Osteopathy, physiotherapy and chiropractic are three systems that approach the diagnosis and management of musculoskeletal and other conditions in different ways. Osteopaths see their profession as fundamentally scientific and which facilitates self-healing of the person by releasing the restrictions which cause blocks and tensions.
Osteopathy views the function of the human body as being reliant on the smooth functioning of all the component parts, such as the bones, ligaments, muscles and connective tissues.
Osteopaths in the UK are health professionals registered with the General Osteopathic Council. In the main they treat musculoskeletal conditions such as back pain, neck pain, joint pains and other pain and physical difficulties.
The three-year osteopathic training covers anatomy, physiology, pathology, research techniques and practical manual and other treatments. The philosophy and beliefs underlying osteopathy are distinct from those underlying chiropractic and physiotherapy, although there are many similarities in diagnosis and treatment techniques.
What Does an Osteopath Do?
Osteopaths look at people and their difficulties in a holistic manner, placing a strong emphasis on the important interaction between our anatomy and bodily physiology. They also consider other factors such as ergonomics, environment and the psychosocial state of the patient, all of which may feed in to disability and pain problems.
Osteopaths aim to rebalance the body’s systems by easing muscle tension, improving joint movement, increasing blood supply to vital tissues and working with the body’s mechanisms of healing. They can also advise on recovery from injury, postural work issues, the promotion of health and the prevention of further problems.
The emphasis during treatment is to optimise the health and efficiency of a patient by maximising their ability to self-heal. Looking for what the patient’s system is already doing to resolve the problem, the osteopath can integrate their understanding of the person and their body to get them to “fix” themselves.
Who can call Themselves an Osteopath?
Like the title “physiotherapist”, the title “osteopath” is protected by law and in the UK it is illegal to call yourself by one of those professional names unless you are qualified and registered with the appropriate bodies.
In the UK, osteopaths are regulated by the General Osteopathic Council (GOsC), and this ensures you have a qualified osteopath who is trustworthy and who continues to update their professional abilities and skills.
What Do Osteopaths Treat?
Osteopaths treat a very wide spectrum of people and conditions. Children, pregnant women, sports people, office workers and older people, all can be helped by seeing an osteopath for their pain or other problems.
Musculoskeletal conditions, such as back pain, neck pain, joint pains, arthritis and sports injuries make up the bulk of an osteopath’s workload.
Some osteopaths may also work to relieve digestive issues, migraines, headaches, painful periods, sleep problems and symptoms from the circulatory, lymphatic and nervous systems. Taking a holistic approach, osteopaths may work on related body systems to the primary problem, to promote good health and healing via restoring the balance of the body.
What Treatments do Osteopaths Perform?
An osteopath may initially concentrate on the particular areas of the body which are painful or have restricted movement.
Direct treatment may include manual mobilisation of, for example, the joints of the lumbar spine, soft-tissue massage, stretching of tight muscles and muscle-energy techniques. The treatments are intended to reduce pain, increase joint movement and improve function.
Osteopaths take time to discuss issues with their patients and to help them understand what’s going on and this is one of the great advantages of an osteopathic consultation. The likely cause of the problems and how they might progress will be discussed.
In the short term, the symptoms are likely to subside, with the osteopath giving manual therapy, advice on job and daily activities and an exercise programme. A few weeks of therapy is usually sufficient to get the problem resolved or moving strongly in a positive direction. In more difficult situations, a rehabilitation programme may be required over the longer term. Psychological help may be needed in some cases.
Osteopaths also advise people to maintain the strength and mobility of their spine and joints and the overall health of their lifestyles. Routine checks, preventative treatment, ergonomic advice and an exercise programme may all be useful.
Osteopaths have a wide variety of treatments to choose from when they have assessed a patient. Massage, manipulation, stretching, manual therapy techniques, exercise programmes, ice packs, postural advice, ultrasound, traction, acupuncture and laser may all be employed depending on the circumstances.
What are the Risks of Osteopathy?
Like physiotherapy, the risks from osteopathic treatment are very low. Osteopaths do not mostly use forceful manoeuvres such as neck manipulation. Common risks are increased pain, stiffness and soreness. Rare risks (as with physiotherapy and chiropractic) are stroke, prolapsed discs, arm or leg pain, nerve damage, muscle weakness and bowel or bladder problems. These problems are very rare and a qualified osteopath will be able to judge the level of treatment required to minimise any potential problems.
What Happens at the First Consultation?
This typically takes 45 to 60 minutes. The osteopath will take a history of the problem and enquire about the person’s medical history and present health. Excluding serious health conditions (“red flags”) is important as in very rare cases immediate medical care may be required. Self-assessment questionnaires may be used to guide the treatment and to judge the outcome over time. For more information about your initial consultation, see what to expect when you see an osteopath.
The Physical Assessment
Once the subjective part of the assessment is complete, the osteopath moves on to the physical examination which may include:
- Observing the person’s posture, body symmetry and movement patterns.
- Checking the ranges of movement of major joints such as the hips, shoulders and other joints.
- Testing the ability of the person to do job-related tasks and daily activities.
- Assessing the movements of spinal joints in the neck, thoracic and lumbar spine.
- Manually assessing the tissues of the back, abdomen or other areas.
- Performing specific tests to identify a particular diagnosis.
You may need to remove some of your clothing for the testing and examination to be performed, but your dignity will always be respected and you may choose to have someone come along with you to the consultation. Once the assessment is done, they will discuss treatment with you and, if you are happy with that, the osteopath will then go ahead with the osteopathic treatments.
What’s the Evidence for Osteopathy?
Research evidence supporting osteopathic effectiveness is not plentiful. Manipulation on its own has been shown to have limited usefulness for low back pain. However, combining manual therapies with psychosocial approaches has increasing research evidence to support it in the treatment of pain problems. Osteopaths are well-placed to provide this more holistic care.
NICE recommends manual therapy, if performed with exercise, as a treatment option for lower back pain, whether severe leg pain (sciatica) is present or not. Like physiotherapy, there is limited evidence that osteopathy may also be effective for some neck pains, shoulder pains, leg pains and recovery from knee and hip operations.
There is no good evidence that osteopathy is useful for treating any conditions which are not related to the musculoskeletal system.
How Do I Get to See an Osteopath?
Most osteopaths work privately, although there are a few in the NHS. Costs vary across the UK, but typically a 30-40 minute session will cost from £35 to £50 and these costs may be covered by your medical insurer.
You do not need to be referred by your GP or a consultant, but an osteopath will accept referrals from a doctor on a private basis. Some insurers will require a doctor’s referral but you can ring an osteopath clinic directly and book yourself in if you are paying privately. If your condition is unsuitable for osteopathy, you will be informed of this when you attempt to book or after your assessment with the osteopath.