In osteopathy, the Primary Lesion is the original, fundamental trauma that disrupts the body’s structural integrity and starts a chain reaction of pain. It is not necessarily where you feel the pain today, but where the dysfunction actually began.

 

What it Is it

The body is interconnected by a continuous web of tissue called fascia. When you experience a physical or emotional shock—whether it’s

• a birth trauma,
• an old sports injury,
• or a car accident

—the fascia and joints in that specific area “lock” or become stiff.

This original site of restriction is the Primary Lesion.

 

What happenes next: the Chain Reaction

Because the body is a single mechanical unit, it must compensate for this “stiff” area to keep you moving. This leads to:

1. Compensation: Other joints and muscles work harder to make up for the locked area.

2. Symptoms: Over time, these overworked areas become inflamed, leading to chronic back pain, migraines, or fibromyalgia.

3. The Trap: Traditional medicine often treats the symptom (where it hurts), but unless the Primary Lesion is released, the pain will always return.

 

The Goal of Treatment

The “Osteopathic Art” is the ability to ignore the noise of the many symptoms and use the hands to find that one specific, original blockage. By correcting the Primary Lesion, the therapist “knocks over the first domino,” allowing the nervous system to reset and the body’s natural healing powers to take over.

Dr. Adel Rayess’s discovery of the primary lesion was a journey of personal suffering followed by intensive clinical research. It was born from the realization that modern medicine often treats the “smoke” (symptoms) while ignoring the “fire” (the origin).

His discovery process can be broken down into three distinct phases:

 

1. The Personal Catalyst

In the mid-90s, Dr. Rayess suffered a catastrophic skiing accident that broke his pelvis in three places and dislocated his shoulder. Despite years of conventional medical treatment—including hundreds of physiotherapy sessions, steroid injections, and heavy anti-inflammatory medication—he remained in a wheelchair and in constant pain.

His breakthrough occurred when a Swiss osteopath ignored his localized symptoms and performed a specific, high-velocity adjustment on his pelvis. The immediate restoration of his ability to walk proved to him that the site of pain is rarely the site of the problem.

 

2. Research in the Morgue

While studying medicine, Dr. Rayess worked as a technician in a morgue. This gave him a unique, “behind-the-scenes” look at human anatomy that a living patient cannot provide. During dissections, he noticed a recurring phenomenon:

• In almost every cadaver, there was a specific area where the fascia (the connective tissue wrapping muscles and organs) was abnormally thick, scarred, or resistant to the scalpel.

• While most tissue cut smoothly, these “lesion sites” required significant force to penetrate.

• He realized these were the “biological imprints” of old traumas—accidents, falls, or even birth stresses—that the body had never truly released.

 

3. The Development of the “Mind-Hand Connection”

Dr. Rayess spent nearly 30 years refining his sense of touch to detect these “dead zones” in living patients. He discovered that a primary lesion has a distinct physical signature:

• Stiffness: It feels like a joint that has “died” or frozen in time.

• Spiderweb Effect: The lesion creates tension lines that pull on the rest of the body’s fascia, similar to how a snag in a sweater pulls on the threads at the opposite end.

• Three-Dimensional Blockage: By testing joints in multiple directions, he found that the primary lesion is a joint that has lost its ability to move in a 3D plane, forcing the rest of the skeleton to compensate.

 

Read here the full Interviews transcript of above Youtube Video

Below is the full transcript of the video titled “Dr. Adel Rayess: the osteopathic art: finding the primary lesion – origin of body pain,” which features an interview between Dr. Amelia Frigowitsch and Dr. Adel Rayess.

 

---

Dr. Amelia Frigoich: Welcome to this interview. My name is Dr. Amelia Frigoich, I’m a general practitioner and psychiatrist, and I have the honor to interview here very special persons, therapists, and persons who have great gifts and astonishment results in the health care sector. Like today, I am very proud in having here Dr. Adel Rayess. We are here at the conference, the EGMET in Vienna, and I heard today your speech. It was so impressive, so I’m very lucky to have you here right now. Thank you for your time. [00:00]

Dr. Adel Rayess: Thank you. I’m honored. Thanks.

Dr. Amelia Frigoich: Well, I will just introduce Dr. Adel Rayess to the audience with a few sentences. Dr. Adel Rayess is an osteopathic medicine doctor and brain stimulation specialist. He graduated from the University of Lugano, Switzerland. So we have this in common—Switzerland, I was there too. [00:41] And he has more than 20 years of experience in treating patients with very different physiological problems in the body. He specialized in spine treatment. He has a private clinic in Lebanon and he’s very famous there. And just today you told me that at the airport some people here in Vienna came also to you; they recognized you. So it is very difficult in getting a treatment because you have a very long waiting list. [01:09]

Dr. Adel Rayess: Yes.

