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. ❤️

Getting back to my roots with an eye-rolling review of a silly kind of pain treatment: microcurrent therapy. There’s no science to report on here, just bad ideas. 🙄 Strap yourself in for a little tell-us-what-you-really-think debunking! PainScience.com/blog/micro-review-of-microcurrent-therapy.html

YES—nociception IS necessary for pain, and the idea that it is NOT has been uncritically embraced by too many pros, with nasty effects (gaslighting, basically). I’ve written about this before, of course (paywalled but free intro): painscience.com/post_can_the... More on this paper soon.

Read all the reasons it’s hard to find good help for #chronicpain in a NEW POST, the 3rd and final post in my members-only series on this topic. Go here to unlock the series: www.painscience.com/blog/why-is-...

Lately the moon has been … what’s the word? 🤔 “SUPER.” Took this with a new camera! A relatively humble bit of gear, but specialized for zoom, and it is indeed quite special at large focal lengths: a Panasonic Lumix FZ80D. More moon shots coming soon.

Why is it so hard to get good help for #chronicpain? Reason #14… If patients aren’t carelessly dismissed as hypochondriacs…they are TAKEN SERIOUSLY as hypochondriacs instead. That’s from the last batch of 5 of my series of 15. Collect them all! www.painscience.com/blog/why-is-...

We are bombarded with the message that nature is one giant pharmacy. But extracting drugs from it is a lot harder than wellness influencers believe. My latest for @mcgilloss.bsky.social

Not all fat is unhealthy. But when it is…it’s a risk factor for #chronicpain. And it’s mostly the BELLY fat that is the issue—the visceral fat tucked around your organs like foam packing peanuts. NEW POST! 5-min read, audio for members. www.painscience.com/blog/belly-f...

Imagine having baaad knees… But then recovering enough to climb THIS mountain. And not JUST this mountain, but also the 7 Summits—the tallest mountain on each continent! 🤯 Amazing knee pain recovery story: www.painscience.com/blog/is-ther... Photo by Samdesherpa, CC BY-SA 4.0, Wikimedia Commons

This is the “what’s really going on here” with RFK Jr. Acetaminophen was just a convenient scapegoat, part of the "chipping away," inching closer to the real target: VACCINES as the cause of autism.

“You know how this ends: despite a lot of allegedly ‘promising’ evidence over the years… platelet-rich plasma injections remain experimental, supported almost exclusively by low quality trials with mixed and generally unimpressive results.” PainScience.com/platelet_rich_plasma

“You’ll take this non-opioid … and you’ll like it!” I fear that many patients who need opioids will be given Journavx instead, and it will end badly for them. NEW POST: "Can Journavx replace opioids?" 5-min read, audio for members. PainScience.com/blog/can-journavx-replace-opioids.html

You don’t say. 😏 "Respondents preferred physical therapies with higher effectiveness, quicker symptom improvement, lower out-of-pocket expenses, reduced side effects, and shorter duration." Yep, that'd be what people want: better, faster, cheaper, safer! www.jospt.org/doi/10.2519/...

Just did a run with a 5kg (11lb) weight vest, just to see how it would feel to carry that mass again … after recently losing about that much in fat. Yep, sure does feel heavy! And yet … not that big a deal. It felt like more of a slog, yes, but nothing dramatic.

Tylenol does not cause autism. It’s a crackpot theory, getting promoted at a level that we've never really seen for any crackpot theory in modern times. There are safety issues with Tylenol (acetaminophen, paracetamol), but at recommended dosages it’s one the safest medications that exist.

Did a late summer trip, 1st stay at Yellow Point Lodge, a fascinating, famous camp/resort on Vancouver Island. Slogan: “Eat. Read. Sleep.” (But we did the eat, read, EXEECISE version: hiking, kayaking, swimming, tennis! Full review and 20 pics… paulingraham.com/yellow-point...

Pet theories about compensatory injury really do get QUITE silly. 🙄 Compensatory injuries exist, but mostly just the boringly obvious ones. I’ve banged out a “new” article about implausibly COMPLEX compensatory injuries, which has been in the pipeline for ages: www.painscience.com/blog/new-pai...

The "within-group significance fallacy" is a tricky but worthwhile concept if you care about how clinical science works. But is it really so “tricky” though? 🤔 I’m contractually obliged to say it is, because, you know, statistics. 😱

Fine design of a PRP study…but they missed the only analysis that mattered? So odd. Stranger still: if they HAD done it right, it likely would've made PRP look GREAT! But nope. And it is a deal-breaker. Textbook “within-group significance fallacy.” www.painscience.com/blog/two-lea...

