In an ideal world, you and your patient would address and resolve every single issue in their health – Physical, metabolic & emotional.
They get up early and do an hour’s meditation, then an ice bath, followed by infrared sauna, a piece of liver for breakfast with glass of kefir on the side.
They do regular exercise, a combo of strength, flexibility and cardio.
They have loving relationships with family and friends, with a career that fulfills them, and when you adjust them……oh it slides right in and stays in.
Hallelujah, and praise to DD and BJ.
But in reality no one does and has all that.
And the truth is, they do not need to do all that, because not all parts of their health problems are equal.
That is to say, their health is like a jigsaw, BUT not all the parts are the same size or equally important.


You see, ultimately, you have to break the vicious cycle they are in, not make them perfect human beings (because they do not exist).
In acute situations, this is usually an adjustment to the right area in the right way.
But it is the chronic patients where breaking the vicious cycle is harder as there are more parts to work on.
And in my opinion, this is what sorts the real clinicians from the posers.
Hence, we need to avoid trying to get all parts of the health jigsaw right and focus on the big parts.
For chronic patients to get well, the first thing is to “move the needle” and make them feel something has changed.
I am looking in the first 2–4 weeks for anything that is significant and sustainable. If I can get them 10, 20, 30% improved (when they have had no change for years), then they have confidence in me and will carry on (and often commit more to the process).
Once you have broken the vicious cycle, they have that all important thing: Hope
They believe they can now recover or at least manage the issues, so they are no longer dominating their life.
Without hope, people give up.
So, rather than chase after every single thing that is wrong with the patient, I/you need to find the big pieces of their health jigsaw puzzle.
We need to avoid/remove/reduce the “bad” stuff they have too much off that is creating the bigger imbalances.
In the example below, gluten sensitivity, poor sleep and high homocysteine from low B12/folate are the really big bits causing an imbalance.

Check these out:



And add/increase the big “good” stuff they are missing. In this case vitamin D, magnesium, & B12.

This plus you Neuro-mechanical care and you have a path to recovery.

With good “stuff”, we are after “KEYSTONE” nutrients, the ones that, when low, mean your system is so dysfunctional that nothing else is going to help.

It is a bottle neck to change and recovery.

Such as Vitamin D, or B12.
Check out this case series of patients with failed low back surgery syndrome.

https://www.jabfm.org/content/jabfp/22/1/69.full.pdf
Or this one on B12 for low back pain.

This is pretty much what we are dedicated to at ACN with Core Concepts in Chiropractic Nutrition.
Laser focussed, protocols for results from Chiropractic care.
All killer, no filler.