The Hidden Healthcare Crisis: Why the General Population Must Learn Self-Treatment Strategies part 1

From the Author

Abstract

This article examines what the author identifies as a hidden healthcare crisis: the growing number of individuals experiencing complex, multi-symptom disorders associated with chronic stress, Long COVID, persistent fatigue, cognitive difficulties, sleep disturbances, brain fog, headaches, and other neurological symptoms.

Based on more than fifty years of professional experience, clinical observations, personal research, and treatment of thousands of patients, the author describes a significant change in the clinical population observed during the past five years. Patients who previously presented primarily with isolated musculoskeletal conditions increasingly present with multiple simultaneous symptoms involving several body systems.

Based on available data and observations from his own clinical practice, the author warns of a significant possibility that the general population may face an increasing risk of developing dementia and other degenerative brain diseases.

The article discusses the increasing pressure on primary care and specialty healthcare, the challenges created by fragmented care, and the potential limitations of addressing complex chronic stress-related disorders primarily through symptom management.

Particular attention is given to persistent muscular tension, autonomic dysfunction, impaired cerebral perfusion, chronic stress, sleep disturbances, prolonged inflammation, and possible neuroinflammatory processes as interconnected components of chronic stress-related disorders.

The author also discusses the potential relationship between persistent neuroinflammation, cerebrovascular dysfunction, cognitive decline, and neurodegenerative disease, while emphasizing the need for comprehensive medical and interdisciplinary evaluation.

The author argues that the scale and persistence of these disorders make patient education and active participation in self-care increasingly important. Because patients experience physiological /psychological stress every day while professional treatment may occur only intermittently, self-treatment strategies may provide an opportunity to continue appropriate supportive care between professional visits.

The article introduces a structured chronic stress-related self-massage program developed from the author's professional clinical protocol, with the goal of helping individuals participate more actively in their own recovery without replacing medical care.

A Personal Journey That Changed My View of Modern Healthcare

During more than fifty years of practicing and teaching medical and sports massage, I have had the privilege of working alongside physicians, physical therapists, chiropractors, and other healthcare professionals in integrative medical settings.

Throughout my professional career, my primary clinical interests included spinal disorders, prevention of unnecessary spinal surgery, sciatica, cervical dysfunctions, vertebral artery compromise, hypertension associated with cervical pathology, headaches, and numerous neuromusculoskeletal disorders.

Most of my patients were referred by physicians. These were often difficult clinical cases requiring careful evaluation and individualized treatment.

Almost overnight, the clinical picture changed.

Instead of seeing patients with isolated orthopedic or musculoskeletal disorders, I began receiving referrals for individuals suffering from multiple symptoms occurring simultaneously.

These patients complained of:

• Persistent headaches
• Dizziness
• Brain fog
• Poor concentration
• Memory impairment
• Chronic fatigue
• Sleep disorders
• Anxiety
• Depression
• Autonomic dysfunction
• Unexplained muscle pain
• Exercise intolerance
• Overwhelming exhaustion

Even more concerning was the enormous increase in the number of these patients.

Many had already consulted primary care physicians, neurologists, cardiologists, psychiatrists, rheumatologists, physical therapists, chiropractors, and numerous other specialists.

Despite extensive diagnostic testing, many were still searching for answers.

Even more discouraging, treatment methods that had produced reliable clinical outcomes for years suddenly became much less predictable. Patients frequently experienced temporary aggravations or incomplete recovery.

Looking Back Helped Me Understand the Present

Earlier in my career I had experience working with olympic and professional athletes.

Elite athletes constantly expose themselves to intense physical and psychological stress.

Some eventually developed severe burnout characterized by:

• Exhaustion
• Cognitive decline
• Insomnia
• Autonomic disturbances
• Persistent muscle tension
• Chronic fatigue
• Emotional instability

Their symptoms were remarkably similar to those I was now observing throughout the general population.

Recognizing these similarities became one of the turning points in my clinical thinking.

I began modifying treatment protocols that I had previously used for severely overtrained athletes.

During the last five years, chronic stress-related disorders and Long COVID gradually became the primary focus of my clinical practice.

The growing number of these complex patients also motivated me to study not only the situation within the massage therapy field, but also the condition of the healthcare system as a whole.

A Healthcare System Under Extraordinary Pressure

As I reviewed current healthcare statistics and compared them with my own clinical observations, one conclusion became increasingly difficult to ignore.

Healthcare professionals across virtually every discipline are treating an unprecedented number of patients with chronic, complex, multi-symptoms disorders.

