Detailed guides to painful problems, treatments & more

What’s New on

New featured articles, updates to articles, recent blog posts, and noteworthy new scientific papers

See also the about page, complete articles index, and sitemap.

I have been expanding and upgrading this website for 20 years now, and full-time since 2010. Useful new references are added almost daily. I am always working on an endless list of improvements, and corrections and mea culpas are always the highest priority items. This page lists everything that’s new or changed lately … or just Google for content that’s new in the last month or year. ~ Paul Ingraham, PainSci Publisher

Never Miss an Update — Subscribe!

Or get premium posts
& support the salamander with PainSci Membership. See also “better” and “awesome” plans.

The 10 newest featured articles on (out of 240)

  1. Bone on Bone » Jun 2024
  2. DMSO for Pain » Jun 2024
  3. Manual Therapy: What is it, and does it work? » Jan 2024
  4. Reluctantly Reconsidering RESTORE » Dec 2023
  5. Whole Body Cryotherapy for Pain » Nov 2023
  6. Does Pandiculation “Reset” Muscle Tone? » Jan 2023
  7. The Double-Edged Sword of Imaging to Diagnose Pain » Mar 2022
  8. The Tibiofibular Joint and Knee Pain » Feb 2022
  9. Ozone Therapy for Pain » Dec 2021

The last 60 updates to featured articles and tutorials

Like good footnotes, update logging sets apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages. I log any change to articles that might be of interest to a keen reader.

Current Update Stats — 60 updates to 33 articles & books in 209 days, breaking down into 20 major updates, 24 medium, 15 minor. That’s every 3.5 days in recent history; there have been 1720 updates since comprehensive logging started in mid-2016 ?Comprehensive update logging started in the summer of 2016. Prior to that, I only logged major updates for the most popular and controversial articles. (about one every other day) … plus very roughly ten thousand more since the early 2000s. See the complete update archives.

