Detailed, evidence-based help for common painful problems

The “dull and rusty” science of pain

 •  • by Paul Ingraham
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.

I did a short interview with Austin Frakt for Here, I’ll give you all the good bits, no pesky nuance and detail:

Q. How did you hone your craft?

A. My craft wasn’t so much “honed” as thrown into a volcano, melted down, and ejected at high velocity.

Q. What are the top few things people get wrong about pain?

A. Pain is weirder the people realize, even in seemingly simple “mechanical” problems like runner’s knee or frozen shoulder. The nervous system is volatile, glitchy, prone to false alarms. There can be huge disconnects between pain and what’s actually going on in the tissues.

Q. Who should we trust?

A. Trust the doubters. The field is polarized: hype and myths are mostly either being busted or perpetuated, so the absence of obvious skepticism and citing the science is a red flag.

Q. What is on the cutting edge of pain science?

A. The cutting edge of pain science is dull and rusty — there’s just too much that we still don’t know. There are always headlines about potential breakthroughs, but they all remind me of news about battery tech: there are always major caveats. “Did we mention this only works in a vacuum?”

Read the whole thing, it’s not huge. In fact, it was all a bit rushed compared to how I usually work — which is probably a good thing. Given more time, I would have just carried on agonizing over my answers indefinitely, with dimishing returns. Really, I’ve been trying to figure out how to answer these questions for 20 years, and I’ll probably never stop.

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