Osteopathy for lower back pain

Your health expert: Mr Damian Moore, Osteopath
Content editor review by Rachael Mayfield-Blake, April 2023
Next review due April 2026

Osteopathy is a system of diagnosing and treating musculoskeletal conditions (those that affect your muscles and skeleton), such as lower back pain. It focuses on the structure and functioning of your whole body. It’s based on the idea that your general health and wellbeing depend on your skeleton, muscles, ligaments and connective tissues all working smoothly together.

About osteopathy

If you have lower back pain that’s causing significant problems or isn’t getting better, it could be worth trying manual therapy. Your practitioner will use skilled hand movements to manipulate and move your joints and soft tissues to get your body back to a state of balance.

Osteopaths use a wide variety of hands-on techniques to try to reduce your pain and prevent it from coming back. These aim to release tension and improve how your body moves. An osteopath can offer this type of treatment for short-term or long-term general lower back pain. They can also help sciatica, which is pain that spreads from your back down your legs.

Your osteopath may also suggest some self-help measures you can take and give you advice on exercises to help your symptoms get better.

Most people arrange treatment with an osteopath themselves, by booking a private appointment.

Find an osteopath in your area

Most osteopaths work in the private sector either alone or in group practices. In some areas, osteopathy may be available on the NHS and your GP may be able to refer you, but this is less common.

All osteopaths in the UK should be registered with the General Osteopathic Council (GOsC). This means they have completed approved standards of training and follow the GOsC standards of practice and conduct. It’s against the law for anyone to call themselves an osteopath unless they’re registered with the GOsC.

You can find a registered osteopath by checking the General Osteopathic Council register. Your osteopath may also display their registration certificate or the GOsC registration mark in their practice.

Osteopathy for back pain

Finding the problem

A first appointment with an osteopath will usually take around 45 minutes to an hour. Your osteopath will want to talk to you about your back pain and your health in general, as well as any other treatment you’re having. They’ll probably ask you to remove some clothing so that they can examine you. If so, you should be provided with a gown or a towel. If you wish, you can ask for a friend or relative to accompany you.

Your osteopath will look at your whole body in relation to your back pain – they may look at you while you do some simple movements and stretches. They’ll also feel around your joints, ligaments and tissues with their hands (this is called palpation).

Informed consent

Your osteopath will talk to you about what they found when they examined you before they go ahead with any treatment. They’ll explain what treatment they recommend, and the benefits and risks involved. They should also talk to you about how many sessions you’re likely to need and what this will cost. Be sure to ask your osteopath if you have any questions. It’s important that you fully understand what is involved in your treatment because you’ll be asked to give your consent for it to go ahead.

Osteopathy techniques

Your osteopath will use manual techniques to try and reduce your back pain. Osteopathy techniques aim to increase the movement in your joints and relieve muscle tension.

The main techniques your osteopath may use include the following.

Soft tissue techniques. This is when your osteopath directly applies pressure to the soft tissues of your back. It aims to reduce tension in your back and relieve your pain.
Articulation. In this technique, your osteopath will move your joints through their natural range of motion.
Stretching. This can help to relieve stiffness.
Manipulation. In manipulation, your osteopath will make a quicker thrusting action with their hands at a particular point of your spine. You might hear a ‘pop’ sound when they do this.

Other techniques that an osteopath may use include the following.

Muscle energy technique. This is a technique in which your osteopath will ask you to push against them, while they apply force back. This aims to increase the range of motion in the affected joint.
Functional technique. In this technique, your osteopath will gently move your joints into positions that reduce your tension and pain, before gradually working them back to the original position.
Counterstrain. This involves your osteopath slowly moving you into the position that causes you least pain. They’ll hold you in this position for a short time while they monitor ‘tender points’ – areas on your body that cause your pain.
Still technique. This is a form of articulation where your osteopath will push your joint close together or keep a pulling force on it while they move it through its full range of motion. The additional forces help increase the range of motion you have and can result in a release similar to manipulation.

