Your back hurts. Your shoulders are tight. You’re exhausted in ways that sleep doesn’t fix. Your hormones feel off. You’ve seen doctors, had scans, tried treatments — and nobody can quite explain why.
Here’s a different question: what if the body isn’t broken — just mismatched?
What is evolutionary medicine?
Evolutionary medicine asks a simple but powerful question: why did this symptom appear in the first place?
The human body was shaped by roughly 200,000 years of evolution as hunter-gatherers. Then, in an evolutionary blink of an eye, everything changed — our diet, our movement, our sleep, our light exposure, our social structure. The body hasn’t had time to catch up. That gap between the environment we evolved for and the environment we actually live in is called an evolutionary mismatch.
Chronic pain, persistent fatigue, hormonal disruption, allergies, and many other “modern” health problems can be understood — at least in part — through this lens. Understanding why a symptom exists changes how we approach it.
The six axes of mismatch
At Kyoto Osteopathy Center OQ, we organize evolutionary mismatch patterns into six categories. Each axis illuminates a different set of symptoms:
Axis 1 — The cost of walking upright
Bipedalism freed our hands and expanded our brains — but it compressed our lumbar spines, narrowed our birth canal, and overloaded our pelvic floors. Back pain, scoliosis, and pelvic floor dysfunction are not accidents. They are the price of standing on two feet.
Related reading: Why only humans get back pain / Plantar fasciitis, bunions and modern shoes / Osteoarthritis isn’t just aging Why Osteoporosis Is Not Just About Calcium Plantar Fasciitis & Bunions — The Price of Modern Shoes / Cervical pain & text neck — an evolutionary problem / Frozen shoulder — why only humans get it
Axis 2 — Collision with the modern environment
Smartphones, processed food, artificial light, sedentary work — the body encounters stimuli it has no evolutionary preparation for. Neck pain from screen use, myopia from indoor living, jaw problems from soft diets, and chronic fatigue from circadian disruption all belong here.
Related reading: Why smartphones damage your neck / Wisdom teeth & jaw shrinkage / Mouth breathing & jaw development / Dizziness & tinnitus / Loneliness is worse than smoking / ADHD & the hunter-gatherer brain / Type 2 diabetes & obesity — the thrifty gene / Depression is not a brain malfunction
Axis 3 — Misread defense signals
Fever, morning sickness, allergic responses, and immune reactions are not malfunctions. They are ancient defenses — and in the modern context, they’re often being triggered by the wrong signals, or suppressed when they shouldn’t be.
Related reading: Allergies & the hygiene hypothesis Autoimmune Disease — When Immunity Loses Its Enemy The Appendix Was Not Useless After All Survival of the Sickest — Why Disease Genes Persisted / Why the immune system attacks itself / Hashimoto’s disease & evolution / Why pain persists after healing / Chronic inflammation in modern life / Why disease genes didn’t disappear / Morning sickness is not weakness / Why atopic dermatitis is increasing / IBS — the gut was the first brain
Axis 4 — Female hormonal environment transformed
Women in hunter-gatherer societies had roughly 160 menstrual cycles in a lifetime. Women today have around 450. That threefold increase is unprecedented in evolutionary history — and it underlies conditions like endometriosis, PCOS, PMS, and fertility challenges.
Related reading: Modern menstruation as evolutionary mismatch / Why dysmenorrhea is increasing / Menopause & the Grandmother Hypothesis / PCOS & thrifty gene theory / Postpartum depression & evolution / Why sperm counts have halved / Why uterine fibroids are increasing
Axis 5 — Chronic HPA axis activation
The stress response evolved for short, intense threats — a predator, a flood. Modern life delivers low-grade, continuous stress that the nervous system was never designed to handle. Autonomic dysregulation, gut-brain disruption, and insomnia all live in this axis.
Related reading: Redefining autonomic nervous disorders / Waking at night is not insomnia / Panic attacks & CO2 sensors / Why heart disease has increased / Long COVID & autonomic dysfunction / Weather pain & the inner ear / Why rest doesn’t fix fatigue / Orthostatic dysregulation is not laziness / Overactive bladder — an evolutionary view / Depression is not a brain malfunction / IBS — the gut was the first brain
Axis 6 — Evolutionary legacies
Some constraints are built into our biology and can’t be changed — only understood and worked with. The obstetric dilemma (childbirth is difficult because our pelvis narrowed as our brains grew), and infantile colic as a signal of birth stress, belong here.
Related reading: The obstetric dilemma / Infant colic & birth trauma / Why newborn heads are cone-shaped / Why children get recurrent ear infections / Latch difficulty & birth mechanics / The appendix was never useless / Why humans choke on food / Infant torticollis — why it happens / Why babies don’t sleep / The eye is built backwards / Why myopia is surging / Breech presentation — an evolutionary view / Why adenoids and tonsils swell
What this means for treatment
Understanding a symptom evolutionarily doesn’t make it disappear. But it changes what we do about it.
If back pain is partly the cost of bipedalism, then treatment isn’t just about the disc or the muscle — it’s about how the whole upright body is organized, how load moves through the spine, and how the nervous system has adapted. Osteopathy is well-suited to this kind of whole-body, whole-person thinking.
At OQ, we use evolutionary medicine as a framework — not to overwhelm patients with theory, but to explain what’s happening in terms that make sense, and to guide treatment toward the root rather than just the symptom.
Frequently asked questions
Is this just theory, or does it actually change treatment?
It changes how we think about treatment. Understanding that a symptom has an evolutionary origin means we’re not just chasing pain — we’re asking what the body was trying to do, and whether we can help it do that more effectively. In practice, this often means broader, more holistic approaches rather than isolated interventions.
Do I need to read all the articles before coming for treatment?
Not at all. The articles are background reading for those who are curious. Treatment always starts with your situation — your symptoms, your history, your body. The evolutionary framework is something we use in the background, not something we lecture about during sessions.
Can I book an appointment in English?
Yes. Yusuke Sakata (BSc Osteopathy, EVOST) conducts sessions in both English and Japanese. Book online via SimplyBook.me. Visit our For Visitors page for practical details including location, fees, and what to bring.