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What toxins actually are

The idea of “toxins” is usually used as a tactic to scare people into buying de-toxifying snake oil of one sort or another. What is meant by it? The folks who sell detoxification are notoriously vague.

I delved into this while writing an update for my Epsom salts article recently, and it ended up being quite useful in a couple other articles too: my main toxins page (duh), of course, and my article picking apart the popular practice of promoting hydration after massage.

A poison is literally any harmful substance, and even something safe in typical doses becomes a poison in overdose (so you can be poisoned by either by lots of water or a minuscule amount of lead). Toxins are technically poisons produced by living things, like venom or metabolic wastes, but informally the word is synonymous with poison.

There’s a staggering variety of poisons/toxins, but the two major categories that are probably what most regular people hope they can purge are pollutants and metabolic “wastes”:

Pollutants are probably what most regular people hope they can get rid of with a detox. The best specific candidates would be the persistent organic pollutants like pesticides, flame retardants, and polychlorinated biphenyls (PCBs, now banned, but formerly ubiquitous in many plastics). Lead is also an alarmingly common environmental poison (and much in the news lately). All of these are indeed found in our environment and our bodies, where they mostly get trapped in fat and otherwise sequestered. We definitely would like to get rid these… if only we could.

Metabolic “wastes” is a much murkier category, because many of them aren’t “wastes” at all. Cellular chemistry produces a lot of molecules, with many fates. Technically these are toxins because they are biologically produced and they would be harmful in abnormal concentrations… but they are normal products of biology, and so most of them are either safely excreted, or actually re-used and re-cycled. As in the rest of nature, not much in cellular chemistry is wasted. Lactic acid is the ultimate example: misunderstood for decades, even by many people who should know better, lactic acid isn’t a persistent waste product and you wouldn’t want to “flush” it or “suck” it out of your muscles even if you could.

Read more in any of these articles:

[Go to this post on PainScience.com]

What toxins actually are


Orginally Published At: Pain Science

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The Effects of Partners’ Helping Motivation on Chronic Pain Patients’ Functioning over Time

Because partners of individuals with chronic pain (ICP) may differ considerably in their helping responses (e.g., providing emotional, instrumental and informational support4), various attempts have been undertaken to categorize helping responses of close others in terms of its expected implications for ICP’s functioning (e.g.,9). To fully understand whether partners’ helping response is truly helpful and promotes ICP’s adjustment, the present research draws on Self-Determination Theory (SDT,7,34), a broad theory on human motivation.

The Effects of Partners’ Helping Motivation on Chronic Pain Patients’ Functioning over Time

Orginally Published At: Pain Journal

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Waiting for a pediatric chronic pain clinic evaluation: A prospective study characterizing waiting times and symptom trajectories

Epidemiological studies indicate that chronic pain is common in children and adolescents with median prevalence rates of 11% to 38% depending upon the condition.14 Chronic pain negatively affects multiple domains of functioning for children and adolescents including school attendance, social, physical, and athletic activities, and emotional functioning.16 Because longitudinal data demonstrates that childhood chronic pain places individuals at significant risk for developing or continuing with chronic pain, physical symptoms, and psychiatric complaints into adulthood,22 effective treatment of pain in childhood is critical for preventing or lessening the enormous societal impact of adult chronic pain.

Waiting for a pediatric chronic pain clinic evaluation: A prospective study characterizing waiting times and symptom trajectories

Orginally Published At: Pain Journal

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Characteristics associated with high-impact pain in people with TMD: a cross-sectional study

Temporomandibular disorder (TMD) is characterized by pain in the jaw joint, face, and masticatory muscles that can become chronic. Although the hallmarks of TMD, as a regional pain disorder, are pain in the temporomandibular joints and masticatory muscles, people with TMD often experience pain in many other areas of the body.44

Characteristics associated with high-impact pain in people with TMD: a cross-sectional study

Orginally Published At: Pain Journal

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Inspiring lifter of heavy things

This is some good inspiring stuff, and I was especially pleased to hear that she was initially inspired by the evidence-based advice from her son that she would only need to go a couple times a week — it is true and important that strength can be built with surprisingly little time investment. If more people knew that, a lot more people might be willing to go to the gym and get the many health benefits of strength training (see strength training frequency). You do not have to be as hardcore as this lady has gotten. 😉 But nearly anyone who wants to can!

[Go to this post on PainScience.com]

Inspiring lifter of heavy things


Orginally Published At: Pain Science

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Topical anti-inflammatories are effective, safe

Fresh science! Multiple studies have concluded that topical anti-inflammatories are both effective and safe for osteoarthritis. That’s topical, not oral — a completely different beast. This new paper (Zeng et al) reviews the results of 43 studies and concludes that “diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal adverse events were observed in trials or the general population.”

