My publishing has slowed to a crawl lately. Time to say why: multiple family health crises, some more serious/ongoing, but the “perfect storm” factor ever since the early winter has been…impressive. ☹️ Despite the storm, I have gotten SOME work done, and good things are coming to your inbox soon.

Twenty stretching experts pooled their expertise for an ambitious consensus paper. The clickbait headline for this would be “The Great Stretching Myth: 20 Scientists Reveal What Actually Works — and What Doesn’t.” And it doesn’t work for much! NEW POST, 3m read: www.painscience.com/blog/stretch...

Sooo … another post about the necessity of nociception thing? 😱 Again! Sorry! But the whole reason I’m returning to the topic is that I do NOT think it’s just a word game. It is part of an important ongoing debate about whether psychosomatic pain exists. www.painscience.com/blog/is-it-m...

An updated red flag for a rare type of back pain… Cauda equina syndrome (CES) is caused by compression of the horsetail-looking end of the spinal cord. It is a fairly rare kind of back problem, and sometimes very serious. And the classic red flag for it…ain’t great! 🧵

Are noisy joints arthritic? Is “crepitus” associated with early signs of osteoarthritis? YES. They are indeed “associated,” and quite strongly, in a new study in JOSPT. Footballers with hip/groin pain were 5× likelier to report hip crepitus (popping and grinding noises).

It’s been a bit of a struggle here to find content to share about physical medicine and pain science. So how about this absolutely fabulous galaxy instead?

Not everyone is sturdy enough for a “deep” massage—not even seemingly healthy people—due to many sneaky, underdiagnosed pathologies, genetic quirks, and medication side effects that make tissues physically FRAGILE. New article! PainScience.com/blog/sneaky-soft-tissue-fragility--a-new-article.html

I need a word for the PAIN of having the perfect snarky comment to take down some smug putz on social media … but you can’t use it because you have promised yourself to always, no matter what, “keep it classy.” *sigh*

What a perfect fit for the gross new CBS News. And Huberman too?! Ew ew ew ew ew. 🤮

I share WeRateDogs posts sometimes, just because I ❤ dogs. They are rarely relevant to pain or physical medicine. Almost never. But THIS? This is about has therapy, dogs, AND cats too. And I also ❤ cats! So … perfect storm really. MUST SHARE.

Days of mist and fog in Vancouver. And it has just a little colour right now.

For 15 years now, I’ve eked out a living writing very skeptically about all the nonsense in healthcare for pain and injury rehab. But … emphasis on “eked”! I have come close to calling it quits several times.

NEW POST, first about “trigger points in ages. Two parts: PART 1—A little rant about the need to acknowledge the clinical phenomenon of sensitive, aching spots: people have them! Please stop saying they don’t “exist”! Just because we don’t understand how they work doesn’t mean they don’t “exist.”

The whole business of helping people with pain & injury is a shambolic parody of good healthcare. In this three-part series, I explore 15 major reasons why it’s SUCH a dumpster fire. www.painscience.com/blog/why-is-...

Down with fee-for-service practice models, FFS! FFS immerses clinicians in the perverse economic incentives that have undermined good care for #chronicpain for decades. In the future, I hope practitioners will move away from fee-for-service practice models…and towards “value-based care.”

Many patients feel like it’s crazy hard to get GOOD HELP for #chronicpain. I’ve written all about the problems! Now let's talk about solutions. Got any ideas for improving pain care? Here's ELEVEN in a new post. Call it a starter kit. PainScience.com/blog/ideas-for-improving-pain-care.html

Gua sha is scraping massage, and the bruising is the point. Here's a full critical analysis…but there’s not much to analyze. The claims are simplistic, implausible; barely any science: “Gua sha will need more than a spoon or a jar lid to smooth out the many wrinkles in its scientific literature.”

