Reviews of Therapies & Treatments

See also the about page, complete article index, sitemap, or master list of self-help tips. There are also reading guides for patients & professionals.

Spinal manipulation: one of the classic treatment options. But does it actually work?

There are countless treatments for people in pain. Scams are everywhere, but so is evidence-based hope. Get started with a big compilation of pain survival tips, with links to dozens more articles about popular DIY treatments like self-massage, ice or heat, or the amazingly controversial Epsom salts. I also review major therapy methods like massage, chiropractic, and acupuncture.

Exercise! The closest thing there is to a miracle drug

• Strength Training Surprises — Why building muscle is easier, better, and more important than you thought, and its vital role in injury rehabilitation
• Strength Training Frequency — Less is more than enough: go to the gym less frequently but still gain strength fast enough for anyone but a bodybuilder
• Quite a Stretch — Stretching science has shown that this extremely popular form of exercise has almost no measurable benefits
• The Art of Rest — The finer points of resting strategy when recovering from injury and chronic pain (hint: it’s a bit trickier than you might think).
• The Trouble with Chairs — The science of being sedentary and how much it does (or doesn’t) affect your health and back pain
• Microbreaking — Lots of little breaks may compensate for too much time spent in chairs
• Mobilize! — Dynamic joint mobility drills are an alternative to stretching that “massage with movement”
• Does Posture Correction Matter? — Posture correction strategies and exercises … and some reasons not to care or bother
• Get in the Pool for Pain — Aquatic therapy, aquajogging, water yoga, floating and other water-based treatment and injury rehab options
• Deep Cervical Flexor Training — “Core” strengthening for the neck

Massage therapy: everyone’s favourite luxury therapy

• Does Massage Therapy Work? — A review of the science of massage therapy … such as it is.
• Basic Self-Massage Tips for Myofascial Trigger Points — Learn how to massage your own trigger points (muscle knots) Or, for a lot more detail …
• Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option. This is a huge, comprehensive guide.
• Fascial therapy — A trendy style of massage aimed “releasing” connective tissue by pulling on it artfully.
• Poisoned by Massage — Rather than being DE-toxifying, deep tissue massage can probably cause a slightly toxic situation in the body.
• How to Find a Good Massage Therapist — Lots of tips for finding good quality medical massage therapy in your area (especially trigger point therapy).
• The Pressure Question in Massage Therapy — What’s the right amount of pressure to apply to muscles in massage therapy and self-massage?
• The Bath Trick for Trigger Point Release — A clever way of combining self-treatment techniques to self-treat your trigger points (muscle knots).
• Massage Therapy Side Effects — What could possibly go wrong with massage? The risks and side effects of massage therapy are usually mild, but “deep tissue” massage can cause trouble.
• Deep Friction Massage Therapy for Tendinitis — A guide to a simple self-massage technique sometimes helpful in treating common tendinitis injuries like tennis elbow or Achilles tendinitis.
• Massage Therapy for Tension Headaches — Perfect Spot No. 1, in the suboccipital muscles of the neck, under the back of the skull. The first of a series of 14 articles about “perfect spots” around the body for massage.
• PS Trigger Point Doubts — Do muscle knots exist? Exploring controversies about the existence and nature of so-called “trigger points” and myofascial pain syndrome,
• Why I Quit My Massage Therapy Career — The story of how I was formally investigated for professional misconduct because I criticized pseudoscience in alternative medicine. I quit the profession instead of submitting to regulatory censure and censorship.
• 💩 Massage Therapists Say — A compilation of more than 50 examples of the bizarre nonsense spoken by massage therapists with delusions of medical knowledge.

Chiropractic: perpetually the most controversial health care profession

• The Chiropractic Controversies — An introduction to chiropractic controversies like aggressive billing, treating kids, and neck manipulation risks.
• Spinal Subluxation — Can your spine be out of alignment? Chiropractic’s big idea has been misleading patients for more than a century Probably not.
• Does Spinal Manipulation Work? — Spinal manipulation, adjustment, and popping of the spinal joints and the subluxation theory of disease, back pain and neck pain.
• Organ Health Does Not Depend on Spinal Nerves! — One of the key selling points for chiropractic care is the anatomically impossible premise that your spinal nerve roots are important to your general health.
• Digital Motion X-Ray — What’s the risk from the radiation exposure? Is the diagnostic potential worth it?

Medications & supplements

• Does Epsom Salt Work? — The science of Epsom salt bathing for recovery from muscle pain, soreness, or injury.
• Does Arnica Gel Work for Pain? — A detailed review of popular homeopathic (diluted) herbal creams and gels like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation.
• Voltaren® Gel Review — A useful rub-on anti-inflammatory medication for arthritis, tendonitis, bursitis, runner’s knee, and muscle strain.
• Opioids for Chronic Aches & Pains — The nuclear option: “Hillbilly heroin” (Oxycontin), codeine and other opioids for musculoskeletal problems like neck and back pain.
• Can Supplements Help Arthritis and Other Aches and Pains? — Debunkery and analysis of supplements and food-like medicines (nutraceuticals), especially glucosamine, chondroitin, and creatine, mostly as they relate to pain.
• Vitamin D for Pain — Is it safe and reasonable for chronic pain patients to take higher doses of Vitamin D? And just how high is safe?

Tools, gadgets & hardware

• Zapped! Does TENS work for pain? — The peculiar popularity of being gently zapped with electrical stimulation therapy.
• Does Ultrasound Therapy Work? — Many concerns about the widespread usage of therapeutic ultrasound, especially extracorporeal shockwave therapy (ESWT).
• Kinesio Taping Review — A quick analysis of that colourful therapy tape that was so popular at the Olympics. Does it help?
• Cold Laser Therapy — A critical analysis of treating pain and injury with frickin’ laser beams.
• Spinal Fracture Bracing — My wife’s terrible accident, and a whirlwind tour of the science and biomechanics of her spine brace.
• Are Orthotics Worth It? — A consumer’s guide to the science and controversies of orthotics, special shoes, and other allegedly corrective foot devices.
• Does barefoot running prevent injuries? — A dive into the science so far of barefoot or minimalist “natural” running.

