Detailed guides to painful problems, treatments & more

Hotshot in the dark

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Do we really have a cool new cure for athletic cramps? Have they been “un-invented”? And wouldn’t that be great?! Or … is it just another case of putting the marketing cart before the science horse? A good new article from Dr. David Colquhoun about Hotshot anti-cramp product breaks it down for us:

[Hotshot provides] three references, two are to unpublished work. The third is not about Hotshot, but about pickle juice.

… [the pickle juice results] are sufficiently suggestive that it might be worth testing Hotshot properly. One might have expected that would have been done before marketing started. It wasn’t.

And it still hasn’t been done. Shocker.

The other critical point Dr. Colquhoun makes is that “it’s well known that nobody understands cramp.” Indeed, we just do not have a good grip on the biology of that malfunction, which makes it tough to treat. While it is possible to stumble on a cure for a mysterious problem — such things have happened before in the history of medicine (e.g. lithium jumps to mind) — most shot-in-the-dark treatments never pan out. So, wake me up when there’s good trial evidence.

Meanwhile, being prone to cramps myself, I look forward to trying some for kicks. Not that my personal experience with it will matter one whit. As Dr. Colquhoun points out, “There can be no condition more susceptible than muscle cramps to self-deception because of regression to the mean.”