Published data indicate that:

• Approximately 75–90% of visits to primary care physicians involve stress-related complaints.
• Approximately 17–20 million Americans continue to experience Long COVID.
• More than half of American adults now live with multiple chronic medical conditions.
• Demand for psychiatric and psychological care has increased dramatically since the COVID-19 pandemic.
• Prescriptions for antidepressants and anti-anxiety medications remain substantially higher than before the pandemic.
• Large longitudinal studies have reported an increased long-term risk of cognitive impairment among many COVID-19 survivors, particularly those with persistent symptoms.

The Primary Care Crisis

Primary care physicians today are expected to diagnose and manage an enormous variety of complex disorders.

Unfortunately, appointment times continue to shrink while patient complexity continues to increase.

Many patients present with multiple concerns, symptoms, different complaints during a single office visit.

Under these circumstances, identifying the underlying physiological mechanisms becomes extremely difficult.

Patients are referred from one specialist to another.

Each specialist evaluates only one body system.

Yet the patient's symptoms frequently involve the nervous system, immune system, endocrine system, cardiovascular system, musculoskeletal system, and autonomic nervous system simultaneously.

This fragmented approach may delay recognition of the broader pathophysiological picture.

Are We Treating Symptoms Instead of Addressing the Underlying Pathophysiology?

One of my greatest concerns is the growing dependence on medication to control symptoms while the underlying physiological disturbances remain largely unchanged.

Modern medicine has produced extraordinary medications that save countless lives.

They are indispensable for many serious conditions.

However, in cases of multi-symptoms disorders, medications somewhat may be control symptoms rather than directly reverse the pathophysiological processes contributing to chronic stress-related dysfunction.

In my opinion, this distinction deserves far greater attention.

When persistent muscular tension, autonomic imbalance, impaired cerebral perfusion, physical inactivity, poor sleep, chronic stress, and prolonged inflammation coexist, symptom suppression alone may not fully work, because there are currently no medications that can specifically address the dysfunctions mentioned above.

Rather, it emphasizes the importance of combining appropriate medical care with rehabilitation, patient education, and other non-pharmacological interventions whenever appropriate.

Millions May Be Living With Persistent Neuroinflammation

One of the concepts that has become central to my clinical thinking is neuroinflammation.

Current scientific research increasingly suggests that inflammation within the nervous system may contribute to persistent neurological symptoms following viral illness, chronic stress, immune dysregulation, and other conditions.

In my clinical opinion, a considerable number of patients suffering from chronic stress-related disorders and Long COVID may be experiencing persistent low-grade neuroinflammatory processes that contribute to:

• Brain fog
• Impaired concentration
• Memory problems
• Headaches
• Dizziness
• Autonomic dysfunction
• Chronic fatigue
• Sleep disturbances
• Emotional instability

Whether Neuroinflammation Is the Primary Cause or One Component of a Broader Syndrome?

The answer is that chronic stress-related disorders represent a cascade of multisystem disorders.

Although we know that brain inflammation is one of the early responses to chronic stress and prolonged exposure to stress hormones, persistent neuroinflammation is a dangerous condition that may contribute to the development of dementia and other brain dysfunctions.

Nevertheless, this possibility deserves serious attention because prolonged neuroinflammatory processes have been associated with an increased vulnerability to the later development of dementia and other irreversible degenerative brain diseases.

Brain Dysfunction Is Becoming Increasingly Common

During the past several years I have become increasingly concerned that subtle brain dysfunction is affecting far more people than most of us realize.

Many individuals continue working despite:

• Poor concentration
• Forgetfulness
• Mental fatigue
• Reduced productivity
• Emotional instability
• Sleep deprivation

These symptoms are often dismissed as normal consequences of stress.

In reality, they may represent important warning signs that the nervous system has exceeded its adaptive capacity.

Recognizing these symptoms early may create opportunities for intervention before more serious dysfunction.

Psychiatry Faces Its Own Challenge

Another issue that deserves thoughtful discussion is the overlap between primary psychiatric disorders and psychiatric symptoms that arise secondary to prolonged physiological stress.

Patients with chronic stress-related disorders frequently experience anxiety, depression, irritability, panic attacks, cognitive impairment, sleep disturbances, and emotional dysregulation.

These symptoms can closely resemble primary psychiatric illnesses.

From my clinical perspective, careful differential evaluation is extremely important.

Whenever psychiatric symptoms develop in association with chronic stress related disorders, persistent pain, autonomic dysregulation, post-viral syndromes, or Long COVID, consideration should also be given to potential medical contributors alongside psychiatric assessment.

