Detailed guides to painful problems, treatments & more

Article reborn: Pain professionals reviewed

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Adam Meakins, physical therapist, on the state of manual therapy, all the techniques/professions that focus on “fixing” people with hands and relatively simple tools, like spinal manipulation, massage therapy, or nerve flossing:

If manual therapy could rid itself of all the over-complicated pseudo-scientific egotistical narcissistic bollocks that infests and surrounds it then I think it could be so much more effective for so many more than it currently is.

I will still argue that manual therapy as a treatment does not belong in any evidenced-based healthcare profession being administered by degree qualified diagnostic clinicians due to the time-cost/reward ratio. Instead, manual therapy should be given as a service by less qualified non-diagnostic staff at a much lower cost and greater reward ratio for patients.

Back in the day, when I was just a pup, I thought of manual therapy as mostly legitimate but blighted with some terrible ideas. These days, as an old dog, that seems backwards: manual therapy is mostly a mess, with just a few islands of sanity and humility.

I’d like to introduce a “new” article I’ve taken out of storage and re-written:

Reviews of Pain Professions — An opinionated guide to the most popular sources of professional help for injuries and chronic pain.

Spoiler alert: it’s hard to find good help! All the more reason to have a good, skeptical understanding of the options, right? That’s what this website is all about.

I wrote my first version of that article in about 2006. It was amateurish and snarky, almost childishly biased in favour of my own profession at the time (massage therapy, if you’re not a regular here). Embarrassingly, I had rated most professions in terms of their potential to deliver trigger point therapy. It was probably some of the worst writing I did in the 2000s. It provoked a lot of outrage and hate mail. I took it down around 2012 and it has been mothballed ever since.

I have been planning to re-write it properly ever since, and I finally got around to it. It’s alive! And based on vastly more knowledge.

But still strongly opinionated. 😜