Unicorns Aren’t Real—And Neither Are Trigger Points
I’ll take “Unpopular Opinions” for $1000, please.
Let’s start with a simple question: what does real actually mean?
Having objective, independent existence
Occurring in reality
Detectable and reliably identifiable
Now compare that to the traditional definition of a “trigger point”:
a hyperirritable nodule or taut band in muscle tissue, said to cause myofascial pain.
Here’s the problem:
There is no credible, consistent scientific evidence that these structures exist as discrete, identifiable physical entities.
They can’t be reliably found.
They can’t be objectively measured.
They don’t show up on imaging.
Different clinicians don’t agree on where they are—or if they’re there at all.
That’s not a solid foundation. That’s a shaky theory.
Pain Is Real. The Explanation Might Not Be.
Let’s be very clear about something important:
People absolutely experience sore, tender, sensitive areas in their bodies.
That experience is real. The discomfort is real.
What’s under scrutiny is not the pain—it’s the explanation.
There’s a meaningful difference between:
“Your pain isn’t real” (not true, not acceptable), and
“This explanation for your pain may not be accurate” (worth examining)
We can—and should—update explanations when better evidence comes along.
Why This Matters
Language shapes how people understand their bodies.
Telling someone they have a “knot” or “trigger point” can unintentionally suggest:
There is something structurally wrong
It needs to be “released” or “fixed”
Their body is damaged or dysfunctional
That framing can increase fear, reinforce dependency on treatment, and narrow the focus of care.
More importantly, it can distract from the bigger picture:
Pain is complex, and influenced by multiple factors—mechanical load, nervous system sensitivity, stress, sleep, context, and more.
Reducing it to a tiny “knot” in a muscle isn’t just simplistic—it can be misleading.
So What Is Happening?
Instead of discrete “trigger points,” what we’re likely dealing with is a broader, less tidy phenomenon:
Localized sensitivity
Changes in muscle tone or guarding
Nervous system amplification
Context-dependent pain responses
In other words: real symptoms, without a neat little lump to blame.
Where I Land
I’ve moved off the fence.
I agree with critics like John Quintner—the trigger point model doesn’t hold up under scrutiny, and it’s time to let it go.
That doesn’t mean abandoning hands-on care.
It means being more honest and precise about why we think it helps.
If You Want to Go Deeper
For a thorough, well-cited (and surprisingly entertaining) deep dive, I recommend the work of Paul Ingraham at PainScience.com—especially his trigger point index.
Bottom Line
Pain is real.
Sore spots are real.
But the idea that there are tiny, pathological “knots” causing that pain?
That’s a story we’ve outgrown.