In a World With No Manual Therapy – would there be more back pain, or less?

Pain Science Back Pain

Paul Ingraham from speaks with Evie from

This is the first clip taken from a longer interview with Paul. Here we discuss a thought experiment in which physiotherapists, chiropractors, osteopaths and some massage therapists haven’t existed for the past 200 years.

The question is based on an earlier twitter poll asking whether there would be “more or less suffering” in the world if manual therapists hadn’t existed. This is a surprisingly difficult question to answer.

On the one hand, hands-on treatments can be pain-relieving and stress-reducing. See Paul’s article about the science of massage for some of his more thoughts on that. On the other hand, poor explanatory models used by therapists can feed into unhelpful, false beliefs about pain which may contribute to longer-term pain and disability.


About Paul and

Paul Ingraham is a Vancouver science writer and a former Registered Massage Therapist. He left that profession over concerns about pseudoscientific beliefs and practices, and went on to create, a website about the science of pain, injury, treatment, and rehab, where he has published hundreds of articles and ten books on these themes, the most successful of which is his guide to the tricky topic of trigger points. He’s also a reluctant runner and an avid ultimate player (the Frisbee sport) with a long list of his own sports injuries and pain problems. Although not currently blessed with pets, has shared his life with both a dog and a cat in the past. He is currently hiding from COVID-19 with his wife while working on his next book and an endless supply of science updates to

Paul Ingraham:

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