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. ~ Paul Ingraham, PainSci Publisher

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The 10 newest featured articles on (out of 234)

  1. Does pandiculation “reset” muscle tone? » Jan 2023
  2. The Tibiofibular Joint and Lateral Knee Pain » Feb 2022
  3. Ozone Therapy for Pain » Dec 2021
  4. Mind Over Pain » Sep 2021
  5. What Works for Pain? » Jun 2021
  6. Counterstimulation » Jun 2021
  7. Autonomous Sensory Meridian Response » Jun 2021
  8. Neurodynamic Stretching » Jun 2021
  9. The Science of Pain-Killers » May 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 37 articles & books in 195 days, breaking down into 18 major updates, 23 medium, 19 minor. That’s every 3.3 days in recent history; there have been 1614 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

LJun 6Does Posture Matter? — Added content — Added much more information about stability cushions, mostly imported from a minor old article and improved.
MJun 5Does Posture Matter? — Science update — Added two citations: one about the reliability of lumbar curvature assessment; and a thoroughly annotated one to the paper that sparked the “cells phone usage causes horns” idea (Shahar). There’s basically a whole blog post in that footnote!
LJun 5Does Posture Matter? — Rewriting and editing — Many small and medium improvements. I mostly worked on recommendations for changing posture. I also threw out the article's summary and started over, and the new one is 10x better. (A new summary doesn't sound like much, but crafting really good summaries in incredibly challenging. And ChatGPT really just cannot do it like I can do it. 😉)
MJun 5The Trouble with Chairs — Editing. Top-to-bottom content tidying and tuning. It’s uncomfortably rare for me to just throughly re-read one of my own articles. It took two full hours just to go through it carefully fixing minor issues along the way and taking notes on more substantive updates I’d like to do.
SJun 5The Complete Guide to Low Back Pain — Science update, posture — Cited Schmidt on lordosis assessment reliability (there is none).
SJun 3Reassurance for Massage Therapists — Filled out the extro a little. Just a bit more detail and context.
LMay 31Chronic, Subtle, Systemic Inflammation — Added big new section about the role of exercise in reducing inflammation: “Hungry, hungry humans balance the energy budget by … cutting inflammation?! The detailed case for exercise as anti-inflammatory medicine.”
MMay 31The Complete Guide to Low Back Pain — Edited, directional preference chapter — Numerous minor corrections and improvements. Added ‘focalization’ as a clearer alternative to ‘centralization.’ Added two images. There's also now a blog post version of this chapter for PainSci members, and an audio version of the chapter embedded here.
MMay 30Vitamin D for Pain — Added a tiny new section about vitamin D as a possible therapy for statin-associated muscle soreness. Also removed the position statement on vitamin D and COVID. It was more interesting in 2020, but since then the relationship between vitamin D and COVID has become a big nothing burger, and it’s beyond the scope of this article in any case.
SMay 29The Complete Guide to Low Back Pain — Small additions — Post-publication editing and polishing, most notably a couple more citations about MDT efficacy, and an interesting point about the implications of centralization’s origin story.
SMay 28Reviews of Pain Professions — Added several images. Obviously just a minor update, but in this context some visual cues are quite helpful. A few minor edits while I was here.
MMay 27Does Posture Matter? — Improvements, posture article conclusion — This was just a reiteration of a few keys points for a long time. Now it’s more colourful rant and battle cry — death to posturology!
LMay 27The Complete Guide to Low Back Pain — New chapter, McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT)
LMay 26Mind Over Pain — New section, resilience rant — Added a section about the overuse and abuse of the idea of “resilience,” from a 2021 members-only post now made public.
MMay 26Mind Over Pain — Science update, confidence cure section — Cited and critically analyzed that big new study of cognitive functional therapy (Kent) — more on this to come, but the process of citing it widely on PainSci has begun.
SMay 26Mind Over Pain — Many minor adjustments, overview of all mind-over-pain ideas — I remember crafting this summary extremely carefully back in 2021. But it’s amazing how steadily my ideas evolve — especially on this topic in the last two years — and I saw a need for a whole bunch of edits. The idea that you could create something like this and leave it alone is kind of laughable.
LMay 24What’s New on — 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.
MMay 22Neurodynamic Stretching — Added a lovely anecdote about a dramatic success with neurodynamic stretching.
SMay 20The Complete Guide to IT Band Syndrome — Improvements, knee pain diagnosis — Added information about pain referral from the hip joint, plus some other minor clarifications.
LMay 19Vulnerability to Chronic Pain — Added new section, “Health and luck: the non-modifiable risk factors.”
LMay 19Cognitive Behavioural Therapy for Chronic Pain — Added a substantial new section, “What about conventional treatment with a psychological spin?” And it will get more substantive, because there’s more to do on that topic. I also cited Johnsen on CBT for depression, added a note about the tendency of all psychological therapies to get gaslighty, and some clarifications and a link in defense of acceptance and commitment therapy.
