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Is muskuloskeletal medicine lacking soul?
A thought piece by dr neil
In the world of musculoskeletal medicine, practitioners are extensively trained to understand anatomy, physiology, and how to diagnose various conditions within their scope of practice. With time, this rigorous training conditions us to focus on symptoms and physical findings, often turning patient care into a mechanical process of sorting symptoms into diagnostic algorithms. But in doing so, are we missing something deeper? Are we treating the condition and forgetting the person behind it? Is muskuloskeletal medicine lacking soul?
The Mechanistic Approach to Diagnosis
Itโs all good and well, but we often forget the very thing that is driving most of what is presented in front of us, and we tend to lose focus and treat the disease entity and not the person thatโs walked through our door looking for our help.
Consciousness and Pain - Is Musculoskeletal Medicine Lacking Soul?
I recently read a very interesting paper by Wallden & Chek titled: The Ghost in the Machine โ Is Musculoskeletal Medicine Lacking Soul? Itโs a thought-provoking paper and I suppose one that came to me at a time when past, present, and future are top of mind in the greater scheme of consciousness. Two lines that absolutely resonated with me were:
โโฆresearchers in the field of human consciousness estimate that between 95-99% of human cognitive function is unconsciousโฆโ
โPain is a conscious experience. As such, pain can be viewed as a mechanism that brings the unconscious to our awareness.โ
What determines this unconscious? Thoughts, beliefs, behavior, attitudes of ourselves, people around us, things we read, watch, listen toโฆ So are we not merely creating an existence based on algorithms formed by our unconscious?
The Unconscious Mind and Its Influence on Health
Carl Jung said: โUntil you make the unconscious conscious, it will direct your life and you will call it fate.โ
While at the Admired in Africa conference and Photo Fair a few weeks back, I had the privilege of some deep conversation with a few of my photography friends and that really has provoked a sense of wanting to ask more, question more, but most of all also being more mindful.
What is fear, why do we avoid things? What is that anxious feeling that drives so many of our decisions or lack thereof? Are they unconscious, irrelevant, irrational maybe? What effect are these unconscious processes having on our health as individuals if 95% of our cognitive function is governed by them?
Shifting the Focus - Treating the Person, Not Just the Condition
The paper really is worth reading in its entirety as there are so many nuggetsโฆ Iโll leave you with this:
โPain is not an object we can โdo something toโ it is an experience we can seek to assist the patient to make sense of.โ
Final Thoughts
As practitioners, itโs worth reflecting on whether our clinical processes are truly serving the patient or merely the diagnostic algorithm. Pain is complex and deeply personal, influenced by factors beyond the physical body. Perhaps itโs time to reconsider our approach and strive to connect with the human experience of pain, rather than just treating it as a problem to be solved.
Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for personalized recommendations.
about Dr neil cuninghame
Mtech Chiro (DUT)ย ย lย ย PG Dip Pain Mngmnt (UCT)
Hi, Iโm Dr. Neil Cuninghame, aย Hillcrest Chiropractorย specializing in helping you move better, feel better, and live better. Whether youโre struggling with chronic pain, sports injuries, or everyday aches like headaches, back pain, or shoulder discomfort, Iโm here to guide you toward lasting relief. With over 16 years of experience, Iโve helped athletes, busy professionals, parents, and many others overcome pain and return to doing what they love. My approach combines evidence-based care, personalized treatment plans, and a deep understanding of how the body works.
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Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for personalised recommendations.
ยฉ Dr Neil Cuninghame 2025