That’s the science. Now for a useless but encouraging anecdote…

A few weeks ago, I had my first personal experience with dramatic relief from Voltaren Gel (topical diclofenac). It’s not the first time I have found it useful, but it was the first time it was amazing. I’d been having some unexplained knee pain intermittently for several weeks when it kicked up a notch or two and became constant and even started waking me up at night. When I finally remembered to try Voltaren Gel — I’m not sure what took me so long — things were bad enough that it was going to be obvious if it worked. And it was! After many days of constant discomfort ranging from 3-6 on a 10-scale, it just ended: half an hour after applying the stuff, I simply didn’t have that problem anymore. Hallelujah! It’s been weeks since then with no relapse. Although the pain was not terrible, this is actually one of the clearest examples of pain relief from any treatment that I’ve ever enjoyed.

For more information about this stuff, see Voltaren® Gel Review.

[Go to this post on PainScience.com]

Topical anti-inflammatories are effective, safe


Orginally Published At: Pain Science

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Smoking linked to shoulder injuries

Smoking is strongly linked to more shoulder pain and injuries, which is quite odd. This seems to be excellent evidence of two principles:

  1. There doesn’t seem to be *ANYTHING* that smoking will not make worse.
  2. Musculoskeletal pain/injury that seems “mechanical” is often more about subtle biological vulnerability.

This review by Bishop et al considered thirteen studies of shoulder trouble in about 6000 smokers out of 16,000 patients. The studies showed clear links between smoking and rotator cuff tears: more tears and worse tears, with more degenerative signs later on. That is, the “cuff” of muscles around the shoulder joint is apparently more fragile in smokers. They also found a link with unexplained chronic should pain pain and dysfunction. One experimental study showed that nicotine made rat shoulder tendons stiffer.

Smoking is bad for your shoulders! And here’s a weird theory…

Could the mechanism for this be low vitamin C, which happens to smokers? Vitamin C is critical for collagen (connective tissue) synthesis, which is the why the disease of scurvy causes wrecks people. On the one hand, this seems implausible because minor connective tissue disorders from vitamin C deficiency would pretty much just be scurvy by definition — mild scurvy, but scurvy! And I don’t think smokers get scurvy. Easy dismissal, right? Not so fast! On the other hand, subclinical scurvy could actually be a thing, and it is not a new idea. Mild symptoms are easily missed, and it wouldn’t shock me if one of the only signs of trouble was an increased risk something (like connective tissue trauma). I can imagine that connection being missed indefinitely. I doubt anyone has ever looked for it. See this article (very old, but very readable), and this one, and this study.

[Go to this post on PainScience.com]

Smoking linked to shoulder injuries


Orginally Published At: Pain Science

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A skeptic cautiously tries some bizarre-sounding health advice

Five years ago, against practically anyone’s better judgment, I knowingly abandoned any semblance of medical evidence to follow the bizarre-sounding health advice of strangers on the internet. The treatment was extreme, expensive, and potentially dangerous.

This is from a well-written, thoughtful, sobering personal essay by science journalist Julie Rehmeyer, who has also written a book about her experience, Through the Shadowlands. I don’t know what to make of the key claims of the “moldies,” people who believe their health is affected by even trace amounts of mold. But the author is sharp and clearly approached the whole thing with the greatest possible caution and still came out thinking there might be something to it.

I relate strongly to her story on multiple levels: as a health science writer who constantly deals with bogus health claims, and as someone who has suffered seriously from medically unexplained symptoms myself. Hell, I could even be a moldie and not know it. Probably not, but it’s far from the craziest idea I’ve heard — and I live in one of the wettest big cities on Earth!

[Go to the link featured in this post]

[Go to this post on PainScience.com]

A skeptic cautiously tries some bizarre-sounding health advice


Orginally Published At: Pain Science

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The Non-Avoidant Pacing Scale: Development and preliminary validation

Activity pacing has emerged as a common treatment component aimed at improving functioning in patients with chronic pain5,7,35,38,47,48, however, few studies have examined the relationship between pacing and key outcomes. A meta-analysis revealed a correlation between more pacing and reduced depression, but also higher levels of pain and disability1. It appears counterintuitive that pacing, a strategy taught to patients with chronic pain, would be associated with poorer outcomes. However, there is a lack of clarity surrounding the concept itself.

The Non-Avoidant Pacing Scale: Development and preliminary validation

Orginally Published At: Pain Journal