Rather, it emphasizes the importance of comprehensive interdisciplinary evaluation so that both psychological and physiological factors receive appropriate attention.

Why Self-Treatment Has Become Essential

One conclusion became increasingly obvious to me.

The current healthcare system’s available approaches and treatments are insufficient to adequately address the scale and complexity of the clinical phenomenon I have described.

We are facing what can reasonably be described as a global dementia crisis. Persistent neuroinflammation and cerebrovascular dysfunction are increasingly recognized as important contributors to the processes underlying cognitive decline and neurodegeneration.

Evidence from systematic reviews and meta-analyses supports the association between inflammatory processes and dementia, while maintaining healthy cerebrovascular function and addressing modifiable vascular and inflammatory risk factors are increasingly recognized as important components of comprehensive dementia-risk reduction.

Many chronic conditions require continuous management.

Patients may receive one or two professional treatments each week.

Economic Impact of Persistent Chronic Stress-Related Symptoms on Productivity, 2020–2025

The economic impact of persistent chronic stress-related symptoms is substantial, particularly through absenteeism and presenteeism—when employees remain at work but function below their normal cognitive and physical capacity.

Symptoms such as fatigue, sleep disturbances, impaired concentration, memory problems, headaches, dizziness, and emotional instability can interfere with productivity and work performance.

A systematic review found that productivity losses from chronic health conditions can reach substantial levels, with reported work impairment ranging from 10% to 70% depending on the condition.

That imbalance inspired me to develop a structured self-treatment program based upon the same physiological principles used in my professional clinical protocol.

The objective is not to replace healthcare professionals.

The Principles Behind My Clinical Approach

Throughout many years of clinical practice I have focused on several clinical objectives:

• Reducing excessive muscular tension
• Improving soft tissue mobility
• Supporting healthy circulation
• Encouraging normal venous and lymphatic drainage
• Promoting normal movement of cerebrospinal fluids
• Improving oxygen and nutrient delivery
• Supporting autonomic nervous system regulation
• Encouraging relaxation and restorative sleep

These principles form the foundation of both my professional treatment protocol and the self-care program I later developed.

Attention

I personally perform this self-massage protocol at least four times a week. Like millions of people in the post-COVID era, I have also been negatively affected by chronic stress, experiencing symptoms including sleep disturbances, brain fog, and other problems.

Thanks to incorporating this self-massage protocol into my routine, my health has improved. Most importantly, my blood pressure readings have returned to levels similar to those I had approximately 40 years ago.

It may be difficult to believe, but this is absolutely true. I do not even attempt to explain my personal experience—the clinical results are what matter.

Over the past five years, hundreds of cases documented by referring physicians have provided clinical evidence supporting the effectiveness of this massage protocol. That is what matters most.

I highly recommend spending 15 minutes watching my presentation on this subject. It will help you understand the pathophysiological processes involved in brain dysfunction associated with chronic stress and the importance of taking action to help yourself.

Watch the presentation on YouTube

References

• Livingston G, et al. The Lancet Commission on dementia prevention, intervention, and care: 2024 report. The Lancet. 2024.  This is probably your strongest overall reference for the argument that dementia represents a major global public-health challenge and that a substantial proportion of dementia risk is associated with potentially modifiable factors, including vascular and other health-related factors.

• Shen X-N, et al. Inflammatory markers in Alzheimer's disease and mild cognitive impairment: a meta-analysis and systematic review of 170 studies. Journal of Neurology, Neurosurgery & Psychiatry. 2019;90:590–598.  This is a particularly strong reference for your neuroinflammation statement. The analysis included 170 studies and found evidence linking inflammatory markers with Alzheimer's disease and mild cognitive impairment.

• Heneka MT, et al. Neuroinflammatory fluid biomarkers in patients with Alzheimer's disease: a systematic literature review. Molecular Psychiatry. 2025;30:2783–2798.  This is a very recent systematic review and is especially valuable because it examines neuroinflammatory biomarkers across the Alzheimer's disease continuum. It concluded that neuroinflammation is associated with both early and later stages of Alzheimer's disease.

• Kuring JK, et al. Inflammatory markers associated with dementia: a systematic review and meta-analysis. Journal of Psychiatric Research. 2026;197:26–40.  This is very recent and potentially excellent for your article. It analyzed 41 eligible studies and found that Alzheimer's disease, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are associated with inflammatory processes, although the authors appropriately caution that whether inflammation is causal remains unresolved.