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Stress fractures of the foot and ankle.
⚠️ Note the 'high risk' sites they need thorough assessment (including imaging) and cautious management.
(Adapted from Mandell et al. 2017 in Skelelal Radiology)
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The low effect sizes for exercise for pain in people with osteoarthritis is not surprising considering the complex neuroimmune mechanisms underpinning pain. Exercise program are often targeted at the joint to improve tissue capacity and load tolerance.
frontiersin.org/journals/imm…
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These are the mechanisms of painful spinal disc ⚙️
A healthy disc only has nerves in its outer layer.
In a degenerated disc, nerves grow deeper, making the interior of the disc pain sensitive.
The disc becomes more sensitive to both chemical (inflammatory) and mechanical (load) factors.
Thats discogenic pain in a nutshell
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Does “severe” spinal #stenosis on MRI mean exercise is futile and surgery should happen sooner rather than later? Big new study says nope: how bad it looked on the scan didn’t predict who improved. At all. Or their symptoms! Study of the week, 3m read:
painscience.com/blog/stenosi…
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Mixed pain phenotypes in musculoskeletal disorders: mechanisms and management
nature.com/articles/s41584-0…
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Beyond intensity: pain distribution shapes healthcare- and treatment-seeking beliefs in individuals with and without clinical pain
pubmed.ncbi.nlm.nih.gov/4288…
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A Hidden Cause of Low Back Pain
•Stanford pain scientists Einar Ottestad and Anthony Machi highlight a little-known cause of low back pain: superior cluneal nerve entrapment.
•This happens when small nerves near the lower back get trapped, leading to pain in the back, buttocks, or upper leg.
Key points:
•This condition may affect up to 14% of people with low back pain.
Doctors can find it using ultrasound or special X-ray techniques.
•Treatments include nerve blocks, heat treatments (radiofrequency ablation), cold treatments (cryoablation), nerve stimulation, or surgery.
•One patient had an 80% drop in pain after a heat treatment. Another study showed 50–90% pain relief within 10 weeks.
Why it matters:
Many people with back pain never find out what’s causing it. If doctors look for this nerve problem, more patients might get the right treatment and feel better. Scientists still need to study the best ways to diagnose and treat it.
Source: bit.ly/4s81LwX
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Full text article here:
frontiersin.org/journals/psy…
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Diagnostic accuracy of the straight leg raise test for lumbosacral radicular pain: a systematic review with meta-analysis
sciencedirect.com/user/ident…
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Effects of Digital Health Interventions in Chronic Musculoskeletal Pain: Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials
pubmed.ncbi.nlm.nih.gov/4284…
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Updating our model of pain: low back pain through the lens of active inference
sciencedirect.com/science/ar…
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Does exercise wear your discs out?
A 2026 meta-analysis pooled 39 studies (4,152 people) looking at disc health on MRI.
Only one row sits fully to the right ➡️ upright activity, mostly running (7 studies, 586 people). A small benefit.
Cycling, swimming, lifting, more vs less training volume — all crossed the line. No clear difference either way.
Running doesn't appear to wear discs out. If anything, the opposite 🏃
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Low back pain flares: Reflections on how physical activity, sleep, and stress shape individual experiences
pubmed.ncbi.nlm.nih.gov/4281…
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We spend almost all our research effort on what makes pain worse.
This review asked the opposite question — what protects people 🛡️
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Low back pain is middle aged or older adults commonly associated with depressive symptoms, social disadvantage & multimorbidity.
sciencedirect.com/science/ar…
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Bidirectional relationship between pain & depression in middle-older age.
sciencedirect.com/science/ar…
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Here are the factors leading to slower recovery in back pain 👇
Why do some people recover more slowly after #physiotherapy for chronic #LowBackPain? ⏳ In 250 adults, disability, fear of movement, catastrophizing, poor sleep and lower pain self-efficacy were linked with longer recovery time.buff.ly/x8fe6Ft
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‼️New Paper Alert‼️What does it take to change behavior? In a fresh Annual Review article, @JGVoelkel, @AngelaDuckw and I argue it's helpful to consider 3 phases of change:
1️⃣ building motivation
2️⃣ following-through
3️⃣ forming durable habits
🧩KEY TAKEAWAY: At each phase, different obstacles to change arise that need to be met with evidence-based, tailored solutions.
For instance, at the follow-through phase, forgetting can disrupt change. But forgetting can be combatted by reminders or feedback. Impatience can also disrupt follow-through, but it can be addressed in part by making change more fun or providing access to commitment devices. These are not the only obstacles to follow-through, however, and different obstacles arise at the motivation and habit forming phases, which are best tackled with entirely different solutions. Table 1 from our paper (reprinted below) offers a summary of common obstacles to change and evidence-based solutions.
⭐Our review focuses on solutions supported by *high quality evidence*, particularly from field experiments with objective behavioral outcomes (e.g., grades, gym visits, hours spent volunteering).
👀Take a look at our new piece in the Annual Review of Psychology: tinyurl.com/change-annualrev…
Huge thanks to our excellent editor @EliJFinkel. We're very grateful for support from @Wharton, @BehaviorChange, @Penn and @Cornell, which made this work possible.
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Pain as a whole person experience – embracing biopsychosocial clinical reasoning. A narrative review. 2026
share.google/uqLkAM4WUQhwycS…
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Pain Mechanisms in Fibromyalgia: An Integrative Narrative Review of Central, Peripheral, Neuroimmune, and Psychobiological Factors
mdpi.com/2227-9059/14/9/2012






