MMay 19Placebo Power Hype — Added a new conclusion: “Placebo enthusiasm cannot be curbed.”
LMay 16The Complete Guide to Low Back Pain — New chapter, centralization and directional preference.
LApr 28Chronic Low Back Pain Is Not So Chronic — Rewrite and major upgrade. The previous reassurance-is-good-for-back-pain slant has been replaced with a much more nuanced perspective on the relationship between back pain and psychological factors. And there are useful new sections on risk factors.
SApr 22Cramps, Spasms, Tremors & Twitches — Cited a case study about mistaking Parkinsonian dystonia for a knee injury.
SApr 19How Many Muscles Are In the Human Body? — Corrected a minor error: capillaries are not muscular. Hat tip to reader M.C. for reminding me of that.
LApr 19Why Became — A rare update to this mostly archived page about itself, which I thought I’d never touch again: “2023 update: ‘PainScience’ turns out to have problems too!”
SApr 18Ozone Therapy for Pain — Minor revisions and updates. Added a couple of citations.
LApr 15Chronic Low Back Pain Is Not So Chronic — Added a new section with more recent and detailed follow-up evidence, a new table, and two diagrams. Edited the whole thing.
MMar 31The Medical Blind Spot for Aches, Pains & Injuries — Added a section: “Patients are part of the medical incompetence equation.”
MMar 18The Art of Bioenergetic Breathing — Added information about the physiology of breathing and a major new citation about the real potential for anti-inflammatory benefits of hyperventilatory breathing.
SMar 17A Rational Guide to Fibromyalgia — Added content — Added fast breathing exercises (hyperventilation) to the list of treatment options worth considering.
MMar 7Cognitive Behavioural Therapy for Chronic Pain — Added short new section about anti-depressants as a chronic pain treatment.
LMar 7Mobilize! — Complete descriptions of all mobilization exercises are now integrated into this page. The table of contents also got an upgrade.
SMar 6Massage Therapy for Low Back Pain (So Low That It’s Not In the Back) — Minor editorial upgrades and polish.
MMar 1Chronic, Subtle, Systemic Inflammation — Added short new section, “Hyperventilation + cold exposure = anti-inflammatory (maybe).”
LFeb 24Zapped! Does TENS work for pain? — New section about TENS for menstrual pain.
SFeb 10The Tyranny of Yoga and Meditation — Science updated. Cited one important new paper on meditation harms, Kuyken 2022.
SFeb 7Massage Therapy for Tension Headaches — Science updated. Added a citation about the relationship between trigger points and headaches, and updated related footnotes a bit.
MFeb 6The Complete Guide to Low Back Pain — Revised, specific diagnosis — After several years without much attention, this chapter has finally gotten a variety of improvements.
MJan 31Cramps, Spasms, Tremors & Twitches — Upgrades to the relatively new Botox section, including a few more citations, especially about harms and safety.
MJan 28Does pandiculation “reset” muscle tone? — Added information about the link between pandiculation, sex, and — another fun new word — “chasmology.” Added a new emphasis that pandiculation isn’t just about stretching, and added a fun cat video, and some reader reports.
SJan 27Quite a Stretch — Science update, injury prevention — Identified some non-trivial flaws in a trial that dared to challenge my bias. 😜
LJan 27The Complete Guide to Chronic Tension Headaches — New chapter, green light therapy.
SJan 25The Complete Guide to Patellofemoral Pain Syndrome — Reorganization, differential diagnosis — Just a bit of housekeeping: rearranged the content and edited for clarity.
MJan 24Complete Guide to Plantar Fasciitis — Rewritten — Expanded the scope of the section to include dry needling generally, and not just Sconfienza's peculiar version of it. Added some citations. Confirmed that the “Sconfienza protocol” trial remains unpublished (fifteen years later).
LJan 23Quite a Stretch — New section, effect on arterial stiffness.
SJan 23Quite a Stretch — Added a pop quiz — Fun, right?
SJan 23The 3 Basic Types of Pain — Added a footnote about whether it’s okay to call nociceptors “pain fibres.”
SJan 20Does pandiculation “reset” muscle tone? — Minor additions and corrections that arose in the aftermath of publication.
SJan 19Strength Training for Pain & Injury Rehab — Added a fun sidebar “Train like Gandalf.”
MJan 19The Insomnia Guide for Chronic Pain Patients — Science update. Short new section about the use of anti-depressants for insomnia.
MJan 12Quite a Stretch — Science update, injury prevention — Updated and added some citations, including one that challenges my bias (for the first time).
LJan 11Quite a Stretch — New section, pandiculation.
MJan 4What Works for Pain? — Science update. Beefed up the exercise section with four fresh good-news studies.
MJan 3Complete Guide to Plantar Fasciitis — Refinements, orthotics chapter — Several minor improvements and additions, mostly about foot straps, taping, and heel lifts (as opposed to support), adding up to a solid chapter upgrade.
MDec 30The Complete Guide to Low Back Pain — Upgraded, movement snacks and general exercise — Added more about the role of general exercise in treating back pain.
MDec 11The Complete Guide to Low Back Pain — Upgraded, heat/ice chapter — Revised and expanded to include a discussion of Hydrocollators.
MDec 6Pain is Weird — New section, The rhythm of throbbing pain.
LNov 23The Complete Guide to Low Back Pain — Rewritten, scoliosis treatment chapter — Completely rebooted, all new everything about scoliosis treatment.