Physical & manual therapy clients can be SATISFIED completely independently of whether or not they’re actually getting HEALTHIER. Satisfaction is easy to achieve. People WANT to be satisfied. They want to feel like they’re getting their money’s worth—so it’s pretty easy to get them there.

Me talk pretty sometimes. I’ve done many interviews now (getting to be a bit of a habit), but this one stood out as an especially comfortable and substantive chat. I extracted some highlights from the transcript, but give it a listen too. www.painscience.com/blog/thinkin...

Here’s a piece from NYT for which I was interviewed (but ultimately not quoted) on functional medicine. It features @caulfieldtim.bsky.social & @gorskon.bsky.social (yay!). Two things to discuss. www.nytimes.com/2026/01/08/w...

I’ve just shared one article by Jonathan Jarry (@jonathanjarry.bsky.social), another is coming soon, and there are plenty more that I’ve neglected. He’s hard to keep up with! He’s a fine fellow to follow for clear, science-based thinking about the health sciences.

Now there’s AI health slop…for seniors?! 🤮 Jonathan Jarry reviewed generated health videos with millions of views. The slop he waded through was only a fraction of what’s now spewing out of Asian content farms. It also all “seems legit” thanks particularly to COPIOUS FAKE CITATIONS.

Yesterday I ran while sore from a workout, and the soreness backed off after 4 kms. UPDATE: well, that didn’t last long! The soreness was back to full power within an hour, and it remains there today, every bit as strong as it was yesterday…just when it would usually be backing off. Ruh roh!

I just ran 5k with sore legs from a lot of loaded squats 48h ago. Good idea? A bit of the hair of the exercise dog that bit me? Here’s how it went: km 1 → OW! km 2 → ow! km 3 → ow km 4 → ow? km 5 → just a 🤏🏻 ow. So did I actually get better? Or just numb? What’s going on there?

“Pain is inevitable. Suffering is optional.” O rly? This adage contains both genuine wisdom AND great potential for abuse in the context of #chronicpain. Not a useless idea, of course, but problematic. NEW POST, 1000 words, audio for members: www.painscience.com/blog/sufferi...

“You’re being reductionist” is just a pretentious substitute for “you can’t see the forest for the trees” — an ironic insult coming from barely-trained dabblers and dilettantes who have obviously not mastered either forest OR trees. www.painscience.com/articles/red...

I haven’t entirely given up on pain-without-nociception…but I'm now as close to that edge as I can get without falling off it! Thanks to 3 interesting new papers about nociception, PNE, and shifting the burden of pain relief on the patient. NEW POST: PainScience.com/blog/pain-needs-nociception.html

Hopefully a conversation starter for people who believe physical therapy is 100% evidence based, here is @painsci.bsky.social writing for @skeptic.org.uk about PT and quackery. www.skeptic.org.uk/2025/12/phys...

So that’s the first moon I’ve seen in Vancouver in a month — appropriately shown with clouds. It has been a particularly grey and rainy month here, even by Vancouver standards. OR HAS IT? ”Moon, clouds, Sundial app, and getting corrected by ChatGPT” paulingraham.com/moon-clouds-...

I knew a guy who had two very intense chronic pains … but literally never mentioned one of them for months while desperately trying to troubleshoot the other! Why? www.painscience.com/blog/worst-p...

What are the worst possible kinds of pain? The “greatest hits” of pain are problematic … but here’s my list of the candidates anyway! A bit clickbaity of me? Only as a side benefit. 😏 This topic was of genuine interest to me, and overdue. www.painscience.com/blog/worst-p...

What are the worst possible kinds of pain? The “greatest hits” of pain are problematic … but here’s my list of the candidates anyway. A bit clickbaity of me? Only as a side effect. 😏 This topic was of genuine interest to me, and overdue. www.painscience.com/blog/worst-p...

Ozempic works for arthritis. And probably other pain. Am I dreaming? Too good to be true? Nope. This is the real deal, actual good news we can have some confidence in. Free summary, lots of nerdy details for members only: www.painscience.com/blog/ozempic...

