The real-life practice-based examples given below are designed to illustrate the critical importance of addressing patient concerns in terms of the triad of health, and of what it practically means to genuinely follow a holistic approach to supporting patient health and well-being. Please note that patient names have been anonymised to protect patient confidentiality.

 

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Mr. Baxter is a 48 year-old male who first presented to me with bilateral knee pain. He had been suffering from this complaint for close to 20 years and had decided to make an appointment to see me as the pain had started to get worse and was beginning to significantly affect his work as a builder. From a mechanical point of view, there were a host of typical signs and symptoms that warranted restorative manual treatment to address tight muscles, compressed joints, reduced range of movement, mild swelling, and so on. However, a broader inquiry into his complaint clearly revealed a number of other relevant issues affecting his health. He described a chronic history of broken sleep, with fatigue on waking and during the day, morning stiffness, lack of concentration, mild brain fog and a general lack of vitality. His daily diet consisted mostly of sandwiches and carb-heavy meals in the evening. So, aside from providing manual treatment for his knees, I also advised him to stop eating gluten for 2 weeks. After 11 days, Mr. Baxter reported to me that his knees had stopped hurting, but that on the 15th day, he had consumed sponge cake and a beer, which led to his knees feeling like they were ‘on fire’ for 3 days. Having inadvertently re-introduced gluten after a 2-week re-set, his body had confirmed his gluten intolerance! He then persisted with avoiding gluten and four weeks later when he came back to see me he was like a new man, with marked improvement in all aspects of his well-being from his sleep to his cognitive function. 

 

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Mrs. Ryder is a 34 year-old female who first presented with lower back pain. Alongside listening to her description of her complaint, what caught my eye in our first session were her restless leg symptoms, which she indicated she had been suffering from over the previous 6 months. Both of her legs would uncontrollably move and jerk about, mostly at night. She had been advised by one practitioner that it was a ‘genetic’ condition and that there was little she could do about it, other than perhaps to try some exercising and breathing work, and by another that it was 'all in her head’. I advised her to take a good quality magnesium vitamin and after five days her symptoms had completely gone away. 

 

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Mr. Tenner is a 54 year-old male who came to see me on the suggestion of his daughter, who was worried about his neck. He had a slight hump at the base of his neck but suffered from no pain and he himself was not concerned about it. Upon investigation there was a straightforward postural issue in how he was carrying and using his neck, but more importantly he indicated that he had not slept properly for 40 years. He said he had tried ‘everything possible’ to resolve his insomnia but nothing seemed to have helped. On further questioning, he indicated that he could easily fall asleep, but was then waking up every hour or so. This is often due to poorly controlled blood sugars. If your blood sugars drop below a certain threshold at night, then you will very likely wake up - this is your body's way of sounding an alarm to let you know your blood sugar levels are low. Glucose is the main fuel source for our brain, and without it we die. I advised him on what he could do to influence his blood sugar levels at night by changing his diet during the day, including by taking the right combination of vitamin supplements, and within 2 weeks he reported that the quality of his sleep had greatly improved. He was also no longer needing to take sleeping pills.

 

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Mr. Webster is a 39 year-old male who initially presented with low back pain. He coincidentally also had high blood pressure. As he was not a smoker, did not consume alcohol and engaged in a moderate amount of daily exercise, his blood pressure problem had been diagnosed as “of no known origin”. In parallel, his family history included cardiovascular disease from “familial hypertension” (genetically high blood pressure), as well as strokes and heart attacks on his father’s side. There is in fact no direct link between genetics and high blood pressure. However, around 44% of people have a very common defect in the MTHFR gene which prevents them from being able to convert homocysteine to methionine. Elevated levels of homocysteine affect the arterial walls. One way in which this happens is a subtle clamping effect of the arterial wall. When you have blood flowing through a small tube and you make the tube even smaller, the pressure goes up, hence this was a possible explanation for Mr. Webster's high blood pressure. After advising him to take methylated vitamins (methylated vitamins bypass this particular gene defect), his blood pressure had dropped to normal levels within three days.

 

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I have seen multiple patients who present with chronic fatigue and “low mood disorders”, many of whom are on anti-depressants and suffer from symptoms and side effects that have adversely affected the quality of their lives for many years. In my experience it can be the case that many such patients are actually suffering from low or sub-optimal vitamin D levels, which can and does cause many of the symptoms they present. The significance of Vitamin D deficiency is not well known or understood, and yet, if it is the underlying cause of a patient’s chronic fatigue and low mood (as opposed to other organic or psychosocial causes that may be relevant) it is a simple and relatively inexpensive problem to address. Most of my patients with this presentation have responded very well to taking sub lingual vitamin D (with K2), with marked improvement in their mood and level of vitality.  

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Allostatic load refers to the cumulative burden of various sources of stress (physical, metabolic and psychosocial) on our bodies over time. As we go through our lives, we inevitably add to our load through, for example, poor dietary choices, faulty movement patterns, emotionally stressful relationships, and so on. Above and beyond that, our genetics significantly shape how we interact with our environment, but it is our lifestyle choices that largely dictate how much load we are adding onto our system over time. Ill health and disease (dis-ease) is the result of this load becoming too great for our body to cope with. 

 

Any health condition that affects us will have as its root cause one or more of these three areas - physical, metabolic and psychosocial - if not typically a combination of all three. This is what we refer to as the triad of health and an understanding of health in these terms is key to being able to properly address each patient’s health challenges.

 

In that light, manual therapy works best whenever the foundations of a person’s health are optimal. If a patient’s triad of health is challenged in any of its key dimensions, for example as a result of poor diet, this will inevitably inhibit the body’s capacity to self-heal. The manual treatment you receive may make you feel better temporarily, but the complaint will persist, re-appearing soon after treatment, and will remain unresolved unless and until other relevant aspects of our health are addressed. 

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As the above cases illustrate, a holistic approach is essential to finding the right solutions to your health issues. Having your back clicked and most passive therapies do not actually resolve most health problems, and under certain circumstances, taking medication can also be counterproductive. It is unfortunately the case that much of the currently available information about health, whether from health practitioners themselves, medical textbooks or from the internet, is not a reliable, relevant or accurate source of information. At Healthiem, we always strive to provide you with the quality of information you need to best support your on-going health and will always offer evidence-based approaches to any treatment we advocate.