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In 2016 I started systematically logging all updates to this website, large and small, flattering or embarrassing — anything that would be of any interest to a keen reader. The total number of logged updates just hit 1000. Like most arbitrary milestones, it’s kind of silly to celebrate it. Despite the policy, there are still plenty of minor unlogged updates, and many significant updates in past years were never logged, so the real total is probably something like 10,000.
But still: 1000 logged updates! It feels like a good threshold to reach early in 2017.
You can always find summaries to the most recent 50 updates on the What’s New? page, and here’s the last few (including a whole new article):
A major new report on marijuana reports that there is now strong evidence that it is an effective treatment for “chronic pain” — which covers a lot of ground — as well as the painful spasticity caused by multiple sclerosis (the only specific painful condition for which there was enough evidence to draw a conclusion). How well does it work? The effect is described as “clinically significant” but “modest.” So it won’t work miracles in most people, but it will help — and we also know, from this report and others, that it’s very safe, particularly if you don’t smoke it.
Beginners should mostly avoid edibles (dosing is awkward and unpredictable), consider learning to vaporize, and generally favour CBD-rich strains.
And so marijuana finally makes it to the pain tips page! Overdue — some would say extremeley overdue — but the evidence is rock solid now, and that NASEM citation is bedrock.
Tricky little problem: a good summary of a complex topic can make readers overestimate their comprehension. “Oh, I’ve got it now! Case closed.” Listen to the story on the BBC, a few minutes.
And probably this summary of the problem with summaries is making you overconfident in your knowledge of the problem with summaries right now.
If there’s anything I’ve learned in a decade of intensive science reporting it’s that science is immune to dumbing down: everything is the tip of the iceberg, the fin of the shark, that one fossil poking out of the ridge. Tug on any thread in science and you find another whole damn wardrobe.
Psychologist James C. Coyne, PhD, has a nice new website, CoyneOfTheRealm.com. Dr. Coyne is best known for his debunking of unrealistic stories about beating cancer with will power and optimism, and also a broader interest in exposing crappy science reporting. (He got interested in the topic when Psychology Today “complained my blog posts discouraged Pharma adverts.”) I’m recommending his excellent blog specifically — well worth signing up for email updates if the subject matter interests you — plus his ebooks on mindfulness and positive psychology.
For at least fifteen years, I’ve assumed that lots of sitting is a risk factor for low back pain. I’ve given a lot of advice based on that belief. Unfortunately…
“I’ve made a huge mistake.”
GOB Bluth, Arrested Development
My belief was wrong. A lot of time spent in chairs may be unhealthy in some ways, but they are not the back torture device I once thought. The evidence, which was available the entire time, clearly shows that there is no important link between a lot of sitting and back pain. See Chen et al for one the most recent scientific reviews, but there’s quite a bit more. It’s just not a thing. Treating it like a thing has been one of the most worst bloopers of my career.
How did this happen? Easy: I just never checked. My assumption felt safe enough that I never got that sinking citation-needed feeling. I thought I had bigger research fish to fry. There are a lot of things to pay attention to in musculoskeletal medicine. Surprisingly, I never even stumbled across the evidence, even though I have delved deeply into many similar topics, such as the absence of a clear link between posture and back pain.
I’ll probably be stumbling across minor references to this assumption for years to come in my writing. Meanwhile, three key pages have already been repaired: my report on The Trouble with Chairs, my microbreaking guide, and my low back pain book, where I had to actually completely trash an entire chapter (which I haven’t had to do in years) and write a replacement from scratch. Being wrong is a lot of work!