Differences in Musculoskeletal Care Between Korean and Western Patients:

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

The Limitations of a Soft Approach and the Need for Tailored Treatment

1. Cultural and Systemic Differences in Patient Response

Clinical outcomes in musculoskeletal disorders are not determined solely by pathology but are strongly influenced by healthcare systems and cultural expectations.

  • Healthcare accessibility: In Korea, the National Health Insurance system allows patients to access frequent and diverse treatments such as injections, physical therapy, and manual therapy at relatively low cost【1】. In Western countries, higher medical expenses and limited accessibility often lead patients to rely more on self-management and exercise【2】.

  • Patient expectations: Korean patients generally demand immediate symptom relief, while Western patients are more accustomed to gradual, long-term improvement【3】.

  • Accumulated treatment exposure: Korean patients often present after undergoing multiple interventions, creating expectations for “strong and definitive effects” from any new therapy【4】.

2. Why the Soft Approach Often Fails in Korea

The “soft approach” refers to gentle, non-aggressive techniques that aim to restore musculoskeletal balance gradually. While safe and well-tolerated, it often appears less effective in Korean patients due to several factors:

  1. Tolerance from repeated exposure
    Many Korean patients have already received multiple strong interventions (e.g., manipulations, injections, acupuncture). Their bodies and minds are less responsive to subtle stimuli【5】.

  2. Mismatch with psychological expectations
    Patients often associate strong manual pressure or immediate “release” with effective treatment. As a result, a soft approach can feel unsatisfactory despite its physiological benefits【6】.

  3. Lack of immediate relief
    While soft techniques improve neuromuscular control, fascial balance, and microcirculation over time, the effects are gradual. This clashes with the Korean patient’s cultural demand for rapid symptom relief【7】.

3. Clinical Example: Upper Cervical Care

These differences become evident in daily clinical practice.
A patient recently presented with chronic dizziness and headaches after receiving repeated physical therapy and medications at various clinics with little improvement. A purely soft approach was unlikely to meet expectations or produce noticeable relief.

Upon examination, significant upper cervical (C1–C2) malalignment was detected. I applied a precise upper cervical correction combined with injection therapy and myofascial stabilization techniques. The patient reported immediate relief of neck tension and a noticeable reduction in headache intensity.

This case demonstrates that for Korean patients, a tailored combination of strong and gentle interventions—rather than a soft approach alone—can achieve both instant satisfaction and long-term recovery.

4. Conclusion

In Korean clinical settings, a soft approach in isolation often falls short.

  • Treatment should be multimodal, combining injections, IMS, and upper cervical adjustments.

  • Instead of simply applying Western-style long-term management models, clinicians must adopt a “strong stimulus + gradual recovery” strategy.

  • Ultimately, understanding the cultural and experiential background of Korean patients is essential for effective musculoskeletal care.

References

  1. OECD Health Statistics. Health care utilization and access (2023).

  2. Fritz JM, et al. Physical therapy utilization and costs in the United States. Spine J. 2012;12(8):706-714.

  3. Bishop A, et al. Patients’ beliefs about back pain, and how they influence treatment outcomes. BMJ Open. 2015;5:e009356.

  4. Lee JH, et al. Current status of musculoskeletal pain management in Korea. Korean J Pain. 2017;30(2):100-108.

  5. Kong JH, et al. Patient expectation and satisfaction in musculoskeletal pain treatment. J Korean Med Sci. 2020;35(24):e180.

  6. Hurwitz EL, et al. Patients’ perceptions of chiropractic treatment for musculoskeletal pain. Spine. 2006;31(6):629-635.

  7. Schleip R, et al. Fascia as a sensory and regulatory organ. Front Physiol. 2019;10:336.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net

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