My new article about the strange category of “manual therapy” is awkwardly balanced between: ☹️ a bleak and cynical review of an industry with serious problems ❤️ a lov️e letter to methods that I am still faithful to despite those problems www.painscience.com/manual_therapy

There are ~1800 hundred usages of the words "manual therapy" on PainScience.com. So I thought I should finally write an article about it. www.painscience.com/blog/what-is...

Got akes and pains? “Ake” instead of “ache” was one of many early attempts to tidy up English spelling. Just learned from author Gabe Henry, talking about his new book Enough is Enuf on the podcast You’re Wrong About (Nov 11). www.theguardian.com/books/2025/a... linktr.ee/ywapod

This screenshot went wild on social media a while back. That is some *chef's kiss* irony! Nature took down the paywall on this (ancient) article—no doubt because of the flood of traffic! Just a bit more about this, and tips on how to get full text papers: www.painscience.com/blog/inacces...

Today’s moon! Still closer than usual for another month. A recent Astro Photo of the Day shows how much bigger it seems—even halved! This is why I’ve been taking lots of moon photos. And the new camera, of course: Lumix FZ80D, ISO 80, 2400mm, ƒ5.9, 1/250s. Tripod…but it freakishly doesn’t need it.

Pain and suffering: are they different things? Is treating one as good as treating the other? I took a ride on this short train of thought recently. In this new post, I take that train to several more stops, addressing key points raised by commenters: www.painscience.com/blog/pain-an...

What’s the worst health mistake you ever made? The worst thing you’ve ever done to your own body? 🙋🏻‍♂️ Benzo addiction and rapid withdrawal! open.substack.com/pub/tryevery...

Another useless and impractical 😜 but fascinating basic pain science study… Peripheral nerve injury affects the immune cells of the brain, with activity moving around as the pain goes chronic. www.jpain.org/article/S152...

If you keep getting stung, do you get used to it? This is called “habituation” in the world of pain science. Or does it just keep getting worse? “Sensitization.” “It depends,” but on what? Short post about a new study: www.painscience.com/blog/brave-s...

My best moon shot yet! 😄 🌓 This learning curve is nuts. My new camera can get close to this quality handheld & full auto, which is amazing, but falls short of what I really want. So this is on a tripod + full manual, my first time controlling all the exposure variables! A thrill to see this result.

Anything nice or uplifting will “help” #chronicpain, like good music, or puppy boops, or seeing a Nazi get punched. But that's about easing SUFFERING, not pain. At best, there might be some modest modulation of pain intensity…nothing we would mistake for real treatment.

Zapping back muscles back to life: restorative neurostimulation? A surgically implanted gadget…and a new study says it works! Suck it, skeptics! 🙄 Today I’m going to really tear that new study apart—a particularly GOOD example of a BAD clinical trial. www.painscience.com/blog/zapping...

Despite my lifelong love of astronomy, I’ve never really been much of a MOON guy. But with my new hand-telescope? An excellent “bridge” camera that prioritizes zoom, and which can do THIS? Without a tripod?! paulingraham.com/super-zoom-f...

Two-footed plantar fasciitis is the WORST. Literally. New study of how it goes with plantar fasciitis. Many people improve quickly at first, but then things bog down…and often stall entirely or even worsen for the folks with BILATERAL cases. And also the ones who did fewer heel raises. 🤔

Stuck in bed for 60 days? Your Achilles tendons won’t get thin…at first. But then, as you get moving again, they DO get thin, and they may STAY thin for at least a year. This odd trial showed that artificial gravity during the bedrest doesn't help. Curious! www.archives-pmr.org/article/S000...

What’s with the salamander? The regenerative superpower of salamanders is an inspiring and profound example of what is possible in biology and healing … and so the salamander has been a logo and a mascot for PainScience.com for about 20 years now.

That is some VERY gentle tortilla-taking. Who's a gentle boy? It’s Tucker. ❤️