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

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The 10 newest featured articles on (out of 237)

  1. Manual Therapy: What is it, and does it work? » Jan 2024
  2. Whole Body Cryotherapy for Pain » Nov 2023
  3. Does Pandiculation “Reset” Muscle Tone? » Jan 2023
  4. The Double-Edged Sword of Imaging to Diagnose Pain » Mar 2022
  5. The Tibiofibular Joint and Knee Pain » Feb 2022
  6. Ozone Therapy for Pain » Dec 2021
  7. Mind Over Pain » Sep 2021
  8. What Works for Chronic Pain? » Jun 2021
  9. Counterstimulation, Counterirritation, and Gate Control » Jun 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 30 articles & books in 229 days, breaking down into 22 major updates, 21 medium, 16 minor. That’s every 3.8 days in recent history; there have been 1692 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

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.
LDec 22The Complete Guide to IT Band Syndrome — New content, iliotibial tightness 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.
LDec 20The Complete Guide to Patellofemoral Pain Syndrome — Revised and expanded, trigger points chapter — The section had been short and basic for many years, and many readers would never have guessed how much more I’ve written about this topic. It’s now more thorough and more in tune with the times, including the modern skeptical pespective on trigger points, and a more nuanced discussion of what role they might or might not have in patellofemoral pain.
SDec 19The Complete Guide to Patellofemoral Pain Syndrome — Minor editing, patellofemoral pain vs ITBS — Just a few little improvements, especially harmonizing with the IT band tightness chapter.
LDec 12The Complete Guide to Patellofemoral Pain Syndrome — Many improvements, differential diagnosis — After greatly expanding this chapter in 2022, it was a bit of a mess: thorough but disorganized. I eliminated some egregious rambling (was I drunk?).
MDec 9The Complete Guide to Patellofemoral Pain Syndrome — New topic, analgesics chapter — Added a small section: “Be careful what you wish for: pain relief can be problematic.”
MDec 9The Complete Guide to Patellofemoral Pain Syndrome — Major revision, intro to diagnosis — I pretty much just started from scratch and re-wrote this chapter. It’s now better in all the ways, I think.
MDec 9The Complete Guide to Chronic Tension Headaches — Minor update, cervicogenic headache chapter — Added more detail about occipital neuralgia.
LDec 8The Complete Guide to Patellofemoral Pain Syndrome — New section, criteria for discontinuing running.
LDec 8The Complete Guide to Patellofemoral Pain Syndrome — New sub-topic, cartilage thickness — Added a substantive new sub-topic: “Built for pressure: How thick is the patellofemoral joint cartilage? And the patella?”
LDec 4The Complete Guide to Patellofemoral Pain Syndrome — Evidence update — Updated several references throughout the introductory sections, along with many related edits and improvements.
MDec 2The Medical Blind Spot for Aches, Pains & Injuries — Fairly extensive modernization of the article, reflecting substantial evolution in my views over the last decade.
LNov 22The Complete Guide to Chronic Tension Headaches — New section.
MNov 22The Complete Guide to Chronic Tension Headaches — Minor update, cervicogenic headache chapter — Discussed the special case of occipital neuralgia.
SNov 10Cramps, Spasms, Tremors & Twitches — Added hemifacial spasm to the list of examples of pathological contractions.
SOct 30Vulnerability to Chronic Pain — Added a little evidence and evidence-informed speculation about the possibility of more short-term anti-inflammatory benefits of a healthier diet.
LOct 30Chronic, Subtle, Systemic Inflammation — New section, on junk food as an inflammation driver.
SOct 28Marijuana for Pain — Science update about the efficacy and safety of CBD — all bad news, I’m afraid. But it’s not surprising.
MOct 19The Complete Guide to Low Back Pain — Revision, MDT review chapter — Just a bunch of miscellaneous revision as I prepared the chapter for publication as an excerpt.
MOct 7Neuropathies Are Overdiagnosed — Science update with some substance, a bit more than just a citation: Peet et al really adds to the case that the fraudulent marketing of anticonvulsants was a pain care catastrophe, resulting in extreme over-prescription.
LOct 5The Complete Guide to Low Back Pain — New section.
LSep 21The Complete Guide to Low Back Pain — Rewritten, back pain as an overuse injury — Like-new re-write. Before: simplistic and old-school by my 2023 standards. After: not very scientifically rigorous, but much more informed and wide-ranging speculation. And kinda fun.
SSep 20Marijuana for Pain — Added a citation to Gedin on the role of placebo, poor blinding, and media buzz.
SSep 18Ten Trillion Cells Walked Into a Bar — Added a fresh citation (first note) about the number of cells we have: roughly thirty trillion, according to a new paper.
SSep 7Opioids for Chronic Aches & Pains — Edited. Made several minor clarifications, most notably emphasizing that opioids are indeed effective for some kinds of chronic pain (despite being surprisingly ineffective for so many others).
MSep 2Trigger Point Doubts — Added a very substantial (bloated?) new footnote, in which I (finally) provide my best guesses for “what really happened” in a trigger point therapy success story. There’s also a blog post.
MAug 30A Deep Dive into Delayed-Onset Muscle Soreness — A variety of modest improvements to the sections on active recovery, particularly the evidence.
LAug 27The Complete Guide to Low Back Pain — New chapter, treating rib subluxations.
LAug 27The Complete Guide to Low Back Pain — New chapter, rib subluxations — Not just a new chapter, but a particularly huge one, based on interesting new science, with plenty of value. (PainSci Members can also read this in a recent blog post, “Extra, extra! Extra floating ribs are way more common than anyone knew.”)
LAug 26Chronic, Subtle, Systemic Inflammation — Rewritten, psychologically triggered neuroinflammation — Significant revision of all neuroinflammation content.
LAug 26Chronic, Subtle, Systemic Inflammation — Rewritten, neuroinflammation dysfunction — Significant revision of all neuroinslammation content.
LAug 26Chronic, Subtle, Systemic Inflammation — Rewritten, neuroinflammation with subtle triggers — Significant revision of all neuroinflammation content.
LAug 26Chronic, Subtle, Systemic Inflammation — Rewritten, sickness behaviour — Significant revision of all neuroinflammation content.