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 1074 posts dating back to 2010.

  1. Spinal curvature chaos » Jun 5, 23
  2. Massage therapy: occasionally slightly helpful » Jun 3, 23
  3. I prefer extension: Back pain self-help exercise based on “directional preference,” but only “centralizers” need apply (Member Post) 🔈 » May 31, 23
  4. Pain demands an explanation » May 27, 23
  5. Chiropractor harassed for being pro-vaccine » May 26, 23
  6. What do people think triggered their back pain? 🔈 » May 19, 23
  7. Sanctioned post-surgical torture » May 14, 23
  8. Some muscle strains turn out to be stress fractures » May 12, 23
  9. Major good news study for back pain (which validates my career) 🔈 » May 4, 23
  10. How I got a study about pain and anxiety all wrong (and got set straight) » Apr 28, 23
  11. Huberman Schmuberman: A rising tide of criticism of the bright new star of wellness podcasting (Member Post) 🔈 » Apr 26, 23
  12. Why is it always ME-slash-CFS? And where’s FM?! Myalgic encephalomyelitis vs chronic fatigue syndrome vs fibromyalgia 🔈 » Apr 22, 23
  13. That’s no knee injury » Apr 22, 23
  14. Micromuscle errata » Apr 19, 23
  15. So you’re saying meditation is over-hyped… » Apr 19, 23
  16. Promises, promises: the perpetually “promising” state of ozone therapy » Apr 18, 23
  17. 3 neat disc and herniation studies 🔈 » Apr 13, 23
  18. Placebo enthusiasm cannot be curbed 🔈 » Apr 7, 23
  19. What’s worse than not having a pain cure? » Apr 4, 23
  20. Why so much imaging? » Mar 30, 23

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, ~700 of them more substantively annotated.

  1. Centralization and directional preference: An updated systematic review with synthesis of previous evidence. May et al., 2018, Musculoskelet Sci Pract. » added Mar 2023
  2. Surgical interventions for lumbar disc prolapse. Gibson et al., 2007, Cochrane Database Syst Rev. » added Mar 2023
  3. Can Exercise Positively Influence the Intervertebral Disc? Belavý et al., 2016, Sports Med. » added Mar 2023
  4. Inciting events associated with lumbar disc herniation. Suri et al., 2010, Spine J. » added Mar 2023
  5. Nerves are more abundant than blood vessels in the degenerate human intervertebral disc. Binch et al., 2015, Arthritis Res Ther. » added Mar 2023
  6. Diagnosing Discogenic Low Back Pain Associated with Degenerative Disc Disease Using a Medical Interview. Tonosu et al., 2016, PLoS One. » added Mar 2023
  7. Clinical aspects of sciatica and their relation to the type of lumbar disc herniation. Reihani-Kermani et al., 2005, Archives of Iranian Medicine. » added Mar 2023
  8. Severity of symptoms and signs in relation to magnetic resonance imaging findings among sciatic patients. Karppinen et al., 2001, Spine (Phila Pa 1976). » added Mar 2023
  9. Relationship between herniated intervertebral disc fragment weight and pain in lumbar microdiscectomy patients. Mariajoseph et al., 2022, J Clin Neurosci. » added Mar 2023
  10. Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople et al., 1994, Spine (Phila Pa 1976). » added Feb 2023
  11. Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou et al., 2015, BMC Musculoskelet Disord. » added Feb 2023
  12. Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI. van Rijn et al., 2006, Clin Neurol Neurosurg. » added Feb 2023
  13. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. Gugliotta et al., 2016, BMJ Open. » added Feb 2023
  14. Magnetic resonance imaging findings 10 years after treatment for lumbar disc herniation. Fraser et al., 1995, Spine (Phila Pa 1976). » added Feb 2023
  15. Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 2: radiographic evaluation and correlation with clinical outcome. Barth et al., 2008, Spine (Phila Pa 1976). » added Feb 2023
  16. Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. Ferreira et al., 2023, BMJ. » added Feb 2023
  17. Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials. Weng et al., 2023, Br J Sports Med. » added Jan 2023
  18. Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken et al., 2022, Evid Based Ment Health. » added Dec 2022
  19. Is there a relationship between throbbing pain and arterial pulsations? Mirza et al., 2012, J Neurosci. » added Nov 2022
  20. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. Cholesterol Treatment Trialists' Collaboration et al., 2022, Lancet. » added Sep 2022

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.