Detailed guides to painful problems, treatments & more

Lots of updates about vitamin D, stretching, structuralism and 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 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.

I’ve been unusually busy updating articles and tutorials here on PainScience.com lately: about three updates every two days for the last couple months.

Most recently, inspired by recent headlines about the alleged vitamin D deficiency pandemic (see Manson 2016), I’ve rebooted my vitamin D article, Vitamin D for Pain. I’ve now begun the process of turning into a full-blown topic review (it was quite limited before), and there are tie-ins to several other topics: there’s an updated chapter in the trigger points tutorial about it; it’s an interesting candidate explanation for morning back pain; it may explain excessive delayed-onset muscle soreness; and vitamin D is now represented in both my supplements review and 34 Surprising Causes of Pain (along with chronic low-grade inflammation, which was also added recently).

Stretching for trigger points is another topic that generated a large, challenging (nightmarish!) batch of recent updates, most of which was all based on a great analogy that just hit me one day: that trying to stretching a trigger point is “like trying to stretch a knot in a bungie cord.” It’s a useful mental image that shoved me down a deep rabbit hole, forcing a lot of complicated rewriting. It’s most thoroughly realized in the trigger points book (multiple improved sections), but there’s also a free abridged version in Quite a Stretch and related content in Micro Muscles and the Dance of the Sarcomeres.

And lots more:

  • There have been four significant updates since early Oct to one of the site’s most important articles, Your Back Is Not Out of Alignment:
    1. some new guidelines for structuralism-free treatment
    2. a good rant about a common mainstream source of structuralist fear-mongering
    3. a new section about the journal Manual Therapy not wanting to be about manual therapy anymore,
    4. one of the best science updates in ages: an excellent example of how disk herniations are less clinically significant than most people expect …but still matter
  • I’m particularly proud of the writing in a new section in the placebo article: “Placebo minimization: what if we sell it with a wink?”
  • My reviews of both chiropractic controversies and acupuncture have gotten some attention for the first time in quite a while.
  • The site’s newest article, about subtle systemic inflammation, continues to grow and improve … and continues to be extremely interesting to me.
  • My very personal article about lump in the throat (lump in the throat) continues to get even more amazingly popular (now pulling in about 8000 readers per month, which is great for a 2-year-old article). As my own experience fades into a bad memory, I’ve done what I hope is a final round of personal updates; more important, I’ve now started the process of turning it into a more comprehensive guide to all the possible causes of this bizarre problem.