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Legacy update log for the neck pain tutorial

This is a listing of older updates made to the neck pain tutorial. They are provided for historical interest only, a “paper trail” demonstrating how the document has been maintained. Newer updates are listed in the tutorial itself.

2016Major update: Broadened scope of section to include all pain killers. Added a summary of opioids, and a guide to experimenting with the over-the-counter ones; added more science; merged and edited previously separate sections on rebound pain and muscle relaxants. [Section: Pain killers and muscle relaxants.]

2016Correction: Removed overconfident statements about the clinical significance of the effects of psychoactive drugs, plus related minor updates. [Section: Estimating the importance of trigger points in your own case.]

2016Minor update: Some editing and new caveats. [Section: Diagnostic numbing of facet joints.]

2016Update: Added new intro to section about distorted body image. [Section: Subluxation: can your neck be “out”?]

2016Science update: Added citation about the efficacy of ibuprofen for headache. [Section: Pain killers and muscle relaxants.]

2016Science update: Added some particularly good science to shore up the personal anecdote added in January. [Section: Could it be arthritis? Is your spine degenerating? Probably not, no.]

2016Improved: Added a new key point about how to recognize the pain of a nerve root pinch. [Section: How can I tell if there’s a pinched nerve?]

2016Science update: New footnote supporting the use of education (like this tutorial!) to treat chronic pain. [Section: Introduction.]

2016Minor update: Added a good personal ancedote … because my spine is degenerating! Also, a footnote about surprisingly painless joint damage. [Section: Could it be arthritis? Is your spine degenerating? Probably not, no.]

2015Science update: Added some hard evidence on the minor (non-lethal) risks of SMT from Carlesso 2010. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation and cracking of the spinal joints.]

2015Science update: Added an interesting reference to Carlesso 2013 with some discussion of the implications. [Section: Neck pain versus back pain: some similarities and differences.]

2015Science update: Added a humility citation, conceding the absence of scientific evidence that massage helps neck pain. Also, modernization summary of trigger point therapy. [Section: Introduction to treating your own neck trigger points.]

2015Science update: Added a little more information about the nature of uncovertebral joints. [Section: Why does a crick feel the way it does?]

2015Upgraded: More and clearer red flag details, especially about spinal cord trouble (myelopathy). [Section: “What if there’s something really wrong with my neck?” Safety information!]

2015Major update: Completely rewritten and greatly expanded, with much more science, emphasizing strength as a worthwhile treatment option. [Section: Build your neck muscle strength and endurance.]

2015Revised: Editing and some new science about changing head posture. [Section: Will strength improve neck posture/curvature?]

2015Minor update: More data on neck pain recovery rates [Section: Prognosis: What’s the worst case scenario for neck pain?]

2015Minor addition: Added a patient anecdote about a strange muscle spasm experience … which I know all too well. [Section: Is it a spasm? The spasm puzzle.]

2015Minor update: Added an expert quote. [Section: Does abnormal curvature hurt? Not much! The neck posture myth.]

2015Science update: Added brief example of nerve pinch by vertebral artery twistiness. [Section: How can I tell if there’s a pinched nerve?]

2015Science update: Added three good references and a diagram about how much “wiggle” room nerve roots have. [Section: Is it a pinched nerve? Rarely! The nerve pinch myth.]

2015Expanded: Added about 350 words about neck circle safety. [Section: Mobilizations or “wiggle therapy”.]

2014Science update: Added a new good-news study about massage for neck pain. [Section: The case for myofascial trigger points as a major neck pain villain.]

2014Minor update: Upgraded references on neck pain recovery rates. [Section: Prognosis: What’s the worst case scenario for neck pain?]

2014Science update: Added some important acknowledgements that the science of trigger points is a bit half-baked, and linked out to much more information for the curious. [Section: The case for myofascial trigger points as a major neck pain villain.]

2014More content: Explanation of the difference between a subluxation and an MID. [Section: Subluxation: can your neck be “out”?]

2014Science update: Added citation to a key 2012 study of the effectiveness of adjustment for neck pain. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation and cracking of the spinal joints.]

2014New: A new section, but also a summary of an existing free article. [Section: Digital Motion X-Ray.]

2013Minor update: Added a (fascinating) footnote about the myth of anaesthetic paralysis. [Section: Reality checks: some popular treatments that are particularly silly.]

2013Minor yoga update: Added a reference and paragraph about the risks of yoga, which are minor but real, especially for neck pain. [Section: Will stretching help neck pain?]

2013Minor science update: Added a tiny, flawed study about yoga for neck pain (for what little it’s worth). [Section: Will stretching help neck pain?]