Dr. Amelia Frigoich: So thank you very much, and I would like to ask the question: what is your special treatment strategy? [01:33]

Dr. Adel Rayess: Well, actually, thank you for receiving me. It’s an honor. Coming to Vienna this time was very special. I had the privilege of giving a small speech—it was like an hour, a bit short, but I hope I delivered the message. So in resume, what I do is I specialize in treating hopeless cases. When the normal medical field or the normal medical staff says “I cannot do anything for you anymore,” for these cases—these are chronic cases such as chronic back pain, neck pain, any kind of pain—and also neurological diseases such as MS, ALS, Parkinson’s, hemiplegia, whatever, fibromyalgia. I’m very skilled in treating fibromyalgia. And the thing is, the success that I have is by the results—as simple as that. [01:43]

Once you give results, you have success, and success brings you fame. I never asked for the fame; I only wanted my patients to get better because there’s a big cause for that. I was a patient and I suffered a lot because I had an accident in the mid-’90s, so almost 30 years ago. I broke my pelvis in three places, and this resulted in—and twisted my coccyx as well—and dislocated my right shoulder. It was a ski accident and this resulted in chronic pain. [03:08]

Can you imagine a young man who—I used to be a huge bodybuilder as well and preparing for competitions, international competitions—and in one second all my bodybuilding dreams went away. I stayed on a wheelchair for a nice period of time and was treated by anti-inflammatory and pain medicine, let’s say, and zero results. Then they went to steroid injections—zero results. And I did hundreds of physiotherapy sessions and hydrotherapy and acupuncture, and nothing worked. [03:59]

Due to the fact that I took so much—they gave me so much anti-inflammatory, I was still a student in the medical field—this created that I had hypertension. I still have the hypertension till today because of all the anti-inflammatory that they gave me. I took, I think, more than 200 boxes of anti-inflammatory. [04:48] So I got to a point, frustrated to a point where I’m living in pain all the time. It was hell. [05:16]

All of a sudden, the boss of my father—my father worked in a factory—and the factory owner knew about my case and how desperate I was. With all the pain that I had, I couldn’t walk for three or four steps. The pain in my back was 10 over 10. So he decided to send me to an osteopath in Switzerland on his expense. I said, “Yeah, why not? I’m in pain all the time, on a wheelchair, all my muscles went away.” And I didn’t know what was an osteopath; I’d never heard of it before. [05:25]

So I went to this osteopath and he examined me in a very weird way. Because when you go to a normal physician, they see your X-rays and then they tell you “lay on your stomach” and they just press on your back—”you have pain here, you have pain here, okay, take this medication.” He examined me in a very weird way. He asked me a few questions and then he was putting his hands on me and mobilizing me without asking me if there’s pain or not. I was a bit surprised. And then he said, “lay on your side,” and then I heard—and he put his big hand on my pelvis—and then I heard a loud sound, something cracked. [06:24]

I was shocked, I was scared. I thought that he broke me. So I was shouting at him and he said, “Calm down, calm down, just wait for five minutes.” And then I was so furious. So I got up, and then I went to my wheelchair, and then I realized: man, I’m walking! [07:15]

Dr. Amelia Frigoich: You’re walking!

Dr. Adel Rayess: Yeah, but look at him—he was smiling. I thought, “What kind of sorcery, witchcraft did he do to me?” And then he explained the principles of biomechanics and the difference between the normal medical world that relies only on images and prescribing medication, and the real treatments that modern medicine has forgotten because they rely only on what the big pharma tells you to do. And I told him that I wanted to learn osteopathy. I fell in love with it. [07:53]

And this is how I started my journey. This osteopath later became my professor. It took me—I graduated first from Lebanon and then I did my specialty in osteopathic medicine in Switzerland. I had a scholarship from the Swiss government. [08:37]

What we were taught in the university was a bit different from what my professor did to me when I was his patient. Because they teach you a lot about anatomy, physiology, biomechanics, but they do not teach you a lot about how to use your hands and the connection between you—the mind and hand connection. This is very important. This human hand took millions of years to become like what it is today. We started as primates… and with evolution, we can now use our fingers. When we started to use our fingers and hands properly, this is when we started to do technology. Like the wheel is technology. Animals do not have a wheel. [09:13]

So the first true technology was the human hand. You can use the human hand to kill, and you can use the human hand to heal. Human beings prefer to go into violent things, create war… but you can still use it to make good. If you really teach your hands to feel what’s going on inside the body, then you can do wonders. It took me precisely—this is my 28th year—to really master the art of treating people. [10:38]

The treatment is easy; it’s the diagnosis that is difficult. Anyone can do a “crack” or a torsion—open social media, you’ll see people cracking other people in a ridiculous manner. But to do a proper diagnosis, this is the difference between success and just making a living. Success is finding a problem and treating it. [11:27]

