Hello, my name is Per B.E. Bylund and Im a musculoskeletal practitioner (registered chiropractor, DC) based in Hudiksvall, Sweden. I have a background in clinical biomechanics after five years of study at the Scandinavian College of Chiropractic and are currently pursuing a degree in clinical nutrition (dietetics) at Uppsala University. I have been in private-practice since 2013 but have spent most of my time since then as a student of the scientific literature because I believe we, both chiropractors, doctors and physical therapists are viewing musculoskeletal disease from the wrong perspective and are therefore miss-guided in our clinical approach.
About half of what you read on this site will prove to be false… the problem is that the current state of the scientific literature, and my own limited understanding of this very complicated topic prevent me from knowing which half…
There is something very wrong about the current way we look at musculoskeletal disease. Both clinicians and patients perceive improvement from various interventions, yet in the majority of cases, problems seems to persist or reoccur. The explanation for this phenomenon seems to be that symptoms varies and tracks along with treatment rather than the treatment having a true effect, which is mirrored by the outcomes of clinical studies of various interventions matching each-other and also that of non-treated observational cohorts.1)https://www.ncbi.nlm.nih.gov/pubmed/24607083 This means the care of musculoskeletal disorders is failing on a massive scale, with hardly anybody noticing.
I’m a clinician, but I’ve also been a patient with chronic pain, thinking I was just one of those cases that nobody could figure out. But I was the norm, not the exception. Today I’m asymptomatic, but the way I got to that point was not through treatments, courses or certifications, but by thoroughly studying the scientific literature and adopting corresponding modifications to life-style-related factors. These factors are currently not being systematically addressed in common clinical practice, and I suspect this is because our current perspective on the problem is incorrect, which is why I seek an audience.
This project is an online book, a work in progress aimed at providing up to date, detailed and evidence-based explanations of the pathophysiology behind musculoskeletal disease. The reason why I feel this is needed is because there is a big dissonance between current clinical praxis and the basic science of pathology. The rapid rise of chronic disease got a long head-start on modern medicine, and we started treating way before we knew what we were treating. This is still the case today, and the result is that most methods used by clinicians, such as chiropractors, doctors and physiotherapists are out of alignment with what the research is now starting to point to as the underlying cause.
Through complex mechanisms, diseases connected to chronic pain has been shown to be related to lifestyle factors, such as diet, sleep and psychological distress, decreasing the resilience of the human body to environmental stresses, such as physical load. Unfortunately, the current structure of healthcare does not reflect this, and since healthcare is part of the socio-economic system the market instead gets dominated by methods and models that first and foremost succeed financially rather than clinically. In other words, the market favours what creates happy and returning customers, which has surprisingly enough been found to be poorly correlated with true clinical improvement.2)https://www.ncbi.nlm.nih.gov/pubmed/27035585 This is true for both private and public healthcare, and for conventional and alternative medicine. It is a systemic error, that can perhaps only be rectified at the level of the individual, starting by taking a step back from action, towards thought.
The name “The Red Thread” is derived from a Swedish expression for when things follow a theme or a pattern, and is itself rooted in Greek mythology from the story where King Theseus founds his way out the Minotaur’s labyrinth by following a red thread. I chose this title for the project because of the fact that there seems to be a common pattern that stands out when studying diseases at the tissue level. Wether you’re studying the histopathology of cartilage from a patient with arthritis or brain-tissue from a patient with Alzheimers disease, very similar things seems to be going on, which got me curious about weather there was also common etiological pathways connecting various chronic diseases. The scientific literature is full of gaps when studying single pathological phenomenons, but if the premiss of commonalities is assumed to be true, then lines may carefully be drawn between data from other diseases to bridge those gaps. This may potentially accelerate our understanding of these very common and urgent problems in a time where more research is always needed, providing a short-cut that leads us out of the labyrinth.
There also seems to be more to disease than it simply being a set of problems for modern medicine (again, both conventional and alternative branches) to conquer, and by using a evolutionary-biological approach in searching for the underlying mechanisms I’ve often come across facts and observations that seems to suggest that there are micro-ecological mechanisms at work behind the symptomatic scenes which has formed the foundation for my general perspective on pathology.
My purpose with this project is simply the search for truth, which is an ongoing process, full of potential for errors, and therefore I gladly accept criticism and feedback on the hypothesis, and on the content in general. Currently, financial reasons still prevents me from spending as much time on the project as I would like, and I therefore humbly ask for support from readers who values the information and the purpose of this page. I don’t really expect anything in going after this so any support I can get is highly treasured.
For more information on how you can support me and this project financially, visit my profile on Patreon.com.
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