem. But nothing about blogging actually prevents excellence, any more than the widespread use of Comic Sans means that good typography is impossible. These days, blogs — and now social media posting and podcasting and even TikTok videos — have actually become important to science, contributing meaningfully to debate, and in particular they are an informal extension of peer review that often actually has higher standards: see Five reasons blog posts are of higher scientific quality than journal articles.
- Ingraham. Objectivity is Overrated: A response to the common accusation of bias and the mythical virtue of objectivity and journalistic “balance”. PainScience.com. 685 words. Objectivity and balance are highly over-rated as journalistic virtues. They are mostly a pretentious delusion, and we should never trust anyone who claims to be objective. Instead of expecting that, look for someone with a “view from somewhere” (Rosen) from someone who isn’t afraid to disclose and own where they are coming from. The ideal is not to be unbiased, but to be biased with integrity.
- Ultimate is a Frisbee team sport, co-ed and self-refereed, with soccer-like intensity and usually the mood of a good party. Players tend to be jock-nerd hybrids: lots of engineers and scientists. Hippies invented the sport, but have mostly been displaced. I’ve been playing since 1997.