Paul Ingraham – Assistant Editor (Emeritus)

If you’ve ever Googled a stubborn ache at 2:00 a.m. (while bargaining with the universe: “I will stretch more, I swear”),
there’s a decent chance you’ve crossed paths with Paul Ingraham’s workeither directly on Science-Based Medicine or via
his sprawling, obsessively footnoted pain-and-injury library, PainScience.com.

Ingraham’s niche is deceptively simple: explain what the best evidence actually says about pain, physical therapy-ish
treatments, and the many “miracle fixes” that always seem to come with a checkout button. His superpower isn’t a white coat.
It’s translationturning dense research, clinical nuance, and scientific uncertainty into readable, practical guidance
without pretending medicine is a vending machine (“Insert foam roller, receive enlightenment.”).

Who is Paul Ingraham?

Paul Ingraham is a Vancouver-based science writer and former Registered Massage Therapist who shifted from hands-on care
to full-time science writing and editing. He joined the Science-Based Medicine (SBM) team after meeting key SBM physicians
at a skeptical science conference, and later became the site’s assistant editoreventually “retiring” into emeritus status.

That background matters. Ingraham isn’t writing about pain from a distance; he’s worked with chronic pain patients in
clinical settings, and he’s also described living with chronic pain himself. The result is a voice that can be skeptical
without being smug: critical of weak claims, but sympathetic to the very human reasons people chase them.

What does “Assistant Editor (Emeritus)” mean at Science-Based Medicine?

“Emeritus” is the academic world’s classy way of saying: you stepped back, but you’re still part of the family.
On SBM, Ingraham’s assistant editor role was both technical and editorialhelping keep a high-volume medical skepticism site
functional, readable, and consistent while working with a wide range of contributors.

SBM itself exists to evaluate medical treatments and health claims through the lens of scienceespecially in areas where
hype outpaces plausibility. The site has long focused on controversies where evidence is noisy, incentives are messy,
and “alternative” claims often get a free pass in popular media. In that context, an assistant editor isn’t just fixing commas;
they’re helping maintain standards: clarity, accuracy, and intellectual honesty.

Why this role matters in the age of health hot takes

Modern health misinformation doesn’t always look like obvious snake oil. Sometimes it shows up wearing a lab coat costume:
selective citations, exaggerated conclusions, and a sprinkle of “studies show…” confetti. A strong editorial hand helps keep
readers orientedwhat’s solid, what’s uncertain, what’s wishful thinking, and what’s just marketing with better lighting.

From massage therapy to medical skepticism: the “CAM apostate” storyline

One of the most revealing chapters of Ingraham’s story is why he left massage therapy. In a widely discussed piece, he
describes professional conflict after criticizing pseudoscience in chiropractic and massage culturepressure that ultimately
pushed him to choose writing over practicing. That’s not a small pivot. It’s walking away from a stable identity to keep saying
the quiet part out loud: not all confident claims deserve confidence.

This is also where his tone comes from. He knows the appeal of simple explanations (“It’s a knot!”), tidy villains (“toxic buildup!”),
and satisfying rituals (“realign the fascia!”). He also knows how quickly those explanations can harden into dogmaespecially
in pain care, where outcomes are variable and placebo effects are powerful.

PainScience.com: a sister site with an “SBM-ish” backbone

If Science-Based Medicine is the skeptical newsroom, PainScience.com is the long-form library where the footnotes live.
Ingraham has described it as a large, continuously updated collection of deep-dive articles and book-length guides on
musculoskeletal pain and injury topicswritten for regular humans but dense enough to be useful to clinicians, too.

What he covers (and why readers keep finding it)

• Common pain problems (back pain, neck pain, repetitive strain issues, running injuries)
• Controversial explanations (trigger points, “muscle knots,” fascia claims)
• Overhyped solutions (miracle supplements, trendy tools, one-weird-trick stretching doctrines)
• How pain works (why symptoms don’t always map neatly to tissue damage)

The consistent theme is not “everything is fake.” It’s “most things are complicated.” Ingraham’s writing tends to separate
three questions that get mashed together online:
(1) Is the explanation plausible?
(2) Does the treatment outperform placebo or usual care in meaningful ways?
(3) Even if it helps a little, is it worth the cost, risk, and opportunity loss?

Why pain is the perfect storm for confusion

Pain is not just an alarm bell; it’s an interpretationyour nervous system evaluating signals in context. That’s why chronic pain
can persist after tissues heal, and why pain intensity can be “out of proportion” to visible damage. Modern pain science uses
ideas like sensitization (peripheral and central) to describe how the nervous system can become more reactive over time.

If that sounds abstract, here’s the practical consequence: it’s possible for someone to have real pain and limited tissue pathology,
and it’s also possible for imaging findings to look dramatic while the person feels mostly okay. This mismatch creates space for
confident nonsense to move in and redecorate.

The treatment landscape: lots of options, modest effects

For many chronic pain conditions, mainstream guidance increasingly emphasizes multimodal care: movement, graded activity,
psychological skills (like cognitive behavioral strategies), sleep support, and careful use of medications when appropriate.
U.S. public health guidance has also emphasized maximizing nonopioid and nonpharmacologic approaches for subacute and
chronic pain, reserving opioids for situations where benefits are expected to outweigh risks.

Where does that leave hands-on therapies like massage? Not “never,” but also not “miracle.” Reviews summarized by U.S. health
agencies have often found that massage may help some people with low-back pain in the short term, but evidence quality can be
limited and long-term effects are less clear. Recent research syntheses in major medical journals similarly describe small,
short-term improvements in some contextshelpful, but not the stuff of cinematic cures.

