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So many citations are utter nonsense if you take the time to look. I encounter all the time as I work, but recently the phrase “better citation needed” popped into my head. So I doodled this up for my article Bogus Citations:
[better citation needed]
Not a big deal on a small screen, but nice and big and bold in a larger window, like an image of text but quicker to load. It’s just text styled with CSS, very simple, but with one nifty new trick I learned: it uses viewport percentage units so that the font-size scales with the size of the window it’s in. I have wanted this “simple” text-styling effect countless times over the years. Where have you been all my life, VPUs?!
Massage therapists and others who do “energy work” tend to be contemptuous of those who don’t. (This is a sign of their spiritual sophistication, I assume.) Laura Allen, massage therapist, author of Excuse Me, Exactly How Does That Work? Hocus Pocus In Holistic Healthcare:
There are some strange ideas floating around out there about massage therapists who stick to the practice of massage without throwing in energy work. I laugh with my clients. I grieve with my clients. I empathize or sympathize with whatever emotional time they might be going through and at times comfort them. Leaving energy work out of my practice does not mean I am some kind of uncaring robot just going through the physical motions. But that seems to be the general characterization a lot of people make about us.
I have often encountered this attitude towards energy atheism, as though my inability to see human interactions through a spiritual lens is stunted and pitiable. I think it’s actually the other way around. It’s far more rewarding to try to understand why life actually feels the way it does, rather than chalking it all up to unknown and unknowable forces.
There is infinite room in psychology and biology for profound, meaningful shared experiences. It isn’t necessary or helpful to attribute strange and interesting sensations to poorly defined “energy.” Actually, it’s a cop-out, a failure of imagination and knowledge, a grossly oversimplified reckoning of the amazing richness of human nature.
These thoughts originally came up in a Facebook discussion. I refined them and baked them into my article about Therapeutic Touch is Silly.
A reader asked me that. It’s not actually quite as outrageous as it looks. It’s really just a whole-body TENS machine treatment (mild electrical stimulation of tissue). But it does reek rather amusingly of “What could possibly go wrong?” And, medically speaking, it’s waaaay out in left field, and unlikely to be good for anything. If nothing else, it was doomed to extinction by economics: the high cost of the infrastructure and equipment to deliver such treatments is way out of proportion to the slim hope of any significant benefit.
Plus, can you imagine the lawsuits it would generate today?
Well this sucks: reading backlit devices like iPads before bed probably hurts sleep, according to a new study. A dozen people were studied for 14 days, half reading regular books and half reading backlit e-books each evening. Blood tests, brain waves, and other measures showed that the e-book readers were less sleepy, took longer to fall asleep, shifted their circadian rhythm later, were less alert the next morning, and produced much less melatonin (the time-to-go-to-sleep hormone).
Reading a light-emitting eBook in the hours before bedtime likely has unintended biological consequences that may adversely impact performance, health, and safety.
Not really surprising, I suppose. But so unfortunate. E-books are one of the best things about The Future. They are the main reason I’ve bought any mobile device for almost a decade. They’ve changed my life as much as any technology ever has — like earning a living from selling them, for instance — but perhaps in worse ways than I realized.
Only a half dozen study subjects read e-books for four hours each evening. That’s a lot of reading. I’m lucky to squeeze in a half hour at the end of the day. And I mostly read on a well-dimmed iPad, usually with inverted colours, which probably emits an order of magnitude less light than what was studied here.
And there are also other options, like e-ink devices, or shifting the display colour away from daylight hues with like software like f.lux (sadly, unavailable on iThings). With some moderation and precautions, the risk is probably not great — or at least no greater than many other ubiquitous challenges to sleep in modern living.
Still, it’s really a shame we might have to add e-books to that list.
I’ve added this science to my main insomnia article.
“Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness”
Even at their sharpest, brains mistake new stimuli for scary old wounds. We feel what we fear. And what if we fear a lot? What if our judgement is poor? This grave tweet grabbed my attention recently:
The worst diseases known to science pale in comparison to the chronic and untreatable nature of somatoform disorders.
Mark Reid, MD, Twitter, @MedicalAxioms, Apr 16, 2015
Somatoform disorders are mental illnesses that cause bodily symptoms, including pain (especially pain). There are several sub-types of somatoform disorder, such as conversion disorders, in which emotional stress is “converted” into physical disabilities like blindness or trouble swallowing. They are a big deal and an extreme example — maybe the most extreme example — of how pain is weird, because it is entirely generated by the brain… which can be fooled. By a red herring on an MRI. By a doctor who warns, “This might need surgery.” By a Google search that turns up a scary possibility. By the sneaky side effect of a drug. Or by the haze of mental illness.
Even “just” depression and anxiety are strongly associated with chronic pain, because they warp our reasoning towards worst case scenarios, but that’s just the tip of the iceberg. Imagine how much worse it can be, how completely a mind might succumb to the fear that something dangerous is going on.
But imagine it carefully, please.
“Central sensitization in patients with rheumatoid arthritis: a systematic literature review”
Meeus et al. concluded that there are signs of this, from analyzing 24 scientific papers (although “more research is needed,” of course). RA mainly attacks joints, but patients often experience pain elsewhere, and in response to a variety of stimuli, and symmetrically — all of which are a good fit for central sensitization. Also, as with many other chronic pain conditions, in RA there’s often more (or less) pain than detectable tissue trouble (e.g. see Younes), indicating that the progress of the disease is probably not the only driver of pain. Sensitization may be the best way to explain this.
Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation that delivers low intensity direct current stimulation to the brain through electrodes applied to the skin over the target area. It has been found to modulate cortical excitability at the target site leading some researchers to investigate it as a possible treatment for chronic pain…
Unfortunately, the authors of a new British Medical Journal editorial conclude that it is:
Not recommended; early promise is fading fast as trial methods improve.
The null hypothesis strikes again! Bummer. (Null hypothesis primer: in plain English, the null hypothesis says, “Most ideas turn out to be wrong.” And therefore most weakly positive results will turn out to the product of bias and wishful thinking. Read more about the null.)
In light of this uncertainty, I suggest that we should not be explaining trigger points as muscle knots, but rather that they are simply soft tissue sore spots of an unknown origin!
STSSOAUO doesn’t exactly roll of the tongue, but I like the sentiment: by all means, let’s (please) start regularly conceding our ignorance of the nature of this beast. Every book on the subject still reads like it’s a nearly-solved mystery, with just a few details to be filled in, which is just a tad overconfident.
And yet I don’t really have any beef with the term “trigger points.” Everyone acknowledges that there’s a painful phenomenon, and we have to call it something. Mystery points? Sufferin’ spots? Humility matters more than the label.
Filed under “Pain is Weird.”
The Salt Spring Island terrain in the video is gorgeous, and in my backyard. (I’ve spent a bunch of time on that island.) You can’t beat yoga under an arbutus tree!