Specialist in recovering people with pain, NOT A PAIN SPECIALIST. People with pain have a lot more than pain and I’m interested in the other things!
Joined February 2019
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Our new manuscript- Free download: authors.elsevier.com/a/1hy6j…
Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference (PI) and improved functioning ....?
Yes! PI ⬇️es from 35% ➡️ 22%- Remarkable!!
A 🧵
sciencedirect.com/science/ar…
Ajay Manhapra retweeted
After failed PFA, how much ablation is too much? In a 2026 @westernafib roundtable, @rranjanMD urged EPs to think beyond lesion sets: eliminating AFib matters, but so does preserving atrial function.
Join #WAFIB2027, Feb 25–27! hubs.ly/Q04zGZXt0
@nmarrouche
The practice of medicine is to help the patient make sense of their lived experience and thus help them to change it to a better experience, using available scientific knowledge and skills
"Rethinking Lived Experience" via @TheLancet
thelancet.com/journals/lance…
Patient outrage re: antidepressant withdrawals is understandable. But, why do clinicians/experts act surprised as if this a new discovery??!! Withdrawals are normal expected responses when long term stimulation of reward/motivation system with any intervention is suddenly stopped
The whitewashing of Paxil withdrawal was not so different from the whitewashing of withdrawal from all SSRIs.
In the archive, you can see the language being softened, the timelines shortened, the dependence reframed.
Paxil was where that tactic was perfected. Not where it ended.
The newly searchable archive makes that pattern visible across files. Explore at ChristopherLane.org
#PaxilPapers #SSRIs #ChristopherLane
There goes another myth in pain
Pain may not increase linearly with age, with the sharpest rises occurring before the age of 55, according to a global analysis of more than 6 million people published in Nature Medicine. go.nature.com/4jGAiQx
ALT This is figure 5, which shows risk factors, site-specific associations and PAFs for pain across the lifespan.
Ajay Manhapra retweeted
We don't ask whether a model touched their prose. We ask authors to own every word.
@JACCJournals parted w/ICMJE & doesn't require disclosure of AI writing help: the rule is unenforceable, biased, & not good for medical communication.
My Editor's Page: jacc.org/doi/10.1016/j.jacc.…
God! Surgeons still believe this crap?!! NYT journalists write this up without fact checking?! These are old disproven myths!
Human body is designed to do bend, lift and twist.
The Worst Habits for Your Back, According to Spine Surgeons nytimes.com/2025/03/28/well/… via @NYTimes
These guys at university of Queensland comes up with really useful studies in chronic pain flare ups, an area that does not get much attention from providers but dominate patient narratives
Low back pain flares: Reflections on how physical activity, sleep, and stress shape individual experiences
pubmed.ncbi.nlm.nih.gov/4281…
Tapering is hot stuff with many so called experts
We found out in opioids that it’s a highly risky intervention that causes excess overdose, suicides and mortality in addition to discomfort
We also found that most things the experts recommend will not work for many
On paper, benzodiazepines are a short-term tool. Xanax, Klonopin, Ativan, Valium: approved for brief anxiety relief, sleep, the occasional procedure.
Here's the problem. Almost nobody is using them short term.
Why? Because most people don't have short-term anxiety. They have enduring problems in their lives, and enduring problems produce enduring anxiety and insomnia. So a drug designed for a two-week crisis quietly becomes a years-long prescription, refill after refill. And used that way, these drugs turn on you: long-term benzodiazepine use is associated with worse anxiety and worse depression, the exact conditions they were prescribed to treat, while the effect itself wears off over time.
And then there's the exit. I'll say something that surprises people: benzodiazepines probably have the worst withdrawal syndrome of any pharmaceutical. Don't take my word for it. Talk to polydrug users, people with experience coming off fentanyl and heroin, and nearly all of them will tell you the same thing: the benzos were the worst, most uncomfortable drugs to come off. Think about that. The prescription your doctor refills without blinking is the one hardened opioid users fear quitting most.
Short-term tool. Long-term trap. The difference is the refill count.
If you're looking to safely taper off a psychiatric medication, comment TAPER and I'll send you my free tapering guide. It's the exact protocol we use with our patients at TaperClinic.
Never stop a benzodiazepine abruptly. Coming off too quickly can be dangerous. Any taper should be gradual and medically supervised.
Misleading/nonsensical posts from reputable places makes it difficult for patients with chronic pain to get the treatments that works. Most have chronic pain SYNDROME which means pain is not a symptom of physical problems at pain site. How is this picture helpful?
There is no one-size-fits-all treatment for chronic pain. We use a whole-person approach that may include physical therapy, pain psychology, medications, complementary therapies, and targeted interventions.
This graphic highlights examples of treatments that may be appropriate for different chronic pain conditions.
Most do not believe that regular cannabis use leads to violence because each use leads to transient anger relief. But substances create an illusion it’s working while everything worsens. It’s a good idea to do UDD in pain clinics if patients are unreasonably angry
NEW: “Cannabis use is associated with increased risk of violence: A systematic review and meta-analysis”
pubmed.ncbi.nlm.nih.gov/4277…
I guess white coat makes everything scientific
An article about alcohol hangover without even a brief mention of opponent effect, the most likely explanation. This reflects the fallacy that all symptoms should be caused by a singular physical or chemical or molecular factor.
The Hangover Molecule newyorker.com/culture/annals…
Cardiologists finally discovering that illness happens to people living in environments and not to hearts, metabolic pathways and molecular structures. They’re very excited about this “discovery”.its like discovering Africa😁😁
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Why do we do steroid injections for knee pain? Somebody explain …..
Results of Large Multi-Site Pragmatic Clinical Trial Comparing Corticosteroids or Blinded Lidocaine-only Injections in Treating Osteoarthritis of the Knee acrabstracts.org/abstract/re…
Another unhelpful piece in chronic which talks about everything other than IASP accepted science of pain and it’s treatment
nytimes.com/2025/01/12/magaz…
It’s funny when judges become reductionist scientists. Most people who criticize disease model do not understand the model- the disease model is not devoid of psychosocial influences
A Court Rejected the Disease Theory of Opioid Addiction. Will We Listen? filtermag.org/court-opioid-a…
Ajay Manhapra retweeted
A Court Rejected the Disease Theory of Opioid Addiction. Will We Listen? filtermag.org/court-opioid-a…
