Detailed guides to painful problems, treatments & more

Lessons from the 2019 Nobel prize for medicine

 •  • 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 PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

A Nobel prize was awarded for discovering the dazzlingly complex mechanism by which cells sense oxygen levels. Such impressively detailed reductionist exploration of physiology is science at its hardest and best, and it highlights the futility of amateurish speculation about “what works” for health problems. Dr. Steven Novella (transcribed from the Skeptics’ Guide to the Universe episode 744 @ ~36:00):

This is all strictly mechanistic, because our bodies are freakin’ machines and you don’t have to invoke any kind of magical energy to make them work. Also it’s humbling. This is complex. I went into enough detail that the only thing you’re going to walk with — because you’re not going to remember any of this tomorrow — is “Wow! This is complicated!” The body is a complicated homeostatic, dynamic equilibirum. That’s how the body works, and simplistic notions of “this is low so let me increase it” or “this is good so more is better” or any other idea like that are hopelessly naive. Sometimes that works out but we’ve already picked all that low hanging fruit, and we’re way beyond that now. Trying to interfere with this homeostatic system is complicated and yet the entire supplement industry is based upon a ridiculously simplistic notion about how the body works, which is belied by this kind of research. This is why pseudoscientists fail, because they are not operating at this level of complexity… but this is the level of complexity at which the body actually functions.

Please consider this the next time you have an impulse to try a supplement to fix a symptom that’s a mystery. (And, yes, drugs too! Big Pharma has a very different “style,” but for every genuinely valuable use of a drug, there are a lot more that are based on grossly oversimplified notions of how they might work.)

Dr. Novella also discussed this in an article, but I liked his phrasing on the podcast even better.

End of post marker

Last post: Lifting awkwardly as a risk factor for back pain

Next post: Massage may be lovely, but it’s not “medicine”