The year of “finally”! PainScience.com highlights from 2019

The close of 2019 marked nineteen years of writing the website, thirteen since I first started selling books, and nine since I started earning enough to make a living from it. Nine! Almost a decade of making a living one of the hardest ways I can imagine.

This thing might just work out. Maybe.

One of the many things I finally wrote this year was the PainScience.com origin story. I get lots of email from people wondering just how I am pulling this off, usually because they are hoping to do so themselves — and of course most are doomed to failure. Wringing an income out of the internet seems like an increasingly improbable achievement for an individual to unlock if you’re not a YouTube star or some other weird gen Z thing.

2019 was also my most productive year yet. “Finally” was the word of the year. I checked off dozens of better-late-than-never jobs, most importantly two new books, but also 8 new or like-new articles, 70 major updates, 90 blog posts, and dozens of technical upgrades…

2019 content highlights

• 2 new books completed, about headaches and frozen shoulder.
• 8 new articles or major revisions:
  • Vulnerability to Chronic Pain: Chronic pain often has more to do with general biological vulnerabilities than specific tissue problems
  • Achilles Tendinitis Treatment Science: Evidence-based guidelines for the fastest possible recovery
  • Does Massage Increase Circulation? Almost certainly not in a clinically important way, and definitely not as much as even a small amount of exercise
  • Baxter’s Neuritis versus Plantar Fasciitis: A rare nerve entrapment that can explain some stubborn cases of “plantar fasciitis”
  • Knee Replacement Surgery Doubts: Is it legit? Knee replacement is extremely popular, but it (still) isn’t evidence-based medicine
  • Why I Quit My Massage Therapy Career, published on ScienceBasedMedicine.org (plus some significant follow-up).
  • Does Epsom Salt Work?, an extremely old article but so heavily revised that it was basically reborn. (That article also got a new audio version, along with another perennially popular one on structuralism.)
  • 38 Surprising Causes of Pain. This page was updated dozens of times this year, and no writing project has done more for the breadth of my understanding of the world of chronic pain.
• 70 major updates to existing articles (which doesn't include dozens of updates to the new books), plus dozens of others, for a total of 236, of about one every day and a half. There’s so much diverse work represented here it’s impossible to sum up, but here are several that stand out in some way:
  • Rewrote and greatly expanded my chapter on strength training for shin splints patients, with a strong focus (for the first time on PainScience.com) on the topic of the “corrective exercise trap.”
  • Finally dove into vagus nerve stimulation and the inflammatory reflex, for an update to my article on subtle systemic inflammation.
  • Finally tackled cannabinoids, a topic I haven’t wanted to touch with a ten-foot pole. There’s now a good dose about it in four of my books.
  • I get a lot of fascinating stories from readers. One of the most amazing in recent memory came from Frank the “adhesion machine,” which was a slam dunk update for the fascia page.
  • The low back pain book got three new or like-new chapters on hamstring stretching, sacroiliac joint dysfunction, and prolotherapy. All neglected topics, finally well covered.
  • A basic article about progressive training I haven’t touched in years got beefed up with a key point that has crystallized for me over the last few years: you can recover from practically anything with baby steps… but not everything.
  • “Spatial summation” is a tricky, nifty concept that finally gotten some attention, most notably in my neck and back pain books, but you can get the basics here.
  • Joint noise, also known as crepitus, worries a lot of people. I finally responded to all the email about it in updates to both my runner’s knee books.
  • And a frivolous item to finish: “matter/energy equivalence and quantum rationalizations” in Use the Force! The myth of healing energy in massage and bodywork.

• 91 blog posts, many of which were basically just summarizing some of the major 70 updates, but a couple dozen were originals on new topics, such as:

  • high somatic awareness
  • narcolepsy (oddly)
  • interesting fallout from being quoted in the NYT
  • “sickness behaviour” and chronic pain
  • reality versus best practices in musculoskeletal medicine
  • whether an informal science writing style can be credible
  • the trouble with demonizing trivial physical stresses
  • two pet theories about inflammation
  • benzodiazepine withdrawal syndrome.

Paying down the tech debt

Graphics of the Matrix code cascade with the PainScience.com salamander superimposed.

“Business” for me mostly means the dorky business of running a website — web servers, programming, analytics, and so on. For years now I have been paying down a huge “technical debt” that I accumulated in the early years of the business.

Translation: I’ve been cleaning up the messes I made as an inexperienced programmer.

A big part of my job is putting out technological brush fires as they crop up; it’s amazing how often I had a Very Bad Day in 2019 because I programmed something poorly in 2009. This big part of my job has also become the worst part, and I am hell bent on tediously re-building all of the foundations of PainScience.com. Someday it will be more reliable and easier to maintain.

With some good help, I’ve been picking up speed on the long journey to that goal. There were dozens of technological upgrades to the site in the last year, often the result of months or years of chipping away at various challenges…

Significant technological changes to PainScience.com lately

• PainScience.com now has a more normal-ish login option. I had relied exclusively on something quirkier for many years. Thanks to this, my top tech support inquiry for a decade has almost been eliminated, freeing up quite a bit of time every week.
• Two different kinds of bookmarking bugs were finally solved. (One of those was 100% a consequence of a major technological change on iPhones, which is actually a great example of how some of my tech problems are not self-inflicted wounds — tech is always changing, and surprising often it’s for the worse.)
• Purchase confirmation emails were improved in a big way this year, all with the goal of improving deliverability. Email is kooky old tech. You would not believe how deep this rabbit hole goes.
• I launched my bulk sales program for clinicians and teachers, which required some ambitious upgrades to my e-commerce infrastructure.
• At long last, I have more or less “mastered” my personal webdev environment. I finally really and truly have a good understanding of how to install and configure the web-development technologies on my Mac, the “AMP stack” (Apache, MySql, PHP). I’d been getting by for years with a half-arsed grasp of it all. It is great to finally have a whole-arsed grasp.
• For years I had a weird problem with Google think there were thousands of broken links on PainScience.com, but they weren’t actually broken links. Breathed a sigh of relief when I finally fixed that.
• All over the site, internal links (links to other locations on the same page) are now visually distinctive, green instead of blue. It’s a simple, nice upgrade I’d had in mind since about 2012. Better late than never.
• I now have an excellent custom analytics system for monitoring the effect of website changes on sales. Creating this system involved the largest investment I’ve made in the business in years, but it’s a vital tool for making sure PainScience.com continues to thrive for many years to come. For instance, as I write this, it is in the process of confirming that green buy buttons sell more books than blue.
• The new analytics system is forward looking, but I also looked back this year: I had more than a decade of messy financial and sales data that I finally cleaned up to produce my first ever all-time sales charts. Learned quite a lot from that, too.
• I got properly hacked for the first time in the history of the business. No real harm was done, and no user data was exposed, but there was an actual successful breach and a bad guy got to exploit the PainScience.com server for about a day to send about 8000 spam email messages in my name. Lovely. This inspired several overdue security upgrades, the kind of stuff that doesn’t seem all that important until you get pwned.

And that’s just the highlights! The ones that aren’t top-secret, anyway.

I could do a third this much in 2020 and feel satisfied with it! That’s a nice feeling to have.