2013New evidence: Rare good news: the first good quality scientific test showing that reducing fear is actually good medicine. The section got a decent editing as well. [Section: Relaxation and the confidence cure.]

2013New section: No notes. Just a new section. [Section: A massage success story.]

2012Science update: Added evidence that the stakes are high with chronic pain: it may even shorten lives. [Section: Neck pain myths busted here!]

2012Science update: Added a key reference about the effectiveness of massage for back pain, with the (safe) assumption that it probably applies to neck pain as well. [Section: The case for myofascial trigger points as a major neck pain villain.]

2012Science update: A new study shows that massage therapists cannot reliably find the side of pain by feel — good evidence that no gross spasm (or other structural factor) is usually involved. [Section: Is it a spasm? The spasm puzzle.]

2012Minor update: Added some creative problem-solving for hot climates. [Section: Accidental icing: avoid drafts at night.]

2011Minor update: Added a minor but odd note about “sensory annoyances” like hats and collars. [Section: Ergonomics are probably more important than posture.]

2011Minor update: Added some unusual research about the risks heavy metal “head-banging” — a fun example, for perspective. [Section: Is it a strain? Probably not! The muscle strain myth.]

2011More content: Added scientific cases studies, examples, pictures and video of true dislocation and abnormal anatomy to help drive home the point that even significant spinal joint dysfunction can be surprisingly harmless … never mind subtle joint problems. [Section: Subluxation: can your neck be “out”?]

2011Minor science update: Cited a study about yoga and stretching for back pain. [Section: Will stretching help neck pain?]

2011New section: This section is a summary of an important concept that’s been available in a free article since late 2008, but also needed to be emphasized here. Now it is. [Section: From the frying pan of injury pain to the fire of trigger point pain.]

2011Minor update: Added a reference about the poor overall quality of online information about common injuries. See Starman et al. [Section: Neck pain myths busted here!]

2011Added a fun thing: I can’t believe I didn’t know about inflatable neck extenders until now! [Section: Pull my neck! The potential of traction.]

2011New section: More information about an important characteristic of muscle-dominated neck pain. [Section: “Out of nowhere”: seemingly random episodes of neck pain.]

2011Major update: Totally renovated section: re-written, reformatted, expanded, upgraded. A few new checklist items were added, most were expanded, and all were clarified. A separate and handier “quick” checklist was added to the existing “slow” checklist. [Section: Estimating the importance of trigger points in your own case.]

2011Major update: Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.

2011Upgraded: New artwork from PainScience.com artist Gary Lyons, plus some important new references. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation and cracking of the spinal joints.]

2010Updated: Updated with an important story about a disastrous example of neck stretching that backfired. Not just for customers: this particular section is a short version of a new free article. [Section: Will stretching help neck pain?]

2010Minor update: Some good new science cited in the introduction, about the overall effectiveness of manual therapies. See D'Sylva et al. [Section: Neck pain myths busted here!]

2010Major Update: Rewriting and expansion of the Special Supplement on spinal manipulative therapy. [Section: Subluxation: can your neck be “out”?]

2010Update: New science confirms that helmets do not cause neck injuries — they just keep your head safe. However, minor injury remains likely and problematic. [Section: Is it a strain? Probably not! The muscle strain myth.]

2010New cover: At last! E-book finally has a “cover.”

2010Science update: Updated with a summary of a bizarre experiment with muscle relaxants that had quite surprising results. [Section: Reality checks: some popular treatments that are particularly silly.]

2010Minor update: Update with another recent study showing that strength training doesn’t work. [Section: Will strength improve neck posture/curvature?]

2010Major update: Completely overhauled and substantially expanded, and polished several relevant bibliographic records. [Section: Will strength improve neck posture/curvature?]

2010Rewritten: Completely overhauled and substantially expanded, and polished several relevant bibliographic records. [Section: Does abnormal curvature hurt? Not much! The neck posture myth.]

2010Science update: Added an interesting reference about how muscle relaxants are surprisingly ineffective. [Section: Reality checks: some popular treatments that are particularly silly.]

2009Minor update: Shored up substantiation of the relationship between migraines and trigger points. [Section: The case for myofascial trigger points as a major neck pain villain.]

2009New section: First new section since the huge update in the fall, a short-but-useful section. [Section: A poke in the disc! Cervical provocation discography as a method of diagnosis.]

2009Huge upgrade: Over the past several months, the neck pain tutorial has more than quadrupled the amount of information it offers, and it is now book-length at more than 40,000 words. Almost every single section was overhauled, and many new sections were added. Dozens of references to more recent scientific research were integrated and their significance explained, including several good new studies less than six months old.