Science-Based Medicine as a mindset, not a personality

A common misconception about skeptical health writing is that it’s just contrarianism with better vocabulary. But science-based
medicinewhen done wellis closer to disciplined humility. The point isn’t to sneer at hope; it’s to protect it from becoming
expensive and distracting.

The EBM vs. SBM twist (and why Ingraham cares)

Ingraham has written about the difference between evidence-based medicine (EBM) and science-based medicine (SBM) in plain
language: EBM is vital, but it can be misused when evidence is treated like a scoreboard detached from plausibility. SBM asks an
extra question before we spend years testing implausible claims: does the claim fit with what we already know about biology,
physics, and mechanisms? In other words, not every “more research is needed” is an invitationit can also be a stall tactic.

A reader’s mini toolkit: how to audit a pain claim like an editor would

1) Watch for the “single-cause fairy tale”

Pain rarely has one clean cause. If a product promises to “fix the root cause” of every back, neck, and knee complaint,
be suspicious. Real medicine is annoyingly specific.

2) Separate “feels good” from “fixes the problem”

Relief matters. But short-term comfort doesn’t automatically mean tissue healing or long-term functional improvement.
A therapy can be pleasant and still have modest clinical impactand that’s okay, as long as we’re honest about it.

3) Look for effect size, not just statistical significance

“Significant” in a study can mean “detectable,” not “life-changing.” Small effects can be worthwhile, but they should be
presented as smallnot inflated into destiny.

4) Check incentives and conflicts

Follow the money, the professional identity, and the brand story. Does the claim mainly exist to sell a course, a device,
or a subscription? If yes, apply extra skepticism (and keep your wallet in a secure location).

5) Prefer sources that update and correct

Medicine changes. Good educators revise. One quiet marker of credibility is a visible commitment to updates, corrections,
and transparent uncertainty.

Why Paul Ingraham fits SBM so well

Science-Based Medicine thrives on contributors who can speak to messy, real-world medical controversies without pretending
certainty exists where it doesn’t. Ingraham’s blend of skillstechnical editing, long-form research synthesis, and lived familiarity
with pain culturemade him unusually effective in that ecosystem.

He also occupies a valuable middle space. He’s not a clinician issuing prescriptions. He’s not a “biohacker” collecting
gadgets like infinity stones. He’s a translator who tries to keep readers from getting emotionally mugged by marketing,
while still respecting that pain is personal, exhausting, and sometimes lonely.

Experiences from the trenches: what this topic feels like in real life

Pain education isn’t just a theory exercise; it’s a daily lived experience for millions of people. Ingraham’s work resonates
because it maps onto the patterns many readers recognize immediatelyespecially the ones nobody warns you about.

Experience #1: The “diagnosis carousel.” You start with a sore knee. Someone says it’s your shoes. Another says it’s your hips.
Someone else says it’s “tight IT bands” (as if your leg is a guitar string). You collect explanations like souvenir magnets.
None of them fully stick, and the uncertainty becomes its own stressor. This is where a science-based approach can be calming:
not because it gives you a single magical answer, but because it helps you stop mistaking confident stories for confirmed truths.

Experience #2: The seduction of simple villains. “Inflammation” becomes the boogeyman for everything. “Fascia” becomes the hidden puppet master.
“Trigger points” become tiny gremlins hiding under every shoulder blade. Ingraham has repeatedly aimed his writing at these
tidy villainsnot to say bodies aren’t complex, but to say that complexity doesn’t justify sloppy certainty. If a concept can explain
everything, it may be explaining nothing.

Experience #3: Relief is realeven when the mechanism is messy. Many people feel better after massage, stretching, or hands-on care.
That matters. Comfort can improve sleep, reduce fear, and make movement feel safe again. But readers also learn (sometimes the hard way)
that feeling better today doesn’t always mean the underlying issue is “fixed,” and it doesn’t prove the story attached to the treatment.
This is one of the most useful mental upgrades: you can accept relief without adopting a myth.

Experience #4: The “regulator vs. writer” tension. Ingraham’s own career pivot illustrates a sharper version of a common conflict:
what happens when professional norms reward tradition, certainty, or group loyalty more than critical analysis? His account of leaving
massage therapy after conflict over publicly criticizing pseudoscience is an extreme examplebut many clinicians and patients recognize the
smaller versions of it: pressure not to question, pressure to “just do what we’ve always done,” pressure to be agreeable even when the evidence
is weak. In a world like that, skepticism becomes less of a hobby and more of a public service.

Experience #5: Chronic pain changes your relationship with information. When pain lasts, people often become reluctant experts out of necessity.
They learn the vocabulary. They read studies. They notice how often headlines overpromise. Ingraham has described being a chronic pain patient
himself, and that perspective often shows up as patience for readers who are tired, overwhelmed, and suspicious of yet another “answer.”
The best science communication doesn’t just deliver factsit helps people make decisions when certainty is unavailable.

The takeaway from these experiences isn’t cynical. It’s empowering: you can pursue treatment and hope while staying grounded in reality.
You can try nonpharmacologic strategies, build movement confidence, and use medical care wiselywithout letting hype drive the car.
That’s the core “Science-Based Medicine” vibe: less magic, more maps.

Conclusion

Paul Ingraham’s link to Science-Based Medicine is more than a job title; it’s a philosophy expressed through years of editing,
writing, and patient-centered skepticism. As Assistant Editor (Emeritus), he represents the behind-the-scenes craft that makes
evidence-based discussion readable and resilient. Through PainScience.com, he extends the SBM approach into one of medicine’s
most confusing arenas: painwhere uncertainty is common, marketing is loud, and people deserve better than easy answers.