showing of 60 recent updates

MJul 16Quite a Stretch — Revised intro — Thoroughly re-wrote the introduction and summaries (which are often used when the article is cited by other articles). It’s amazing to me that I can re-visit one of my oldest and most polished articles and immediately find many ways to improve it! Revising introdutions and summaries isn't all that significant for readers, at least not consciously, but it is an art form unto itself — it takes a great deal of thoughtful work to capture as many key points as possible from the body of the article and compress them as much as possible.
LJul 5Many Pages — Significant under-the-hood upgrade to the site. PainSci grew out of two different “content management systems,” which has slowly become a major publishing challenge. This update begins the process of merging them. While largely invisible to visitors, there are a few useful changes: for instance, bibliography pages now “know about” blog posts, and can say which five posts they’ve been cited in. That was a long time coming, I can tell you!
MJul 4Knee Replacement Surgery Doubts — New section: “Severe arthritis: does ‘bone-on-bone’ mean you need surgery? You should be more worried about surgeons who say BOB than your arthritis.”
MJul 4Bone on Bone — Miscellaneous minor improvements, added audio versions, integrated with other closely related articles, especially Knee Replacement Surgery Doubts.
LJul 3Bone on Bone — Extensive minor improvements.
LJul 1Bone on Bone — Publication.
MJun 29DMSO for Pain — Added a section about DMSO2.
MJun 28DMSO for Pain — Numerous improvements, individually minor, collectively significant. Great example of a “day after” update! Twenty-four hours ago I felt done and I was out of ideas, but I just spent 90 minutes improving it.
LJun 24Opioids for Chronic Aches & Pains — Major improvements and updates, adding more information and perspective about the drug war, opioid phobia, and more and newer evidence about the efficacy of opioids for acute and chronic pain.
SJun 19You Might Just Be Weird — Minor improvements.
MJun 11Chronic Pain as a Conditioned Behaviour — A bunch of editing.
MJun 4The Trouble with Chairs — Science update. After flip-flopping repeatedly over the years on the question of whether or not sedentariness is a threat to backs, I have given up and shifted this article to an “it’s complicated” position. Good contradictory studies have now been cited. The story is now about the perpetual controversy and uncertainty.
MJun 4Alternative Medicine’s Choice — Science update. Added a couple citations about the harm that can be done by health care institutions and (closely related) physicians who lack empathy.
MMay 31The Complete Guide to Low Back Pain — Minor addition, posture chapter — Added a bit of a rant, some summary perspective and colour: “Chasing posture as a cause of back pain is a dead end.”
SMay 29The Complete Guide to Patellofemoral Pain Syndrome — Editing, multiple topics — Just editing, but a noteworthy batch of edits to several chapters. I made minor corrections and adjustments to every recently added or revised chapter, and some small but (I hope) meaningful clarifications to how “resting” is presented as a treatment strategy.
LMay 27The Complete Guide to Low Back Pain — New chapter, risk factors — New chapter, inspired by new evidence, about how being out of shape is probably worse for your spine than biomechanical glitches, and how back pain patients are eat more junk food.
MMay 22The Complete Guide to Low Back Pain — Revised, vicious cycle hypothesis — This is mostly an old chapter, but reframed, revised, with significant clarifications and caveats added. Despite being mostly the same, it’s quite different!
LMay 22The Complete Guide to Low Back Pain — New chapter, anxiety and back pain.
SMay 16Reluctantly Reconsidering RESTORE — Conversion from a members-only blog post to a free article in the main PainSci library, with a variety of minor adjustments.
MMay 15The Complete Guide to Low Back Pain — More detail — More and better information about the dramatic over-prescription of anticonvulsants.
MMay 15The Complete Guide to Low Back Pain — Addition — Added an important clarification and citation about Nachemson’s famous flexion loading chart.
LMay 9Bone on Bone — First “draft” published as a blog post (actually it was quite a polished members-only post, but also destined to be the introduction to this longer article).
LMay 5Chronic Pain as a Conditioned Behaviour — Added a substantial new review of the science and plausibility of conditioned pain, especially regarding a new experiment by Kang et al.
SMay 438 Surprising Causes of Pain — Added another good example of early onset Parkinson’s that looked like typical sports injuries.
LMay 2The Complete Guide to Patellofemoral Pain Syndrome — New sub-topic, patellofemoral joint replacement — Added a substantial discussion of patellofemoral joint replacement, and made a number of other modest improvements to the surgery chapter.
LApr 17Whole Body Cryotherapy for Pain — New section: “Ice baths for performance? No!”
LApr 16The Complete Guide to Low Back Pain — New chapter.
LApr 15Water Fever and the Fear of Chronic Dehydration — New section: “Dehydration itself may be less potent than fearing it.”
SApr 14The Complete Guide to Low Back Pain — Added exercise advice — Oddly, the summary of all treatment recommendations chapter had nothing to say about exercise until now. Better late than never!
LApr 14Achilles Tendinitis Treatment Science — New section: “Treating calcific Achilles tendinitis with surgery.”
SApr 13The Trouble with Chairs — Science update. Added another new citation about the weekend warrior exercise pattern, and it’s another quite reassuring one (O’Donovan et al.).
LApr 13The Complete Guide to Low Back Pain — Substantial re-write, exercise chapter — I added a new section about the science of back exercise, based largely on a major new review (IJzelenberg) … and then kept going and significantly improved the whole chapter.
SApr 3The Complete Guide to Patellofemoral Pain Syndrome — Minor upgrades, patellofemoral joint pressure — After publishing part of this chapter as an excerpt, I made several minor improvements, and added one simple diagram.
MMar 27Whole Body Cryotherapy for Pain — Significant improvements to the safety section. Always a good section to improve.
SMar 22A Rational Guide to Fibromyalgia — Minor improvements, alcohol section — Added some reader comments, a footnote about neuroticism and alcohol, and did a little editing.
LMar 20A Rational Guide to Fibromyalgia — New section, about alcohol use disorder and alcohol hyperalgesia.
SMar 16Chronic Pain and Inequality — Science update: cited Boyd on poor demographic reporting and representation in pain research.
LMar 5The Complete Guide to Patellofemoral Pain Syndrome — New chapter, self-exam for patellofemoral joint tenderness.
MMar 4The Complete Guide to Trigger Points & Myofascial Pain — Science update, Botox injection — There is no significant new evidence, but the chapter was missing some significant old evidence. I added that, and did some general editing and revising while I was at it. Bottom line unchanged.
MMar 3Painful Lessons — Added two new items: “Pain is mainly a function of complex and messy physiology,” and “Quackery and crankery is the rule for chronic pain treatment, not the exception.” Elaborated on “the science is a mess.”
MMar 1Reviews of Pain Professions — Added “Manual therapy (a category of professions).”
SMar 1Manual Therapy: What is it, and does it work? — Substantial editing, with particularly meticulous improvements to the article summary, which is widely reproduced wherever relevant around the site. “Integration” with the rest of the library is a standard production step for all articles — linking to and from other articles — but it was particularly extensive here, because the topic is so important to as a whole. There are many dozens of appropriate places to summarize manual therapy, or some aspect of it, and link to more information, so it was very important to have a highly polished summary.
MFeb 29Whole Body Cryotherapy for Pain — Added a few citations. More detail and polish throughout the article.
MFeb 28A Historical Perspective On Aches ‘n’ Pains — General improvements and modernization. I particularly fleshed out the “new” section (from 6 years ago!) about why “poor quality healthcare for chronic pain and injury is still the rule.”
MFeb 27Painful Lessons — Added more thoughts about how skepticism goes wrong, and the accessibility and importance of resistance training.
SFeb 26The Complete Guide to Chronic Tension Headaches — Added detail, chinook headaches — Added some conspicuously missing detail about how cinook headaches work.
SFeb 17You Might Just Be Weird — Added an item about variants of the shape of nasal passages and sinuses being a plausible explanation for the phenomenon of chinook headaches.
SFeb 10Massage Therapy Side Effects — Added citation to a case study of a gluteal blood vessel seriously damaged by “deep tissue” massage (see Sun). Also added a fairly substantive footnote about the reaction this item got on social media.
LFeb 9The Complete Guide to Patellofemoral Pain Syndrome — New section, gait retraining.
SFeb 8Tissue Provocation Therapies in Musculoskeletal Medicine — Minor editing. Added a more or less complete list of “provocation therapies,” also serving as a partial table of contents.
MFeb 2Does Fascia Matter? — Added information, origins section — Discussed naprapathy as a great example of the older, deeper roots of modern fascia pseudoscience.
MJan 31Does Posture Matter? — Editing, conclusion — “Just” a bunch of editing and polish. Sometimes that is a “just,” but in this case I actually worked really hard on the language. I’ve been saying this stuff for many years… it deserves a really good summary and mic drop! Also added an image and some supplementary detail.
LJan 22Tissue Provocation Therapies in Musculoskeletal Medicine — I shared a quote from this article about scraping massage, and it was extremely popular, so I decided to do a wave of updates to this article for the first time in several years. I upgraded the summary, added detail and citations to the eccentric loading section, and added two whole new sections: “The SAID principle: another basic concept in adaptation” and “Is trigger point therapy “provocative”? I also added a more detailed description of the “potency bias.”
MJan 20Guide to Repetitive Strain Injuries — Updated citations for the claim that "a lot of regular exercise does not inevitably destroy joints." I added a couple news ones (Voinier, Weng), a couple old ones (Luke, Williams), and improved the annotations.
MJan 19Anxiety & Chronic Pain — Extensive improvements to the section, “Reasonable doubt: the special threat of health anxiety (hypochondria).” Nothing of substance has changed, it’s just more and better on an important sub-topic. The section is in this guide’s members-only area, but the section is also available as a free post for a while. I added a new audio version.
SJan 12Complete Guide to Plantar Fasciitis — Minor improvements, recommendations round-up — Integrated and updated barefoot running advice, and other minor changes.
MJan 12Complete Guide to Plantar Fasciitis — New content, barefoot running effects — Added specific information about the effect of barefoot running on plantar fasciitis, and related minor editing. This chapter now fits in better with the new one about barefoot walking.
LJan 11Complete Guide to Plantar Fasciitis — New chapter, barefoot walking.
SJan 3Neuropathies Are Overdiagnosed — More and better detail on the over-prescription of anticonvulsants.
LDec 22The Complete Guide to Patellofemoral Pain Syndrome — New content, tight IT band chapter — Added a fascinating and extreme case study that perfectly illustrates the potential relationship between ITBS and patellofemoral pain (though still exasperatingly unclear). Includes audio version.

The last 20 blog posts

Blog posts are smaller and more ephemeral than the articles in PainSci’s main library. I blog about many topics as I work on books and permanent articles. There are 1175 posts dating back to 2010.

  1. Walking back the WalkBack Trial 🔈 » Jul 18, 24
  2. A test of lidocaine for neck pain » Jul 9, 24
  3. Modern Pain Care interview » Jul 9, 24
  4. Empathy is medicinal » Jul 6, 24
  5. Bone-on-bone, Part 2: Should we ever say it? (Member Post) 🔈 » Jul 3, 24
  6. Dancing With Dog Toys + DMSO » Jun 26, 24
  7. The trouble with the OPAL trial of opioids for back pain 🔈 » Jun 20, 24
  8. Debunking for a living » Jun 19, 24
  9. Weird bones are normal 🔈 » Jun 18, 24
  10. Diagnosis or the patient? What matters more for prognosis » Jun 14, 24
  11. Can pain be conditioned? The plausibility and the evidence 🔈 » Jun 11, 24
  12. Pain self-efficacy » Jun 1, 24
  13. Ruben’s miracle: extreme back pain eliminated by ketamine 🔈 » May 31, 24
  14. Back pain: not a couch potato problem » May 25, 24
  15. Is chronic pain a lifestyle problem? » May 24, 24
  16. A rare remission of a savage headache » May 24, 24
  17. What’s “cholesterol denialism”? » May 24, 24
  18. A new molecule to blame for pain: “Xist” » May 22, 24
  19. Have scientists discovered inflammation’s master switch in the vagus? 🔈 » May 20, 24
  20. So sorry about my last post (about trusting pain) 🔈 » May 17, 24

The last 20 bibliography items with beefier summaries

Many scientific papers added to the bibliography are boring and utilitarian, but some are much more interesting, like small blog posts about the science — like the recent highlights are listed here. The are roughly 4000 more items in the whole bibliography, ~750 of them more substantively annotated.

  1. DMSO Represses Inflammatory Cytokine Production from Human Blood Cells and Reduces Autoimmune Arthritis. Elisia et al., 2016, PLoS One. » added Jun 2024
  2. DMSO induces drastic changes in human cellular processes and epigenetic landscape in vitro. Verheijen et al., 2019, Sci Rep. » added Jun 2024
  3. Efficacy of prescribed opioids for acute pain after being discharged from the emergency department: A systematic review and meta-analysis. Daoust et al., 2023, Acad Emerg Med. » added Jun 2024
  4. Physician Empathy and Chronic Pain Outcomes. Licciardone et al., 2024, JAMA Netw Open. » added Jun 2024
  5. Novel approach towards musculoskeletal phenotypes. Meisingset et al., 2020, Eur J Pain. » added Jun 2024
  6. {Order Effects on the Rubber Hand Illusion Expectancy: A Replication and Extension of Lush (2020)}. Tsuji et al., 2024, Collabra: Psychology. » added May 2024
  7. Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl et al., 2021, BMC Musculoskelet Disord. » added Apr 2024
  8. Trajectories of disability in low back pain. Andersen et al., 2022, Pain Rep. » added Apr 2024
  9. Don't be a nocebo! Why healthcare organizations should value patients' expectations. Poulter et al., 2024, Frontiers in Psychology. » added Apr 2024
  10. Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study. Moosmayer et al., 2023, BMJ. » added Mar 2024
  11. Associations of the 'weekend warrior' physical activity pattern with all-cause, cardiovascular disease and cancer mortality: the Mexico City Prospective Study. O’Donovan et al., 2024, Br J Sports Med. » added Mar 2024
  12. Exercise therapy for treatment of acute non-specific low back pain: a Cochrane systematic review and meta-analysis of randomised controlled trials. IJzelenberg et al., 2024, Arch Phys Med Rehabil. » added Mar 2024
  13. Age, Race, Ethnicity, and Sex of Participants in Clinical Trials Focused on Chronic Pain. Boyd et al., 2024, The Journal of Pain. » added Mar 2024
  14. Short term effects of various water immersions on recovery from exhaustive intermittent exercise. Pournot et al., 2011, Eur J Appl Physiol. » added Feb 2024
  15. Reconsidering high intensity zones: its role in intervertebral disk degeneration and low back pain. Sima et al., 2024, Eur Spine J. » added Feb 2024
  16. Large Buttocks Hematoma Caused by Deep Tissue Massage Therapy. Sun et al., 2015, Pain Med. » added Feb 2024
  17. Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial. Júnior et al., 2024, PLoS One. » added Feb 2024
  18. Patients and clinicians managing patellofemoral pain should not rely on general web-based information. Silva et al., 2020, Phys Ther Sport. » added Nov 2023
  19. Inflammation-induced mitochondrial and metabolic disturbances in sensory neurons control the switch from acute to chronic pain. Willemen et al., 2023, Cell Rep Med. » added Nov 2023
  20. In search of conditioned pain: an experimental analysis. Kang et al., 2023, Pain. » added Nov 2023

What’s new on this page about new stuff?

Ironically, I’ve actually updated this page quite a few times without logging the change. 😜

2023 — An update to the updates page?! It’s so meta! It’s not going to happen often, but I just finished improving the whole update-logging system in several ways. Most of the upgrades are "under the hood," but there is now much better filtering for the update list, and the foundations have been laid for more improvements in the future.

2016 — Publication.

PainSci Member Login » Submit your email to unlock member content. If you can’t remember/access your registration email, please contact me. ~ Paul Ingraham, PainSci Publisher