What does a typical treatment consist of?
My treatments ( after a physical examination where the problem area AND adjoining areas are looked at and mobility is assessed ) consists of a mixture of
1/ soft tissue techniques ( STT ). Some of these are very similar to many common massage techniques BUT are more functional rather than relaxing. They can be as deep ( sometimes a little bit sore! ) or shallow and gentle if the person prefers it.
2/ other very gentle techniques e.g functional technique, where parts of the body are slowly and very carefully put into positions of ” ease “. These can be very, very useful especially with neck pain / whiplash.
3/ mobilisations – where parts of the body are moved by the practitioner whilst the patient is relaxing. This is similar, in a way to “passive movement “. ” Active movement ” being when a person uses their own muscles to move themself. This is very useful in most stiff joints and much more effective than when the person tries to stretch joints themselves.
4/ manipulations – where the joint is carefully stretched then moved so that a “click” may be heard. MANY people are cautious / anxious about these. Most often when the neck is involved. They can, however, frequently help some problems very quickly. ALSO, in the neck it is possible to do a TOGGLE manipulation where the neck is moved into a suitable position then “jiggled” gently until the joint releases itself. This is a very gentle and safe technique as the joint is encouraged to move rather than forced.
5/ medical acupuncture – this is described on it’s own page. Treatment is short – 5 – 10 minutes – and frequently very useful. If someone responds very well to acupuncture OR just wants it by itself I can do treatments of 10-20 minutes.
Is osteopathy officially recognised to be a help with backpain?
Yes it is. The UK National Institute for Health and Care Excellence – usually referred to as N.I.C.E – recommends spinal manipulation for lower back pain. Osteopaths are trained to deliver such treatment and offer useful self-management advice. Further research being carried out by a group of osteopaths in the main Nottingham Spinal Care unit is showing hugely favourable results for osteopathy against other accepted therapies.
Will I be safe?
The General Osteopathic Council regulates the practice of osteopathy in the UK, promoting patient safety by setting and monitoring standards of osteopathic conduct. By law, an osteopath must be registered and comply with strict regulatory requirements. This gives the patients the same sorts of guarantees as those given by doctors, dentists and physiotherapists
Will it hurt?
I can be very gentle and use very subtle techniques if the problem calls for it OR if the person requests it. If someone has had osteopathic treatment in the past ( which they have found effective ) then I always try to use similar techniques. If someone has had manipulations ( short movements where and audible click is heard when the joint is stretched ) in the past which have been effective, I will try and reproduce those techniques. If someone does not want to be “manipulated” then I will use other movements to try and get to the same end point. There are certain situations when a few “back cracks” can offer immediate relief when other techniques would take 2-3 treatments OR not work at all. Many manipulations can be done with NO or very minimal discomfort at all. Obviously, the most important thing is that the patient is at ease and trusts the practitioner to not do anything, at all, they are at uncomfortable with. I NEVER do any “surprise” manipulations unless SPECIFICALLY ASKED TO DO SO.
Can I bring someone else with me to the consultation or treatments?
Of course you can. Part of an effective treatment is to feel at ease with the situation. If by bringing someone along with you will make you feel more comfortable then please do so.
NB frequently I find couples coming in with each other so one can jog the others memory – especially useful in situations when the problem has lasted a long time OR when there is a complicated case history.
Cost / length of treatments
These vary between clinics.
1/ Moseley – will be £60 for the initial consultation and treatment. This will last from between 50 – 60 minutes. Follow up treatments are £40 for a half hour appointment.
2/ Walsall – is £50 for the initial consultation / treatment which lasts 45 minutes. Follow up treatments of 30 minutes are £40.
3/ Cheltenham – is £60 for first consultation / treatment ( 45 mins ) and follow ups are £40 ( 30 mins ).
What clothes should I wear.
For neck, shoulder and mid back problems, the patient will be asked to remove upper body clothes ( women down to a bra ) . For a full assessment to be made the whole back needs to be seen so that movement of the shoulders, scapulae and muscles around these and the spine can be seen moving. Also, for soft tissue work ( massage ) the area must be accessible. Woman can wear a big baggy T-shirt if necessary which can be hitched out of the way during examination and treatment.
If the problem is lower back, buttock and/or hips, patients generally undress down to their underwear. Loose jogging bottoms or shorts can be useful – the latter if there is going to be any acupuncture to the hips or thighs.
If there is a knee problem, please either be prepared to take trousers off OR wear shorts ( or dress/skirt ) OR wear trousers that will easily roll up to half way up the thigh. We can always use towels to cover various parts of the body if the patient feels at all worried about being half undressed. This would be quite normal and should not put anyone coming in for a treatment – we can work around it.
What is the difference between osteopathy, chiropractic and physiotherapy? An honest answer.
A good practitioner is a good therapist – full stop. Also, different people suit different types of treatment. There are firmer and more gentle type of osteopathy and chiropractic – the firmer types ( usually ) involving manipulations – making joints go “crack”. Some people love having joints manipulated and others hate it so, naturally they will gravitate towards the type that suits them.
Osteopathy does tend to have more soft tissue techniques used during a treatment. Some chiropractors employ massage therapists to do the hard work when they will restrict themselves to diagnosis, manipulations and advice. Each to their own. I prefer to do my own soft tissue work / massage.
Some chiropractors ( the classic manipulative type usually ) have on site X Ray equipment. In my experience I have found that this means that they can ( sometimes ) be used when not strictly necessary. The equipment is very expensive and must be paid for! However, in certain situations, they are very useful indeed and can save long waits on the NHS.
These days I’m afraid that NHS physiotherapists very rarely treat. A sad reflection of the current state of the NHS. Most appointments happen after a 1-3 month wait, then the appointment consists of a quick chat ( rarely a full examination ), the patient is given a few sheets of A4 showing generic exercises, told to do them and return in 6 weeks. Not a very satisfactory 30 minutes after a 2-3 month wait.
A visit to a private physiotherapist is a different matter competely, Usually they will do some soft tissue work and possibly offer some pain relief acupuncture – occasionally some ultrasound – and then more exercise advice.
One good example of how osteopathy ( MY osteopathy anyway ) and physiotherapy differ is to briefly describe a example of neck pain. Both ( private ) physio and osteopathy would offer some soft tissue techniques, acupuncture, maybe ultrasound. Osteopathy would also offer mobilisations where the neck joints and surrounding tissues are moved PASSIVELY i.e with patient doing NOTHING and also manipulations IF necessary AND if the patient is happy with it. Some physiotherapists have been on some brief osteopathic training courses and offer this but not many.
ALSO… most physiotherapists would recommend stretching exercises to help improve the problem. To be fair, some osteopaths do also BUT I do not. I have seen 100s examples over the last 23 years where stretching exercises merely compound the problem – it won’t make the problem worse BUT it can stop it from recovering / or at least slow it down dramatically. If a stretch is hurting to do… your body is asking you NOT to do it. My advice is ALWAYS keep the neck warm, do not provoke the pain, try to relax the area ( stopping your shoulders from constantly being raised ( via normal stress ), possibly take some anti-inflammatories for 7-10 days and ONLY move the neck more AS it becomes comfortable to do so. By recommending this technique, I have seen many, many chronic problems slowly sort out.
I am not and never will be a practitioner who tells everyone they meet that other types of therapy are useless compared to the one I practice. Out of the 5600 other osteopaths in the world, I am sure that there are some poor or lazy ones – I’ve met a couple myself. Most are decent, hard working professionals. Whether you choose osteopathy, chiropractic or physiotherapy, a decent practitioner is likely to help you. If your problem has not been helped by seeing one of them, try another one.