I was inspired by a few legends who passed away in osteopathy, Americans mainly. One of them is the late Dr. Fulford, who was a phenomenal person, and Dr. Philip Kinman as well. I was inspired by their work and then I did my own research. My research was done in the morgue because I used to work in a morgue as a morgue technician just to get my pocket money when I was studying. [12:10]

I noticed while dissecting that there was always a problem—one big problem in the fascia in each human being. When you cut the fascia, it’s a layer—you cut it with a scalpel, it should cut very smoothly. A lot of times you cut and then it stops. The scalpel does not cut; you need to force and force to cut. I noticed that each person had one particular point in his fascia that was different from all the rest. This intrigued me, and this was the primary lesion—the first trauma that occurred and changed the anatomy of this person. [13:32]

A primary lesion can be from your first breath. When you enter this life, an incomplete first breath can create a primary lesion in your rib cage. When you were born, if you don’t cry to expand your rib cage—because you are breathing through your umbilical cord—if you don’t cry, this will not expand. If it doesn’t expand your rib cage, you will have low oxygen intake during your life. This is a primary lesion. [14:27]

When you fall when you’re a child… those traumas remain in the human body. A primary lesion is a dysfunction in a specific joint where it will interrupt the normal activity of the joint. God created the joint to do a movement. If this joint cannot perform a specific movement in a three-dimensional way, this will create an impact in the fascia and the ligament, and this will create an impact in the muscle, thus the micro-circulation, thus it will spread year after year. This is how we become sick. [15:23]

I’m not saying sick by getting a viral infection—I’m talking about chronic sickness. Medicine cannot do anything for that, just prescribing pills. Take this anti-depressant for life, take this anti-inflammatory for six months. If the pill doesn’t work, take this shot. If the shot doesn’t work, let’s cut you. I’m not criticizing modern medicine—sometimes I do refer patients to surgery when they really need it. When does a patient require spine surgery? When there is paralysis or paralysis has begun. That is the only time where you should do surgery. If you don’t have paralysis, the body will heal. You just need to know how to manipulate the body to help Mother Nature do its work. [16:42]

The body has healing powers. Let’s say I cut my finger now—we sterilize it, put a bandage… after a week, it’s healed. Do you think the tetanus shot or the penicillin did the work? No, Mother Nature did the work. All you did is you helped Mother Nature. This is what I do. I help the body to get better. It’s like a key you put in the door and it doesn’t open—just put some oil to help this key and then it will open. [17:52]

I give you another example: finding a primary lesion. If you want to put light in the room, all you need is the switch and to do a very simple movement—click—and you have light. But if you hit the wall, you’ll never have light. This is how we do the diagnosis—finding the exact lesion, treat the lesion, and leave Mother Nature to do its work. [18:54]

This is why when I do the treatment, I tell the patient: lay down for 20-30 minutes, don’t do anything, just close your eyes. Because the nervous system or the brain is in positive shock. I leave the life force, blood flow, the nervous system, the cells—everything to start working again. And now we use also neuromodulation, which is helping a lot where sometimes we had a few problems with results or very difficult cases. Now we can work the spine and brain. [20:13]

Dr. Amelia Frigoich: Great. It is very admirable. Today I was able to watch you demonstrate—you did the examination and it was very astonishing how you, with only a few touch points, discovered the original primary lesion. How many years of practice does somebody need for being able to examine that well? [21:26]

Dr. Adel Rayess: I graduated in 2005. I would say my level was okay—on a scale of 1 to 10, I was a six. It took me years to educate my hands. I achieved a good level in 2019—meaning 14 years after I graduated. The ultimate level was achieved recently because each year my level goes up; I can feel more. Just like a surgeon who educates his hands to become skillful… it takes a few years to find the deep problems in the human body. It’s very important to examine in a 3D way. [21:54]

Some joints you cannot examine in 3D, like the coccyx because it’s a fused joint. But others, like the occiput, can be examined in a “nine-dimensional” way. The success is to do a proper exam, and you need to double-check and triple-check each time. It takes me two to three minutes to examine a patient now. When I started, it took me 35-40 minutes. [24:00]

I do not examine the skull bones or cranial osteopathy because it lacks scientific evidence. Other osteopaths swear by it, but I didn’t find it very convincing. It’s all about fascia. When you detect this “spiderweb” lesion, this is an anatomy problem. [25:24]

Dr. Amelia Frigoich: What are the main conditions being bettered—like back pain? [26:58]

Dr. Adel Rayess: Neck pain, back pain—we already know that. Any kind of pain related to musculoskeletal dysfunction, and especially fibromyalgia. And any disease where modern medicine cannot find a cause, we can interfere—like migraines. This is one of the easiest problems to treat. [27:16]

