The sneaky pain of arterial tears

By Herman | January 10, 2018

Neck artery tears (cervical artery dissection) can be sneaky, sometimes causing only pain. (See Arnold 2006, Kerry 2009, Maruyama 2012) Some people with neck pain and/or headache may actually have damaged neck arteries, and are at a high risk for stroke. There are two arteries in the neck that do this:
The big high-pressure carotid artery.
The small and often tortuous vertebral artery, which threads its way through a series of holes in the side of the spine.

New free book: Recovery Strategies

By Herman | January 10, 2018

Gregory Lehman (GregLehman.ca), one of my most trusted sources of perspective and expertise, has finished an interesting book, for patients and professionals, “Recovery Strategies–Pain Guidebook” … and it’s free. Although please do consider sending him a donation for it — I know all too well how much work something like this takes! This one is rich in graphics as well, which is particularly challenging to produce (not to mention effective).

Lifting technique article upgrade

By Herman | January 10, 2018

Last week my article about back-safe lifting got shared around a lot… and I was deluged with feedback, especially from powerlifters, which inspired a major upgrade.
Many of my updates to articles and tutorials are very focused: a single new study, a key point, a specific correction. This one was wide-ranging and took DAYS of discussion, study, writing, and citing; it’s practically all I’ve done all this week. The article is like new.

Fibromyalgia guide updates

By Herman | January 10, 2018

Two new sections about two fibromyalgia treatments, one old and one new.
EXERCISE THERAPY for chronic pain in general and fibromyalgia in particular seems like it should be a slam dunk, but it’s not nearly as clear a win as you’d think, and it can even backfire. As with everything in health, turns out “it depends” on how you do it. The section offers some evidence-inspired tips on how to improve the odds that working out will work out.
HYPERBARIC OXYGEN THERAPY is new fangled and exotic.

Paleo sleeping (critical analysis for a laugh)

By Herman | January 10, 2018

Could “paleo sleeping” help aches and pains? This short, bizarre old paper in the British Medical Journal offers some interesting raw data about “instinctive” sleeping postures in primates. Unfortunately, the author’s interpretation is so grandiose and silly that I decided to devote a post to rolling my eyes at it.
You probably do not know that nature has provided an automatic manipulator to correct most spinal and peripheral joint lesions in primates.

Dubious study

By Herman | January 10, 2018

[Image caption] The alt text (hidden caption): “Sounds fine. I looked up the Academy & it says on their MySpace page that their journal is peer-viewed & downloaded biannually.”xkcd #1847 © xkcd.com by Randall Munroe
Just because it looks like science does not mean it’s science. Many people don’t realize how much of a problem this is these days, the sheer number of studies that are truly worthless, or close.

The corrective exercise trap

By Herman | January 10, 2018

“Corrective exercise” is the idea that specific exercises can be prescribed to fix alleged performance deficiencies and injury risks. It’s often pretentious, because it implies that ordinary exercise and training isn’t good enough. And because it needs something to correct, it slips all to easily in pathologizing and nocebo (harm from negative expectations).

Shoddy back pain information from Consumer Reports

By Herman | January 10, 2018

Dr. Harriet Hall, critiquing a recent issue of Consumer Reports about back pain:
I found the [Consumer Reports] articles on back pain very disappointing. I hope I can still trust Consumer Reports when shopping for a washing machine, but I have no confidence that I can trust them when looking for an effective medical treatment. They seem not to understand the difference between anecdotes and data, between a popularity contest and a controlled scientific study.

Frozen shoulder bombshell: it ain’t self-limiting

By Herman | January 10, 2018

Everyone who knows anything about frozen shoulder knows that it goes through three phases, even without treatment — a painful phase, a stiff phase, and recovery/thawing phase. And then you’re good. It’s “self-limiting.” Right? This is in all the textbooks! Dr. Christopher Kevin Wong found convincing evidence that it’s all wrong:
It turns out… not so much.

Understand chronic pain before operating

By Herman | January 10, 2018

Spinal surgeon Dr. David Hanscom:
Surgery is only one tool that can solve a specific structural problem. It is rarely ‘the definitive solution.’ Don’t let anyone place a knife in your back until you understand chronic pain. And most important take back control of your own care.
Excellent back surgery advice from a highly credible source. I’ll definitely be buying his book, and no doubt citing it as well. See “If I Were Your Spine Surgeon….

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