Your osteopath may also give you advice on improving your posture, and what types of exercise you can do to help with your back pain.

Uses of osteopathy

The manual techniques used in osteopathy can help to relieve pain and improve how your back works. The aim is for you to get moving again and start getting back to your normal activities. It’s best to keep active, rather than rest as it’s the best thing for back pain.

If you’re offered manual therapies as NHS treatment, your doctor will recommend that you have them as part of a treatment package. This should include a general exercise programme and, if needed, other treatments such as psychological therapy.

Aftercare for osteopathy

You may feel a little sore for a day or two after your treatment. If you have any concerns, contact your osteopath for advice.

You may need more than one treatment. Your osteopath will assess you at each session and discuss and agree with you any changes needed to your treatment plan.

Manual therapies such as those offered by an osteopath are usually only one part of your treatment for back pain. It’s important that you also follow any advice your osteopath or other healthcare professional gives you about looking after your back and do any exercises they suggest. This will give you the best chance of a quick recovery, and will help to stop your back pain from coming back.

Side-effects of osteopathy

You may get some side-effects from osteopathic manipulative therapy. These usually aren’t serious and only last for a short time. For instance, you may feel some soreness or discomfort in the area in which you received the treatment.

Complications of osteopathy

Serious complications following spinal manipulation are extremely rare. Although these are very unlikely to affect you, your osteopath should talk to you about any potential risks before they carry out any treatment.

Alternatives to osteopathy

There are different types of manual therapy that can treat lower back pain, which all take a slightly different approach. In addition to osteopathy, manual therapies include the following.

Physiotherapists focus on restoring movement and function to your whole body after you’ve been affected by illness or injury. They look at how the nerves, muscles and bones in your body are affected, and how treatment with exercise therapy and manual therapies can help. They’ll encourage you to take an active part in your rehabilitation, rather than rely on passive treatments.
Chiropractors, like osteopaths, look at your body as a whole. They’re interested in how problems with your bones, muscles and joints affect your nervous system and general health. Their focus is on manipulation of the spine – but they may use other techniques too.

Manual therapy can be done in lots of different ways. These may vary according to different types of training, but may also vary between individual practitioners. It’s not known yet if one way of doing manual therapy works better than another.

It’s your choice which type of practitioner you see. But if you would like NHS treatment, you’ll most likely be offered physiotherapy because the other services are often not funded. If you’re going to book private treatment, it can be worth contacting a few different practitioners to discuss your own circumstances. If you have health insurance, contact your insurance provider to see what they cover.

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Yes, an osteopath can help if you have lower back pain. They’ll use a wide variety of hands-on techniques to try to reduce your pain and prevent it from coming back. You can have osteopathy for short-term or long-term general lower back pain.

For more information, see our section: About osteopathy

There are some minor disadvantages of osteopathy but these aren’t usually serious and only last for a short time. For instance, you may feel some soreness or discomfort in the area in which you received the treatment. Your osteopath will talk to you about any potential risks before they do any treatment.

For more information, see our section: Side-effects of osteopathy.

The difference between a chiropractor and an osteopath is that a chiropractor will mainly focus on the spine and joints, and an osteopath will focus on the whole body. They both use manual therapy but osteopathy is based on the idea that your general health and wellbeing depend on your skeleton, muscles, ligaments and connective tissues all working smoothly together. Osteopathy also reduces restrictions to the circulation and nerve supply, with a particular focus on the relationship between the body's structure and how it functions.

Different types of manual therapy, including osteopathy and physiotherapy can all treat lower back pain, but they take a slightly different approach. Physiotherapists will place more emphasis on you taking an active part in your rehabilitation, rather than relying on passive treatments. Osteopaths are likely to provide more hands-on treatment through manual therapy, although they do prescribe exercises too. It’s not known yet if one way of doing manual therapy works better than another.

For more information, see our section: Alternatives to osteopathy.

More on this topic

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