Dr. Amelia Frigoich: Really? What is the cause of migraine? [27:49]

Dr. Adel Rayess: Everything is a primary lesion. Everything has a cause. I treated not long ago an American soldier—he was in Iraq and they blew up a mine. He got PTSD from the shock of the bomb, and then when he flew and hit the ground, that was the physical shock. So he had two major primary lesions. [27:57]

A primary lesion can be anywhere—clavicle, vertebra, jaw, pelvis, hip. It’s usually the joint that doesn’t move, that is different from all the other joints. It is a stiff joint that doesn’t resemble the rest of the body. Sometimes it resembles a joint of someone who has been dead for two hours—they start to become stiff. In the body, there is always one joint that has been “dead for two hours.” [29:48]

When you find it and treat it—with manipulation, HVLA technique, or any other therapy—fix it, and leave the patient alone for some time. Don’t leave this problem, because you will never have a result, or it will be a very temporary result. Always treat the problem, never treat the symptoms. Don’t act like medication. Medication is just popping pills. Drugs have side effects—”First, do no harm.” Treat the patient as if it was your father or your mother. [31:04]

It’s a shame that people have been taking anti-inflammatories for 10, 15, 20 years only because you don’t want to move your ass to examine the patient. Laziness has become the middle name of doctors. [34:47]

Dr. Amelia Frigoich: It’s also the system. How many treatments does somebody need once you’ve found the primary lesion? [35:39]

Dr. Adel Rayess: Only one. Fixing the primary lesion takes one session. Sometimes two if it’s an 80-year-old man who has had it for 60 years. But the difference between the first and second session is between 45 to 90 days, because the body needs time to heal physically and emotionally. A lot of times when you treat the primary lesion, people start to cry—not from pain, they don’t know why—or they start to laugh. [36:39]

There is an emotional release. Some people become very angry because it was a psychological shock that created the problem. The body keeps the score. [37:34]

Dr. Amelia Frigoich: Do you see a connection to mental health disorders like anxiety or insomnia? [38:38]

Dr. Adel Rayess: We see that a lot in fibromyalgia patients. Once you find this original trauma, everything changes—they sleep better, think better, digest better, breathe better. And combining neuromodulation with that, the results are truly phenomenal. We have patients who have been on a wheelchair for years and after 20 minutes they’re walking. It’s not black magic; it’s science. [38:55]

Dr. Amelia Frigoich: Where can colleagues learn your technique? [41:59]

Dr. Adel Rayess: A few years back, I didn’t want to teach it because I was happy with my success and I felt a bit arrogant. But when you become older and wiser, you see this needs to be taught. If I die, this will die with me. I am only one person—I’ve changed maybe 10,000 lives, but we are billions. We’ve been teaching it for the last three years to Arab colleagues, and now we should start to spread it in Europe. [42:14]

I’m getting older. Before, we used to see 80 patients per day; now 40, and I become very tired. I want to teach it to wise doctors who are highly skilled, not fresh graduates. I need someone who wants to do some change, not just a quick buck. Once they know how to find the primary lesion, they will have a lot of enemies. How do you know how much success you have? By the number of your enemies. [43:59]

I never asked for success; I just wanted my patients to get better. Now we have an eight-month waiting list. It shouldn’t be a one-man show. I’ve taught it to about 50 people, but only three really know how to find the primary lesion. It needs someone dedicated and calm. [46:40]

Once you find your first primary lesion, you get addicted. “Oh my god, it was in front of me all the time and I couldn’t see it.” It’s a matter of how to use your hand. I’ll give you an example: put a single hair under a tissue and start to feel it. I examine patients over their clothes—that’s the golden rule. If you examine a naked body, your thermoreceptors (feeling heat) are stronger than your mechanoreceptors, so it’s impossible to see what’s going on inside. Everything is in the hand; I don’t have a different hand than yours. It’s just a “mind-hand connection.” [49:50]

Dr. Amelia Frigoich: This is such a great message. You remind us of the origins of medicine—helping each other with our body. [53:25]

Dr. Adel Rayess: Your hands can be more powerful than a scalpel in some chronic diseases where there’s no way to do any good with normal medicine. Classical medicine has done what they can, but those patients are still in pain. Think how much the government would save—billions of euros every year—if they had a thousand doctors doing this. Each time you give an anti-inflammatory, you’re creating another disease that needs more medication. It’s a vicious circle. [54:21]

Dr. Amelia Frigoich: Thank you so much for reminding us how simple it can be. We will put the links to your Instagram, website, and YouTube. [57:22]

Dr. Adel Rayess: Perfect. Thank you for receiving me.

Dr. Amelia Frigoich: Thank you very much, have a very nice day and bye-bye. [58:13]

---

YouTube Video: Dr. Adel Rayess: the osteopathic art: finding the primary lesion – origin of body pain