Osteopathy

Treatment techniques that osteopaths use include muscle manipulation, joint movements and ‘high velocity thrusts’, which are short, sharp movements. These techniques are designed to reduce joint stiffness along with tension in the muscles, and to help the spine and joints to move more freely. Osteopaths believe that this can improve circulation and promote the body’s own healing processes. The treatment also includes advice about lifestyle. An American doctor, Andrew Taylor Still, believed that some illnesses could be caused by parts of the body becoming even a little out of place. In the 1870s he developed osteopathy to help the body return to normal. The first school of osteopathy in Britain was opened in London in 1917.

Today there are around 3,600 osteopaths on the General Osteopathic Council statutory register, and more than six million consultations every year. Osteopathy is becoming widely recognised by the medical profession, and is now made available by one quarter of GP practices. Many osteopaths do not think of themselves as complementary practitioners. They are regulated by law and prefer to call themselves primary healthcare practitioners. In 2001, about 23% of doctors’ surgeries were providing osteopathic or chiropractic treatment.

Osteopathy is often used for low back pain and there is some evidence that it is helpful for this. The Royal College of General Practitioners recommends manipulation for acute and sub-acute back pain.

Osteopathy is also used for neck pain, muscle, joint and postural problems, pain during pregnancy, sports and repetitive strain injuries, sciatica, headaches, osteoarthritis, digestive disorders and menstrual pain.

Some osteopaths use cranial osteopathic techniques, involving very gentle movements on the head and the sacrum bone, which sits at the bottom of the spine. It is often used for children with colic, glue ear, sinus problems and constant crying, but it can also be used for adults, particularly for face, neck and jaw pain, problems following shock and injury, headaches and sinus problems.

When you visit an osteopath for the first time, they will take a full case history and give you an examination. You will normally be asked to remove some of your clothing and to perform some simple movements. The osteopath will then use a highly developed sense of touch, called palpation, to identify any points of weakness or strain throughout the body. They may need additional investigations such as x-rays or blood tests. This will allow a full diagnosis and suitable treatment plan to be developed for you.

Treatments usually take 30-45 minutes. Osteopaths say that most people get most benefit from between 3 to 6 sessions, depending on the condition being treated.

At the first session, your osteopath should be able to give you an indication of how many treatments you might need. For some acute pain one or two treatments may be all that is necessary. Chronic conditions may need ongoing treatments from time to time.

You may feel a little soreness, tiredness or have a mild headache for a day or two after treatment. Always tell your osteopath if you feel worse or are in pain for longer than this.

The use of a technique known as a high velocity thrust is not advisable if you have certain conditions including: osteoporosis; tumours; broken bones; infections; ligament damage; inflammatory joint disease; aneurysm; haemophilia or other bleeding disorders; active multiple sclerosis; or you are taking anticoagulant drugs or are between eight and twelve weeks pregnant. However, there are other osteopathic techniques that the osteopath can use, if appropriate, so it is very important that they know if you are pregnant or have a serious health condition.

The osteopath should find this information out when taking your case history. It is important, too, that you tell your doctor (and midwife or obstetrician if you are pregnant) if you are planning to have osteopathic treatment.

There has been some discussion about the potential risks associated with manipulation of the spine, such as possible spinal trauma after high velocity thrusts or stroke after manipulation of the upper spine at the neck. These techniques may be used, if appropriate, as part of osteopathic treatment and are also used by doctors, physiotherapists and chiropractors. The BMJ’s clinical evidence website puts the risk of a stroke at between 1 and 3 in 1 million manipulations. A review which looked at the relative risks associated with the use of spinal manipulation for neck pain and the use of non-steroidal anti-inflammatory drugs concluded that manipulation was much safer (by as much as several hundred times) than non-steroidal anti-inflammatory drugs.

Treatments cost from approximately £25-£50 and upwards for a 30–40 minute session. The first session is usually longer and may cost more. Some health insurance schemes and medical cash plans cover osteopathy.

The osteopathy profession is regulated by law. The General Osteopathic Council is the regulatory body for osteopathy and it keeps one register of all osteopaths. In the UK, only practitioners who are registered with the General Osteopathic Council are allowed to call themselves osteopaths. To find osteopaths in your area contact the General Osteopathic Council or look in your local telephone directory.