Hydrotherapy

• Hydrotherapy, Water powered rehab — A guide to using warm and cold water as a treatment for pain and injury.
• Icing for Injuries, Tendinitis, and Inflammation — Become a cryotherapy master.
• (Almost) Never Use Ice on Low Back Pain! — An important exception to conventional wisdom about icing and heating.
• The Great Ice vs. Heat Confusion Debacle — A quick guide that explains when to ice, when to heat, when not to, and why.
• Heat for Pain — A detailed guide to using heat as therapy for acute and chronic pain.
• Hot Baths for Injury & Pain — Tips for getting the most benefit from a hot soak, the oldest form of therapy.
• Contrast Hydrotherapy — “Exercising” tissues with quick changes in temperature, to help with pain and injury rehab (especially repetitive strain injuries).
• Does Epsom Salt Work? — The science of Epsom salt bathing for recovery from muscle pain, soreness, or injury.
• Icing, Heating & Tissue Temperature — How much do ice packs and heating pads change the temperature of muscle and joints?.

Injections, surgeries (mostly minor surgeries)

• Does Platelet-Rich Plasma Injection Work? — An interesting treatment idea for arthritis, tendinopathy, muscle strain and more.
• Stem cell therapy — See the platelet-rich plasma article — the topics overlap so much they are almost the same thing. What I have written about PRP is nearly a clone of what I would write about stem cell therapy.
• Should You Get A Lube Job for Your Arthritic Knee? — Reviewing the science of injecting artificial synovial fluid, especially for patellofemoral pain.
• Do Nerve Blocks Work for Neck Pain and Low Back Pain? — Analysis of the science of stopping the pain of facet joint syndrome with nerve blocks, joint injections, and nerve ablation.
• Does Cartilage Regeneration Work? — A review of knee cartilage “patching” with autologous chondrocyte implantation (ACI).
• Knee Surgery Sure is Useless! — Evidence that arthroscopic knee surgery for osteoarthritis is about as useful as a Nerf hammer.
• Extracorporeal shockwave therapy (EWST) — expensive, hyped and totally unproven for most conditions.
• Tissue Provocation Therapies — Can healing be forced? The laws of tissue adaptation & therapies like Prolotherapy & Graston Technique.
• Knee Replacement Surgery Doubts — Knee replacement is extremely popular, but still not yet based on good evidence of efficacy.
• Steroid injections [coming soon! ish!]

Energy medicine & subtle therapies

• Does Acupuncture Work for Pain? — A review of modern acupuncture evidence and myths, focused on treatment of back pain & other common chronic pains.
• Therapeutic Touch is Silly — No touch included! Auras don’t exist and can’t be felt, let alone massaged for medical benefit.
• Placebo Power Hype — The placebo effect is fascinating, but its “power” isn’t all it’s cracked up to be.
• Homeopathy Schmomeopathy — Homeopathy is not a natural or herbal remedy: it’s a magical idea with no possible basis in reality.
• Does Craniosacral Therapy Work? — Craniosacral therapists make big promises, but their methods have failed to pass every fair scientific test of efficacy or plausibility.
• Do You Believe in Qi? — How to embrace a central concept of Eastern mysticism without being a flake.
• T’ai Chi Helps Fibromyalgia, but It’s Not “Alternative” Medicine — Despite a high profile boost from the New England Journal of Medicine, it’s still just gentle, elegant, and pleasant exercise.

Mind-body

• Mind over pain — The second half of my main review of pain science gets as practical as possible about the “mind over pain” idea.
• The Tyranny of Yoga and Meditation! — Do you really need to try them? How much do they matter for recovery from conditions like low back pain?
• Pain Relief from Personal Growth — Treating tough pain problems with the pursuit of emotional intelligence, life balance, and peacefulness.
• Anxiety & Chronic Pain — A self-help guide for people who worry and hurt
• The Art of Bioenergetic Breathing — A potent tool for personal growth and transformation.
• Civilization Survival Tips — Coping with stress and anxiety in the modern world (without drugs).
• T’ai Chi Helps Fibromyalgia, but It’s Not “Alternative” Medicine — Despite a high profile boost from the New England Journal of Medicine, it’s still just gentle, elegant, and pleasant exercise.
• Critical Analysis Review of Dr. John Sarno’s Books & Ideas — Sarno’s methods are historically important, based on a kernel of an important truth that has been blown waaaay out of proportion.

Consumer tips, advocacy & anti-quackery activism

• Modality Empires — The trouble with the toxic tradition of ego-driven, trademarked treatment methods in massage therapy, chiropractic, and physiotherapy.
• Healer Syndrome — The problem with health care professionals, especially in alternative medicine, who want to be known as “healers”.
• Choose Cheaper, Safer Treatments — All other things being equal, always choose the cheapest and safest treatment option for your pain problem.
• Popular but Weird & Dangerous Cures — The most dangerous, strange, and yet popular snake oils and “treatments” in history (and why anecdotes and testimonials cannot be trusted).
• Alternative Medicine’s Choice: Alternative to What? — Alternative to what? To cold and impersonal medicine? Or to science and reason?
• Extraordinary Health Claims — A guide to critical thinking, skepticism, and smart Internet reading about health care.
• Pseudo-Quackery in the Treatment of Pain — The large, dangerous gray zone between evidence-based care and overt quackery in musculoskeletal and pain medicine.