The 2 least lousy trials of platelet-rich plasma for plantar fasciitis: 1️⃣ is a weirdo, with baffling flaws and too-good-to-be-true results I just don’t believe. 2️⃣ is more believable, but still flawed, AND there is less to believe: mediocre results even if true! Citation still needed for PRP.

Favourite thing about the e-bike? It’s not the help with the hills — it’s the HEADWINDS. 🌬️I mostly don’t mind an honest sweaty hill climb, but I LOATHE headwinds, and erasing that resistance feels like MAGIC.

“Whoever is spared personal pain must feel himself called to help in diminishing the pain of others. We must all carry our share of the misery which lies upon the world.” ~ Albert Schweitzer

A “new” knee ligament: the anterolateral ligament. Who knew? Hardly anyone! This obscure knee ligament probably shouldn’t be so obscure. But it’s entirely missing from my library of anatomy texts. [Image from Claes et al. Journal of Anatomy. 2013. DOI: 10.1111/joa.12087.]

It seems absurd & damning that one of the co-authors thinks this retraction “feels like part of the ongoing effort to block real longevity science from reaching the public.” 🙄 I don’t believe there is such a conspiracy … and I doubt the credibility of a researcher who does.

Phew, Jack takes his fun very seriously! 😮 It has been ages since my last weekend dog share, because I've been summering and only maintaining a light presence on social media. But I’m getting back into it now, and it’s time to revive the tradition. ~ Paul

New evidence that “lifting with your back” is…fine? Lifting safely is more about confidence and adaptability than rigid posture rules, and Au et al. shows that stooping to lift can even be a GOOD thing. PainScience.com/blog/evidence-that-lifting-with-your-back-is----fine.html

I’ve lost 5kg in the last three months, and I am feeling blown away by how much easier it feels to run. 🤯 I knew it would feel easier, of course, but I underestimated it. Next time, I’m going to put on my 5 kilo weight vest to remind myself of what it felt like to run back in May. 😜

This is me playing ultimate about 20 years ago — coordinating a lot of fast, powerful muscle contractions, mostly without injury. But not always! I think I probably had about a half dozen mild to moderate muscle strains in my 25-year ulti career. I recently updated my book about muscle strains…

I tried to quit my sleep medications…which went about as well as you’d expect. 😜 I report on the long term harms of Gravol & marijuana + a bunch about narcolepsy (fascinating disease that it is). Quite a bit of science, naturally. New personal post: tryeverything.substack.com/p/quitting-m...

New study suggests ~2X the shin splints risk for women. But … probably not THAT much more & probably NOT because they're more delicate! The reassuring details matter. I report on them in a way I bet no one else has. PainScience.com/blog/do-women-get-more-shin-splints-than-men-new-data.html

Updated: my detailed analysis of the RESTORE trial of Cognitive Functional Therapy for back pain. "I was a bit giddy from a megadose of sweet, sweet confirmation bias. Aahhh, refreshing! My buzz didn’t last long, though. Do they ever?" www.painscience.com/cft_restore

No matter how much or how good the initial education, IT MUST CONTINUE, because you truly cannot learn enough in school. A professional that isn’t interested in the nerdy science isn't really interested in healthcare.

WHY is it SO HARD to get good help for pain?! I can think of at least 15 reasons why patients feel so poorly served on average. NEW POST: a substantive rant about 5 MORE of those reasons, ~7m read, members only: PainScience.com/blog/why-is-it-so-hard-to-get-good-help-for-pain-part-2.html

A new study is claiming to have found the holy grail of “lasting results” for #backpain — THREE YEARS of less pain/disability from Cognitive Functional Therapy, supposedly based on “good evidence” in The Lancet. Not so sure it’s good … www.painscience.com/blog/cogniti...

Is Cognitive Functional Therapy evidence-based yet? 3 years after the RESTORE trial, a follow-up report says CFT’s back benefits just kept on trucking! But… 37% of the subjects weren’t included. Classic survivorship bias territory. My notes, 2-min read: www.painscience.com/blog/cogniti...

I got into a bit of hot water for a late June blog post about menopause, hormone therapy, and exercise. I hoped I was playing it safe and respectful with a female physician’s seemingly evidence-based perspective in a good journal. It was not “safe”! 😜

A 6 kilometre scale model of the solar system as an attraction at a resort? Sounds like my kind of place. 🙂 paulingraham.com/resort-with-...

Wait, wut? 🤯 Really? Other platforms have trained me so well to avoid links that I’m struggling to wrap my head around this radical idea! If Bluesky actually doesn't penalize posts with links, it’s one of the single best reasons to be here.