Detailed guides to painful problems, treatments & more

PainSci update round-up: pulling on nerves and nostrils, ice cream headaches, and much more

 •  • 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.

So far in 2022 I have published about fifty updates of all sizes to‘s library of articles and books. Too much to round-up! So I’ve rounded down the round-up to 14 highlights, including:

  • pulling on nerves and nostrils
  • the effectiveness of supplement debunking
  • who gets hurt and why
  • the weird pain of ice cream headaches
  • faux profundity like quantum bullshit

See below for details and links.

Even the highlights represent a lot of updating, and yet it’s much less than what I actually did. Maybe I need to slow down? Probably. Speaking of which, here are three recent personal items as well:

The Updates

Freezing nerves to death

I added a small but useful cautionary tale to the icing page. What could possibly go wrong? Falling asleep with an ice pack on… causing serious, long-term nerve damage. See Icing for Injuries, Tendinitis, and Inflammation.

Flexion fear and perceive versus actual spinal fragility

The Nachemson flexion diagram was an unusually popular post on social media. That bit of musculoskeletal medicine history is now a part of the article Don’t Worry About Lifting Technique — plus some refinements, like a small but important important new bit about osteoporosis: “Your back isn’t fragile … unless it literally is.”

Big Suppla

A study showed that calling the supplements industry "Big Suppla" turns out to be an effective way to actually get people to think critically about it. That has been added to Vitamins, Minerals & Supplements for Pain & Healing, plus also an important disclaimer about adulteration and contamination, regarding concerns about the accuracy of a key paper on that topic.

An ancient article gets an update

One of the oldest and least updated articles on is a whimsical meditation on how standing up works. I probably haven’t touched it in a decade. It got an edit, some new colour about microbiology, and a new citation about the role of biotensegrity in cells and molecules. See Ten Trillion Cells Walked Into a Bar.

Nostril yanking and Rolfing

“Nostril yanking therapy” has been deployed as an example of pseudoscience in massage, along with some historical context about Rolfing and “cranial work” more. See either the massage page or the fascia page on

How do ice cream headaches work?

A trivial update, but fun: ice cream headaches as an interesting example of “referred pain.” See the The Complete Guide to Chronic Tension Headaches.

The ultimate deepity: matter/energy equivalence

Citing matter/energy equivalence in the context of healing is a classic “deepity.” I have expanded on the deepity concept and how it applies to energy medicine. See The Myth of Healing Hands.

There’s always more to learn about muscles strains

The topic of muscle strains continues to surprise me with its ability to be interesting. I have added a discussion of neuropathy as a risk factor for strain, along with the potential value of neural mobilization in strain rehab. See the muscle strain book.

Giving credit where due: a better reason for neural mobilization

A reader kindly pointed out that I may not have explained the simplest and best reason for neurodynamic stretching: just good old-fashioned “stimulation” for health. Nerve exercise. So I fixed that with a new mini-chapter. See Neurodynamic Stretching.

Risk factors for shin pain

The most substantive updating of 2022 so far has been on the theme of risk factors for shin splints — which also has broader significance for overuse and bone fatigue injuries generally, and the work I have done for shin splints will spread to other topics this year. But for now it’s all about the shin pain, and my discussion of risk factors is now quite a lot more interesting (and consequential). There’s also a whole new chapter about peak braking forces specifically. See Shin Splints Treatment, The Complete Guide.

Actually using best practices is effective

An important new article on that has spent a long time in the oven, technically published last summer, but simmering ever since. I think it’s finally baked now, after doing a bunch of editing and adding one more section: “Actually using best practices in musculoskeletal medicine.” See What Works for Pain?

A seed of neurological truth that has done a lot of damage

“Counterstimulation” is a basic mechanism for minor pain relief, and it is probably a major-yet-obscure reason that massage and other manual therapies are perennially popular. There’s good news and bad news about that … fully explored in a rather philosophical update about how counterstimulation is an the obscure seed of truth powering an awful lot of quackery. See Counterstimulation.

Acupuncture and FDA approval

I got annoyed with seeing the claim that acupuncture is “FDA approved” used to sell acupuncture, so I’ve debunked that gambit in an update to Does Acupuncture Work for Pain?

Ozone therapy for back pain (and members-only sections)

My first try writing about ozone therapy for back pain was a little too ranty and dismissive. That sub-topic is now more thoughtful and thorough and looks a little closer at the rationale. Still ranty! But the ranting is now a sauce instead of the main dish. See Ozone Therapy for Pain. Member’s only — one of five small new members-only sections created in the last month or so.