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painsci.bsky.social
PainScience.com (Paul Ingraham)
@painsci.bsky.social
1.3K followers 180 following 1K posts
Highlights and skeptical snark about the science of chronic pain and injury rehab, from PainScience.com publisher Paul Ingraham. + Digressions into astronomy, Roman history, palaeontology, more. Everything is too interesting to focus!
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painsci.bsky.social
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.
A close-up daytime photograph of the half moon against a bright blue sky, showing sharp detail in the lunar surface including craters and the rugged terminator line separating light and shadow. Two full Moons are shown. They are different sizes because the Micro Moon image on the left was captured when the Moon was near its furthest from the Earth, while the Super Moon on the right was captured when the Moon was near its closest to the Earth. Please see the APOD explanation for more detailed information.
November 11, 2025 at 6:38 PM
painsci.bsky.social
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...
A Venn diagram showing two overlapping circles labeled “pain” on the left and “suffering” on the right, with the overlapping area labeled “pain-related suffering.” The caption reads “Pain & Suffering: Related but Distinct,” illustrating that pain and suffering often overlap but can also occur independently.
November 8, 2025 at 7:33 PM
painsci.bsky.social
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...
Testing the effect of benzos + my 10th painniversary
Testing very, very, very carefully
open.substack.com
November 5, 2025 at 8:21 PM
painsci.bsky.social
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...
Screenshot of scientific paper abstract.
November 4, 2025 at 9:09 PM
painsci.bsky.social
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...
Brave subjects shocked a lot for science: habituation and sensitization
Repeated pain reveals trait-like sensitization and shaky stress signals.
www.PainScience.com
November 3, 2025 at 8:00 PM
painsci.bsky.social
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.
A sharply detailed close-up photograph of the first quarter Moon, showing its sunlit right half against a completely black sky. Numerous craters and mountain ridges are visible along the terminator, especially near the lunar north and south poles, with subtle shading revealing surface texture and depth.
October 30, 2025 at 8:07 PM
painsci.bsky.social
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.
October 30, 2025 at 3:45 PM
painsci.bsky.social
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...
Zapping back muscles back to life: restorative neurostimulation
A flashy study of the ReActiv8 spinal stimulator went wrong in many ways.
www.PainScience.com
October 27, 2025 at 8:34 PM
painsci.bsky.social
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...
Photo of the perfectly full moon, notably not blown-out, plenty of detail even in the bright areas.
October 22, 2025 at 12:16 AM
painsci.bsky.social
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. 🤔
October 21, 2025 at 11:12 PM
painsci.bsky.social
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...
Achilles’ Tendon Experiences Reduced Depth and Volume After 3 Months of Recovery From 60 Days Bedrest
Bedrest and lower limb unloading are often needed after acute illness.1 The Achilles’ tendon, the thickest and strongest tendon in the human body,1 is the most commonly injured and ruptured tendon in ...
www.archives-pmr.org
October 21, 2025 at 8:11 PM
painsci.bsky.social
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.
Photo of a blue ceramic figurine in the shape of a salamander, decorated with light blue patterns, which include lines and dots that accentuate its body and limbs. The salamander’s open mouth adds character, making it appear as if it’s mid-motion. The glossy, translucent surface suggests it’s crafted from a smooth, polished material. The salamander is placed on an aluminum platform, the stand of an Apple Studio Display on a dark wood desk, contrasting its vibrant blue against a neutral background.
October 18, 2025 at 11:50 PM
painsci.bsky.social
That is some VERY gentle tortilla-taking. Who's a gentle boy? It’s Tucker. ❤️
weratedogs.com WeRateDogs @weratedogs.com · 26d
This is Tucker. He was offered a tortilla but told to take it gently, and no one has ever understood the assignment better. 13/10 (TT: tucker_thegentleman)
October 18, 2025 at 11:35 PM
painsci.bsky.social
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
October 18, 2025 at 8:06 PM
painsci.bsky.social
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.
October 16, 2025 at 12:45 AM
painsci.bsky.social
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-...
Screenshot of all text, mostly 15 bullet points, reading as follow: Why is it so hard to get good help for pain? Here’s TEN reasons I’ve already covered: 👉🏻 Pain is a very hard problem (baked deep into biology) 👉🏻 There’s not enough good science about pain 👉🏻 Pain is too easy to ignore and trivialize 👉🏻 Lack of medical leadership 👉🏻 Specialists aren’t very special 👉🏻 The opioid war is catastrophic 👉🏻 Professional pride, tribalism, corruption 👉🏻 Academic and intellectual weakness 👉🏻 Rank quackery, icky snake oil & flaky bullshit 👉🏻 Tech as ESPECIALLY sneaky quackery And I’ve added FIVE more to that master list of bad news: 👉🏻 Insurance-based medicine 👉🏻 Wellness, bio-hacking & supplements 👉🏻 The shabby OLD paradigm of “structuralism” 👉🏻 A shiny NEW generation of mind-blamers 😱 👉🏻 Pain is a job for a kind of healthcare that barely exists I will follow all that doom and gloom with a note of optimism. 😜
October 15, 2025 at 6:00 PM
painsci.bsky.social
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.
Really great high-magnification photo of a 40% gibbous moon against a blue sky. Lots of crater and mountain detail along the terminator.
October 15, 2025 at 2:50 AM
painsci.bsky.social
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-...
Why is it so hard to get good help for pain? Part 3 (Member Post)
The final 5 (of 15) reasons to be cynical about healthcare for pain & injury rehab
www.PainScience.com
October 14, 2025 at 7:16 PM
Reposted by PainScience.com (Paul Ingraham)
jonathanjarry.bsky.social
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
When a natural compound is introduced inside of a piece of plastic in the lab where individual cells grow, scientists will often see something interesting happen, and these preliminary findings are often used to market the plant to an eager audience. Natural compounds are said to have anticancer activity, or antibacterial activity, or anti-inflammatory activity. It’s true. In artificial conditions, when a large dose of some natural compound is repeatedly dropped on top of cells that have been plucked from the human body, they do cause interesting changes. But that’s a little bit like choosing a child who has just learned to ride his tricycle and immediately putting them in the driver’s seat of an eighteen-wheeler to drive cross-country. Driving in the real world is a little bit more complicated than this.
October 10, 2025 at 3:10 PM
painsci.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...
Belly fat and chronic pain: the waistline plot thickens
Two new studies shoring up the case for visceral fat as a driver of chronic pain.
www.PainScience.com
October 9, 2025 at 8:22 PM
painsci.bsky.social
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
The morning view of Manaslu, 8th highest peak in the world, from Samagaon village.
October 3, 2025 at 8:25 PM
painsci.bsky.social
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.
gavinyamey.bsky.social Prof Gavin Yamey @gavinyamey.bsky.social · Sep 29
RFK Jr wants to outlaw vaccines—but he knows he can’t ban them overnight, so he’s successfully chipping away, little by little, at the US vaccine system, with the help of those Fox News MAGA/MAHA MDs & PhDs (Drs Bhattacharya, Makary, Oz, Kulldorff, & Prasad)

Blaxill is another extreme anti-vaxxer😢
September 30, 2025 at 1:30 AM
painsci.bsky.social
“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
Platelet-Rich Plasma (PRP): Does It Work?
PRP is a simple regenerative medicine concept that’s still far from clinically proven.
PainScience.com
September 30, 2025 at 12:18 AM
painsci.bsky.social
“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
Can Journavx replace opioids?
The reality seems much less awesome than the theory.
PainScience.com
September 26, 2025 at 8:45 PM
painsci.bsky.social
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/...
September 26, 2025 at 5:09 PM