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 1148 posts dating back to 2010.

  1. Podcast at last! » Apr 11, 24
  2. A noisy “release”? 🔈 » Apr 9, 24
  3. Built for pressure: How thick is kneecap cartilage? 🔈 » Apr 3, 24
  4. It’s surprisingly hard to recover from being really chilly » Apr 2, 24
  5. Three painful science snacks: weekend warriorism, exercise for back pain, and calcific tendinitis 🔈 » Mar 29, 24
  6. Ice bath safety and hypoxic blackout 🔈 » Mar 25, 24
  7. Dehydration itself may be less potent than fearing it 🔈 » Mar 21, 24
  8. We’re sharing a drink called pain » Mar 20, 24
  9. Can we ever deny someone’s pain? » Mar 18, 24
  10. Who gets studied? The demographics of pain research 🔈 » Mar 16, 24
  11. Do most painful conditions resolve spontaneously? (Member Post) 🔈 » Mar 15, 24
  12. Fibromyalgia drives people to drink 🔈 » Mar 9, 24
  13. Butt-hurt about hurt butts » Mar 7, 24
  14. The evidence on Botox for muscle knots blew my mind once upon a time 🔈 » Mar 4, 24
  15. Pictures of spinal inflammation: a correlation kerfuffle 🔈 » Feb 29, 24
  16. Any exercise is a lot better than none » Feb 26, 24
  17. Injuries causing injuries causing injuries? 🔈 » Feb 26, 24
  18. A potent link between pain and lousy sleep…regardless of your budget 🔈 » Feb 22, 24
  19. More nocebos + degenerative hair disease 🔈 » Feb 21, 24
  20. A sunset that causes headaches? » Feb 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. 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
  2. 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
  3. 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
  4. 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
  5. Short term effects of various water immersions on recovery from exhaustive intermittent exercise. Pournot et al., 2011, Eur J Appl Physiol. » added Feb 2024
  6. Reconsidering high intensity zones: its role in intervertebral disk degeneration and low back pain. Sima et al., 2024, Eur Spine J. » added Feb 2024
  7. Large Buttocks Hematoma Caused by Deep Tissue Massage Therapy. Sun et al., 2015, Pain Med. » added Feb 2024
  8. 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
  9. Patients and clinicians managing patellofemoral pain should not rely on general web-based information. Silva et al., 2020, Phys Ther Sport. » added Nov 2023
  10. 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
  11. In search of conditioned pain: an experimental analysis. Kang et al., 2023, Pain. » added Nov 2023
  12. Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore et al., 2023, J Pain. » added Oct 2023
  13. Proinflammatory Dietary Intake Relates to Pain Sensitivity in Chronic Nonspecific Low Back Pain: A Case-Control Study. Elma et al., 2023, J Pain. » added Oct 2023
  14. Improved outcome after lumbar microdiscectomy in patients shown their excised disc fragments: a prospective, double blind, randomised, controlled trial. Tait et al., 2009, J Neurol Neurosurg Psychiatry. » added Oct 2023
  15. Prevalence and Risk Factors of de Novo Widespread Post-COVID Pain in Non-Hospitalized COVID-19 Survivors: A Nation-Wide Exploratory Population-Based Survey. Ebbesen et al., 2023, J Pain. » added Oct 2023
  16. C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors. Farrell et al., 2023, J Pain. » added Oct 2023
  17. Total daily energy expenditure has declined over the past three decades due to declining basal expenditure, not reduced activity expenditure. Speakman et al., 2023, Nat Metab. » added Aug 2023
  18. Attitudinal responses to current concepts and opinions from pain neuroscience education on social media. Weisman et al., 2022, Musculoskelet Sci Pract. » added Jun 2023
  19. Centralization and directional preference: An updated systematic review with synthesis of previous evidence. May et al., 2018, Musculoskelet Sci Pract. » added Mar 2023
  20. Outcomes After Lumbar Disk Herniation Surgery in the Dutch Population. Schepens et al., 2023, Global Spine J. » added Mar 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. 😜

May 24, 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