Welcome to this month's edition of Function's pain science round-up: your window into the latest clinical evidence, research studies, and experimental findings for anyone who's found themselves in the world of pain.

Let's get to it.

While spinal adaptations are often blamed for persistent low back pain, there's a growing body of research that calls this blame into question. Adding to this research is a study of over 3,000 patients in Germany, which found that adaptations like degenerated disks, herniated disks, spondylolisthesis, and spinal stenosis had small or no association with low back pain. Importantly, this study looked not just at whether a person had pain when the adaptation was diagnosed, but also whether they developed pain over the following 6 years.

After the CDC reported that 22% of people in the U.S. with chronic pain use prescription opioids, a new study sought to shed light on how else people manage pain. This study used a sample of nearly 32,000 patients and found that most people use a combination of non-opioid treatments, including massage and chiropractic care. What's more concerning, they found that people use mental health therapies only 3.8% of the time, despite an abundance of research showing their ability to reduce chronic pain.

We all know that pain makes it hard to sleep, but a new study finds that bad sleep also predicts pain. This study has as its backdrop the 2011 earthquake in East Japan that led to thousands of deaths and one of the two worst nuclear disasters ever. Looking at the results of 2,000 people living in affected areas across a 3 year period (starting 4 years after the quake), researchers found that the amount of sleep disturbance predicted not only whether people would develop low back pain, but how much.

There's a view in modern pain science that, broadly speaking, movement is helpful in the long-run even if it causes more pain in-the-moment. A new meta-analysis supports this perspective, finding that in people for whom movement causes immediate pain, exercise is more effective than no treatment at reducing pain. As something of a bonus, it also finds that TENS provides more relief than no treatment, but does no better than placebo treatment.

A body of past research shows that your pain increases when you catastrophize your pain—that is, when you worry about it often, expect it to get worse, and feel helpless to do anything about it. A new study of around 300 people adds to this research by finding a strong link between catastrophizing and chronic orofacial (face or oral cavity) pain.