The medical anthropologist Merrill Singer introduced the word syndemic in 1992 and recently updated the definition as "a set of enmeshed and mutually enhancing health problems that, working together in a context of deleterious social and physical conditions, increase vulnerability to significantly affect the overall disease status of a population."1
This novel concept is gaining momentum because it has become increasingly clear that the burden of modern health care cannot be addressed by the traditional policy of designing therapeutic research trials and prevention programs that only focus on one disease or risk factor at a time. It is now understood that few serious and/or chronic diseases occur in isolation. Comorbid diseases occur simultaneously in the same individual, but may or may not interact with each other. Even if they do interact, this does not necessarily lead to worse health outcomes.2
However, in the case of syndemics, the evidence is that there is influential interaction between diseases that negatively affect the disease course, severity and final outcome.3 Many doctors of chiropractic appreciate this distinction and approach each patient as a constellation of interacting influences, including but not limited to the patho-biomechanical, environmental, and neuromusculoskeletal imbalances that may be resolved or managed with chiropractic care. An increasingly common clinical example is the patient with metabolic syndrome (MSyn) or "syndrome X," which includes obesity, insulin resistance, hypertension, high triglycerides, low HDL cholesterol, abnormal clotting and inflammatory markers.4
Over sixty percent of North American adults are currently overweight and the number of obese children has more than doubled among 2- to 5-year-olds (10 percent ) and more than tripled among 6- to 11-year-olds (15 percent). Clinicians need to educate and monitor these patients to ensure that they participate in daily exercise and follow healthy nutritional principles in order to control obesity. This is a reasonable therapeutic goal and addresses a modifiable risk factor.5
Chronic low back pain adds even more complexity to an already overburdened clinical picture. It is generally known that low back pain affects up to 80 percent of the population.6 Low back pain makes any activity, including walking, difficult and is often given as the reason for noncompliance in following a regular exercise program.7 You will likely appreciate what a challenge this presents to clinicians and their patients. Current clinical research demonstrates that chiropractic manipulative therapy is effective in the treatment of acute, subacute and chronic low back pain, and should be utilized at the earliest opportunity.8
This is a very serious constellation of linked health problems acting synergistically - increasing morbidity, diminishing quality of life and increasing dependency on multiple health services.
To prevent a syndemic, we must prevent or control each contributor as well as the interactions that connect them. The Centers for Disease Control and Prevention (CDC) considers syndemic orientation "a way of thinking about public health work that focuses on connections among health-related problems, considers those connections when developing health policies and aligns with other avenues of social change to assure the conditions in which all people can be healthy. Related concepts include social ecology, health promotion, health equity, health dynamics, social epidemiology and system change."9
Chiropractic is well-equipped to make a positive contribution in the fight against syndemics by offering new theories of causation, insightful therapeutic options and a readiness to form alliances with other health care providers in the best interest of patient care.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
