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Osteopathy

  • Summary
  • More Detail
  • Typical Conditions
  • Questions
  • Links

Osteopathy is a safe and natural approach to health care, treating individuals for health problems ranging from the potential trauma of a difficult birth (cranial osteopathy) to arthritis of the elderly (general/structural osteopathy), from cradle to rocking chair, as it were.

The osteopath considers the musculo-skeletal system as being the physical expression of the person as a whole, rather than merely as protection, carriage and support for the vital organs.

A well practiced and highly trained sense of touch is used to identify dysfunction within the body. The person is then treated to remove/reduce all restriction & impediments to improve/restore mobility and balance and thereby enhance well being.

Osteopaths have at hand a wide range of techniques, the more commonly used include; soft tissue techniques, stretching, rhythmic passive joint movements and manipulation. Both osteopaths & chiropractors tend to reserve the word 'manipulation' for what is more technically known as HVT (high velocity thrust). The principle of this is based on a rapid movement over a very short range to release a stiff or locked joint without injury or trauma to the tissues. I mention this as some have concerns about the safety of this approach, especially with regard to manipulation of the neck. In reality it has been found in studies to be significantly safer than taking a course of anti-inflammatories which are available 'over the counter'.

Physiotherapists tend to apply the word manipulation in a wider context. ranging in grades from 1 to 5, with 5 being equivalent to HVT, but there are relatively few physios in the UK that perform grade 5 manipulation, with it requiring extra postgraduate training. Other manual or 'manipulative therapists' may well not be qualified to perform such manipulations, so don't be shy to ask - your health could be at risk!

HVT manipulation is only one approach of many in the osteopaths itinerary, which would be discussed before application and may be unsuitable for some, i.e. those with osteoporosis or vascular complications. The person would be assessed and examined for the possibility/risk of these and not assumed to absent if they have not been previously diagnosed. Those advising that people with such conditions should never consult an osteopath is doing them a disservice, as said there are many more osteopathic approaches that could help.

Usually when treating the elderly and children the very gentle release techniques of Cranio-Sacral Osteopathy are used.

Osteopathy is a particularly successful approach for the treatment of spinal pain most commonly in the lower back and neck, but often referring pain to the lower and upper limbs respectively. Similarly restriction and pain originating in the limbs such as arthritis, injury and repetitive strain conditions may also be helped.

Although osteopaths are best known for treating neck & back pain and yes spinal problems are the mainstay of most osteopathic practices, but many will be surprised by the range of problems that we may well be able to help with.

Pain, unless it's from a recent injury, is often a late indicator that there is a problem and the earlier a problem is caught, then the greater the chances of a full recovery. It is generally accepted that 'early intervention' is more likely to have a better outcome.

 

 

 

Osteopathy - What does it involve?

Initial Osteopathic Consultation

Before anything else happens the osteopath will need to work through a case history to establish exactly what you a currently experiencing (i.e. aches, pain, stiffness, numbness, tingling, 'pins & needles'), where these are, how it came about (i.e. followed a road traffic incident, fall or no apparent reason) and how long it's been going on.

If you have or are pursuing any other avenues of enquiry i.e. via your GP, awaiting tests, images or consultant referral, etc.

The osteopath will then take a general medical history to put your current complaint in context of anything else that may be going on, but also to ensure that you are treated in a safe manner. E.g. a more conservative, gentle approach would be used if someone had rheumatoid arthritis or low bone density (osteopenia or osteoporosis).

The osteopath would then need to examine you and may need to perform some tests (see below). To be able to form a clear diagnosis and to ensure that nothing gets overlooked this is best performed in underware. Now the last thing we want is someone feeling unbearably uncomfortable, so some may want to bring shorts, cycling shorts &/or sports bra and decide on the day. Nothing will be assumed, all can be discussed and hopefully a compromise reached.

Further assesment would take place once on the treatment table, the nature of the problem and proposed treatment would be discussed and assuming there is no good reason not to treat, then the treatment would start.

Commonly Used Osteopathic Techniques

Soft Tissue Techniques

These include a wide range of techniques applied to the connective tissues or 'soft tissues', mainly muscle, tendons & ligaments.

Many of these could be broadly described as massage techniques ranging from a light skin brushing for lymphatic drainage to deep pressure (referred to as inhibition) to tendons of muscles. This can be used to calm excessive muscle tension that is being maintained without good reason.

Joint Articulation

Working a joint through a good range of movment to release any restriction in movement and to re-educate the nervous system that it need not be so protective of the area. These may have been caused by injury, just crept in over the years or a combination of both. Maintaining a good range and regular movement of a joint is important for health of the cartilage of the joint surfaces. While the implications of this may be obvious for say the ball & socket joints of a hip or shoulder, it may not be so obvious for a joint in the foot, wrist, elbow of neck.

Soft Tissue Stretching

While some of the surface muscles and tendons may be stretched with massage techniques, deeper muscles such as those of the hip can be stretched by using the leg as a lever. When the practitioner works with the person to perform the stretch is referred to as an assisted stretch. Appropriate stretches that can be done at home are given when appropriate and those that may aggravate the problem would be advised against.

Joint Manipulation

This is a very quick movement over a very short range of movement. This would be consider where a joint doesn't relase from articulation or stretching. So this may used for example to release one of the joints in the elbow if someone suffers from 'tennis elbow', the ankle if the ankle joint is stiff, but the area that attracts most attention is manipulation of joints in the upper neck. Although rare, complications can arise from this technique, but by ruling out those considered to be at higher risk i.e. those with osteoporosis, history of stroke and other vascular problems, then risk is extremely small. So small in fact that one study found that neck manipulation once a week over 6 weeks was safer than taking a course of anti-inflammatories for the same period of time. The latter being the first line medical treatment for neck and head pain. Article Here!

This of course would be explained and discussed beforehand.

 

Other more specialised osteopathic approaches include Cranial Osteopathy and Visceral Osteopathy.

 

Treatment Plan

Occasionally someone will recover after just one treatment, but for the large majority at least some further treatments are needed. Everyone is different, but we'll usually have a better idea of how many treatments will be needed after the first treatment and how someone responds to it. Osteopaths don't usually treat more than once a week unless it is a particularly severe problem. The body needs time to readjust, heal and repair. Self help exercises are given both to aid recovery and reduce the risk of the problem returning. Sometimes self help exercise at home aren't enough on their own to keep on top of a particular problem and the person may decide to have an occasional treatment in addition to stay free of symptoms.

Assessment & Tests

Active Assesment & Tests

These are assesments or tests that the person does themself or in conjunction with the practitioner, so that they are playing an 'active' role in the assesment.

The body performs in a different way when it moves it's own bits about as opposed to limbs, spine etc, being moved by someone else. For a joint to move the muscles around that joint first tighten to stabilise the joint before any movemnt occurs.

Observing how someone moves their spine (inc. neck), raises their arm or weight bears on a flexed knee would be examples, but others may include nerological tests i.e. comparing muscle strength from side to side if nerve injury may be an issue. Or it can be reporting to the practitioner what they feel if something is tested or provoked.

 

Passive Assesment Tests

These are where the person doesn't play an active role in the process or at least not intentionally.

Things like;

Passive joint movement - where practitioner articulates a joint, moving the limb or spine while the person tries to relax the area. On occasion and especially if an area is particularly painful, then body will try and keep control of the movement, but once this is exlained some may be able to override this instinct and relax the area. This assesment is especially useful to get an idea of any muscle imbalance around the joint and an idea of any injury or degeneration of the cartilage (osteo arthritis) within the joint. It also helps distinguish between an actual joint problem as opposed to a nerve or muscular problem.

Other passive tests may be to provake an involuntary response from the person i.e. reflex tests i.e. the famous 'knee tap' patella tendon reflex.

 

More on Osteopathy

Osteopathy has being practiced in the western world for well over a century. It was founded by an American medical doctor in the late 1800's, in what was then the 'wild west'. A brief history of osteopathy is on Andrew's osteopathic website.

Osteopathy is based on principles rather than being prescriptive. A prescriptive approach to health would be to prescribe a specific treatment based on the persons problem or symptoms, which appears reasonable. However the same symptom i.e. knee pain could be caused by several different problems including; an actual knee problem, refferred pain from the hip or low back. Or a knee pain problem that is caused be additional strain on the knee due to stiffness in the hip or ankle.

Whereas osteopathy seeks to not only diagnose the source of the pain, but works to improve the function of other areas that may be contributing to the problem. In short - rubbing the sore bit may give temporary relief, but may not solve the problem long term.

Call us old fashioned but we still believe that the best way to asses what's going on is to actually get our hands on to feel what's going wrong. i.e. if there is a restriction of movement in a particular joint or which muscles are 'too tight'. This is a skill that needs regular practice and it's what osteopaths do every working day.

Of course x-ray and MRI scans are helpful, but there needs to be a good clinical reason to do these and know which area to image in the first place. In a case of both shoulder and elbow pain on the same side, the person had been sent for an x-ray of both by the time they came for osteopathic assesment. Unsurprisingly neither x-ray showed any problems as they clearly had a vertebral disk injury, which was irritating a nerve where it exits the neck before going on into the arm. The brain was being told that there was pain in the shoulder and elbow as these were amongst the areas that 'sensory' nerve supplied, but there wasn't a problem with either, which would have been apparent if they were examined and appropriate nerve tests done.

 

Further info about osteopathy on Andrew's osteopathic website.

 

A few examples of the problems that people seek osteopathy for;

  • Arthritic Pain - The pain of osteoarthritis or common arthritis unfortunately affects most of us sooner or later. This may just affect one or two joints (i.e. arthritic hip, knee or shoulder), or multiple joints (i.e. throughout the spine, known as spondylitis).

  • Colic in newborn babies is a common complaint that parents seek cranial osteopathic treatment for. The wonder of babies is that they are so adaptable and the colicky baby usually responds with only a few treatments.

  • Joint pain in general - whether it be golfer's or tennis elbow, frozen shoulder, RSI (repetitive strain injury) of the wrist, sprained ankle, foot problems (i.e. heel spur, fallen arches), or knee pain, hip or S.I. (sacroiliac) joint pain. See cranial osteopathy page.

  • Headaches - many headaches have their origin in the upper neck & is officially called cervicogenic head pain and the neck itself may not be painful. Other 'hidden' upper neck problems may also contribute to disturbance of balance, vertigo, jaw problems, earache/ pain, scalp tenderness or numbness, sinus pain (commonly confused with sinusitis), brain fog - the inability to focus or think clearly, etc

  • Low back pain - this and neck pain are the problems most commonly treated by osteopaths. The most commonest causes of low back pain IMHO are caused by an irritation / 'locking' of the small facet joints at the back of the spine and vertebral disc injuries.

  • Neck pain - this may as a result of a road traffic accident, other whiplash trauma or for no obvious reason. As well as local neck pain, it's not unusual for people to present with upper back or shoulder pain only to discover that the problem originates in the neck and it's referred pain to the upper back or shoulder.

 

See the A-Z section on Andrew's osteopathic site for more conditions in detail.

There is also research into the effectiveness of Osteopathic treatment with Irritable Bowel Syndrome (IBS), Chronic Fatigue Syndrome (CFS/ ME), menstrual problems and infertility problems amongst others.

 

 

 

 

 

 

 

 

FAQ's on Osteopathy

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Is osteopathy safe?

A Osteopathic treatment is very safe.

When people ask this question - they usually have manipulation in mind. There have been several studies to show that a series of neck manipulations is actually safer than taking a course of non-steroidal anti-inflammatories (NSAID's) over the same period. Yes, these are the aspirin/Ibuprofen based variety that you can buy over the counter in the corner shop. So compared to the drug alternatives that only treat the symptoms it is extremely safe!

This technique would be explained before hand and is not necessarily indicated or needed. The osteopath has many treatment approaches in his/her repertoire.

How much does it cost?

Fees vary from practice to practice. The initial consultation & treatment are usually more expensive, as it involves taking a full osteopathic & medical case history & therefore takes longer. You can expect to pay at least ?30 & possibly as much as ?80 for your initial appointment depending on your area, the reputation & experience of the osteopath.

Follow-up treatments are shorter & usually less expensive, and vary from about £20 to £40. Many osteopaths offer a concessionary rate with genuine cases of low income. Also, most private health insurance policies now cover for osteopathy, but check you policy first.

Will I be expected to have a set course of treatment?

Quite frankly if you're paying for it, then the decision is yours. We can only advise on this issue. I would advise asking this on the telephone when making the appointment or when you first walk into the treatment room. If the answer is a definite yes, before examination & case history taking, then I would be suspicious.

Most osteopaths continually re-asses at each appointment. Everyone is different & respond differently, so if you get more of a vague answer, then it is actually a good sign. All we can say are generalizations. Such as an acute (short term), never happened before type problem may resolve with a single treatment, whereas a chronic (long term) or recurrent problem is likely to take more treatments to resolve. Having said that, often with chronic conditions pain may actually be a late indication that there is a problem, so you may be advised to have one or two treatments & advised to continue with stretching or strengthening exercises after the pain has gone. With some ongoing problems i.e. chronic arthritis, then an occasional 'preventative' or 'maintenance' treatment may be advised, i.e. quarterly.

Does osteopathic treatment hurt?

A Not ordinarily. The approach that is most like to be uncomfortable is when deep soft tissue work, rather than manipulation - the technique that most fear. With a good patient - practitioner rapport, you should be encourage you to give feedback as to when it is becoming too uncomfortable. Known as 'therapeutic discomfort' this is usually that sort of sensation that is not comfortable, but not unpleasant either. As with a strong massage - a kind of 'it's doing you good' feeling.

If you are particularly sensitive, then pointing this will help formulate the best treatment approach for you.

Am I too old or my baby too young for osteopathic treatment?

Age is not a barrier to receiving osteopathic treatment as treatment is specifically adapted to the individual needs of the person. E.g. The very young are treated with cranial (cranio-sacral) osteopathy.

What sort of problems can osteopathy help with?

Whilst osteopaths are probably best known for low back and neck pain & problems, 'whiplash' type injuries, spinal pain, etc., and all manner of musculoskeletal or mechanical problems, if you prefer. Whether it be a sports injury or the stiffness & pain of arthritis.

What is less well known is that we actually treat a whole range of people, with a wide range of problems. From the colicky baby, glue ear with toddlers ( you will need to find a cranial osteopath for those), right through to the creaking joints that are associated with the more mature amongst us.

For more info on the wide range of problems that osteopaths deal with on a regular basis check the A-Z guide on Andrew's osteopathy site, link below.

Do I need to be referred by my GP?

The short answer is no. This has never been the case even prior to osteopathy gaining official recognition by an Act of Parliament in '93 & giving osteopaths Primary Health Care Professional status alongside doctors, dentists & opticians. However, it is always advisable to keep your GP up to date, but you do not need to see them first.

However there are a few circumstances that it would be advisable;

1) A few insurances companies, i.e. BUPA that require GP referral for your claim to be processed.

2) If your complaint is related to a 'Personal Injury Claim', then you should keep your GP up to date. Your solicitor may ask either or both of us for a copy of your medical records or for a report. For this you would have to have given your signed consent before we can legally release any of your personal details.

3) It may be worth trying your GP to see if you can get a referral to see an osteopath on the NHS. There are a small number of osteopaths that work for the NHS, but there's likely to be a waiting list.

Will I need to undress?

For your best care & to fully asses the nature of the problem, then yes a level of undress would be required. In fact we could be regarded as being negligent if we were to asses, diagnose & treat without fully examining you. Obviously, more minor, peripheral problems (i.e. ankle strain, knee injury, etc) may be addressed with a lesser degree of undress, but we can only give you our best care if we are able to get a fuller, holistic picture of the problem.

Wearing 'appropriate underwear' is a good idea, a bikini or cycling shorts & sports bra would be acceptable or if this is a major issue, then you could see a 'same sex' osteopath.

I would suggest that when it comes to issues of health, then some things are more important than vanity and we wouldn't expect to have been examined properly by our doctor, without having to undress to some degree.

 

Osteopath at the Centre

 

Andrew Woodhouse

Other Pages about Osteopathy

Cranial Osteopathy

Visceral Osteopathy

 

External Links

Andrew also provides osteopathy, visceral & cranial osteopathy, allergy screening & NAET in Liverpool at Liverpool Wellbeing Centre.

Andrew's osteopathic website

Osteopathy - by general, cranial and visceral osteopath practicing in Wirral & Liverpool. Primary health care practitioner advice. What an osteopath is and does, also holism & vitalism.

The General Osteopathic Council

The General Osteopathic Council regulates the practice of osteopathy in the United Kingdom. By law osteopaths must be registered with the General Osteopathic Council (GOsC) in order to practise in the UK.

The British Osteopathic Association - BOA

Professional association for osteopaths and works to promote and raise awareness about osteopathy in the UK.