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Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups

PainSci » bibliography » Shahar et al 2018
Tags: bad science, scientific medicine

One article on PainSci cites Shahar 2018: Does Posture Matter?

PainSci commentary on Shahar 2018: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This is the junk science that triggered that painfully stupid “cell phone usage causes skull horns” kerfuffle back in 2019. The paper achieved completely undeserved virality and has been accessed many tens of thousands of times. The study (and the media coverage) basically claimed that those darn millenials are staring down at their phones so much that the postural strain on the backs of their heads is causing them to grow "horns" (bones spurs).

Kids these days!

But the study is silly garbage. A correction was published, but it should have been a retraction. The whole incident was a pitch perfect example of the power of fear-mongering misinformation based on so-called science … right before a mighty explosion of much more consequential pandemic examples.

What's so bad about the study? Where to start! Nsikan Apkan’s debunking for is ten times more detailed than anything I would have bothered to write about this, despite the fact that it’s exactly the kind of thing I like to write about it — but Akpan really goes for it, leaves no stone unturned, and even gets into tangential detail about the overwhelming power of misinformation. It’s truly great high-road debunking. Bravo!

But Apkan’s piece might be a little too much of a good thing, taking a silly topic a bit too seriously. There’s really just one thing 99% of people need to know about this study: it was self-serving junk science, and the conclusion and the headlines it generated were clickbait crap unworthy of our attention.

But here are a few highlights (or lowlights) extracted from Apkan's detailed work …

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Recently we reported the development of prominent exostosis young adults' skulls (41%; 10-31 mm) emanating from the external occipital protuberance (EOP). These findings contrast existing reports that large enthesophytes are not seen in young adults. Here we show that a combination sex, the degree of forward head protraction (FHP) and age predicted the presence of enlarged EOP (EEOP) (n = 1200, age 18-86). While being a male and increased FHP had a positive effect on prominent exostosis, paradoxically, increase in age was linked to a decrease in enthesophyte size. Our latter findings provide a conundrum, as the frequency and severity of degenerative skeletal features in humans are associated typically with aging. Our findings and the literature provide evidence that mechanical load plays a vital role in the development and maintenance of the enthesis (insertion) and draws a direct link between aberrant loading of the enthesis and related pathologies. We hypothesize EEOP may be linked to sustained aberrant postures associated with the emergence and extensive use of hand-held contemporary technologies, such as smartphones and tablets. Our findings raise a concern about the future musculoskeletal health of the young adult population and reinforce the need for prevention intervention through posture improvement education.

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Specifically regarding Shahar 2018:

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights: