Osteopathy

Published by Bupa's Health Information Team, July 2011.

This factsheet is for people who are having osteopathy, or who would like information about it.

Osteopathy is a manual therapy that is mainly used to treat problems associated with bones, joints and the back. Osteopaths use their understanding of the relationship between structure and function of the body to help resolve the underlying cause of the problem.

Your osteopath will discuss your care with you before carrying out your treatment. It may differ from what is described here as it will be designed to meet your individual needs.

About osteopathy

Osteopathy is used to examine, diagnose and treat conditions. It is also used to prevent certain conditions. Osteopaths believe that many health problems are caused by poor posture and a misalignment of structures within your body. They suggest that if the structure of your body is improved, your body can restore a state of balance, problems will improve and you will return to good health.

Osteopaths claim that osteopathy is holistic and doesn't just treat the symptoms of a condition. It takes into account your medical history, lifestyle and personal circumstances.

Osteopathy is a complementary treatment (one given alongside conventional treatments). It's used for many health conditions including:

• back pain
• neck pain
• sports and other injuries
• restricted mobility
• shoulder and arm problems
• hip, pelvis and leg problems

Where can I find an osteopath?

All osteopaths in the UK are registered and regulated by the General Osteopathic Council (GOsC). It's against the law for anyone to call themselves an osteopath unless they are registered with the GOsC.

All GOsC-registered osteopaths must study for four to five years for an undergraduate degree, plus do at least 1,000 hours of clinical training in osteopathic techniques. Registered osteopaths must also carry out at least 30 hours of learning activities each year as part of a continuing professional development programme to ensure they maintain high standards of practice.

To find a registered osteopath in your area, check the register on the GOsC website or telephone the organisation.

What happens during osteopathy

If you're paying for your osteopathy, you don’t need to be referred by your GP. However, it's important that you keep your GP informed. In some areas, osteopathy is available on the NHS and you will need to be referred by your GP. If you're unsure whether osteopathy is the best treatment for you, you should visit your GP.

If you do decide to have osteopathy, you will first have a detailed consultation. Your osteopath will ask you questions about your full medical history, symptoms, lifestyle, medication and diet. He or she will also examine you. Your osteopathy is likely to ask you to undress down to your underwear, so he or she can carry out a full examination.

Your osteopath may ask you to carry out movements, such as sitting, standing or walking. Some osteopaths also use X-rays and other conventional medical tests, such as blood tests, to help them make a diagnosis.

Treatment is usually carried out while you lie down in various positions. Osteopathy treatment will involve a variety of mostly gentle, manual techniques. These include massage and stretching to relax stiff muscles, articulation, which involves stretching the joints to help them become more mobile, and manipulation. Manipulation is a technique most commonly used on your spine. Your osteopath will make a short, rapid, forceful movement called a high-velocity thrust to your joints. You may hear a clicking similar to knuckles being stretched, which is normal. Your osteopath might also give you advice on your diet and exercise and advise you on other treatment, for example counselling.

There are other specialised techniques that your osteopath may use including cranial osteopathy, which is a gentle manipulative technique that focuses on your skull (cranium). Therapists claim to be able to feel a subtle, rhythmical shape change in your body tissues called the cranial rhythm. This shows them what stresses and strains your body is under and gives them an insight into the overall condition of your body.

Your first consultation with an osteopath will last about 45 minutes. If you have any further consultations, they will be shorter – usually around 30 minutes. The number of treatments you need and how often you have them will depend on your condition. At your first treatment session, your osteopath should give you an idea of the length of treatment you will need.

Your osteopath might refer you to your GP if they don't think osteopathy is suitable for you.

Is osteopathy effective?

Several studies have looked at the outcomes of osteopathy on a number of diseases and conditions. Some of these may have involved using a placebo (dummy) treatment to see how it compares with osteopathy.

There is evidence that spinal manipulation and mobilisation techniques (carried out by osteopaths, chiropractors, physiotherapists and doctors) provide relief for low back pain. The National Institute for Health and Clinical Excellence (NICE) recommends manual therapy (therapies that involve manipulation, massage and mobilisation of soft tissues and joints) as a treatment option for this condition. Manipulation may also be useful for reducing migraines and some other types of headaches.

Whether osteopathy is useful for other conditions, such as asthma or painful periods is unclear – the evidence is limited. The research is often conflicting and although symptoms of some illnesses improve, the best evidence generally fails to prove that osteopathy cures illnesses. Although osteopathy is accepted by many conventional medical practitioners, more research is needed to prove whether it's effective.

What are the risks?

As with every treatment, there are some risks associated with osteopathy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your osteopath to explain how these risks apply to you. 

Side-effects 

Side-effects are the unwanted but mostly temporary effects you may get after having the treatment. Side-effects of osteopathy may include:

• discomfort or mild pain at the point of manipulation
• bruising
• tiredness
• a headache

These should disappear within a day after treatment.

Complications

Complications are when problems occur during or after the treatment. A technique called spinal manipulation has been linked with severe complications, such as damage to an artery, stroke and even death – particularly when used on the upper spine (the neck). It has also been linked to cauda equina syndrome, where the nerves at the bottom of your spinal cord become compressed. This can happen if the nerves within your spinal canal are damaged during manipulation. However, these events are rare. Ask your osteopath for more information.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.