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Critical evaluation of a critical evaluation 

 •  • 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.

Professionals interested in the trigger point debate should have a look at this fierce new critique of Quintner et al. That paper is still the only example of a peer-reviewed paper expressing skepticism about the nature of myofascial pain syndrome. I believe it has many serious problems, but for many reasons I have refrained writing my own full-throated critique.

Happy to recommend someone else’s, though.

Just a quick reminder: I am officially “on the fence” on this topic, and I have examined the topic in insane detail over the years. You can read a summary of my position near the top of “Trigger Point Doubts.”

In contrast to Dommerholt et al’s more formal rebuttal, this one by Brent Brookbush is more pointed and strongly worded. This will be warmly received by the choir, but dismissed as crankery and ax grinding by anyone on “Team Quintner.” I’m happy to see it added to the debate.

I agree with most of the key points made by Brookbush. In particular, I believe he is especially correct to point out that “the authors consistently misuse and misrepresent citations. If you do not look at each individual citation you would assume this paper is well supported. It is not.”

And I agree that “most of the research and hypotheses on trigger points were not even addressed in this paper.”

And I particularly agree that Quintner et al. attacked “claims that were never made.” Their paper is a parade of easily knocked over straw men.