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Osteopathy


Expert reviewer, Mr Rohit Dhillon, Osteopath
Next review due February 2022

Osteopathy is a way of diagnosing, treating and preventing health problems by moving, stretching and massaging your muscles and joints.

People may seek out osteopathy to help them with problems such as low back pain, joint pain, headaches and sports injuries.

Two women stretching in a fitness class

About osteopathy

Osteopathy is a type of physical therapy that is practised in the UK by trained professionals called osteopaths who are regulated by the General Osteopathic Council (GOsC).

The General Osteopathic Council says that osteopathy, “is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.”

Osteopaths use their understanding of the structure and function of the body, along with a wide range of hands-on techniques to treat health problems. These include touch, physical manipulation, joint mobilisation, stretching and massage. Osteopaths may also give advice on posture and exercise to help you recover and prevent your symptoms coming back.

Osteopaths are trained to refer patients to other healthcare professionals if that would be the best way to get treatment for your particular health condition.

What is osteopathy used for?

Osteopathy is a complementary therapy, which means it’s not part of conventional medicine, but may be used alongside it.

Osteopaths are known for treating problems with your muscles and joints. According to The Institute for Osteopathy (the professional association for osteopathy in the UK) and the General Osteopathic Council, it may be used to help treat the following.

  • Back pain
  • Pain in your joints including your ankle and foot, shoulder, knee, neck, hip, hand and elbow (including tennis or golfer’s elbow)
  • Pain from arthritis
  • Headache
  • Problems with your posture due to driving or work strain
  • Changes to posture during pregnancy
  • Minor sports injuries

Osteopathy is sometimes suggested as a treatment for other problems such as excessive crying in babies (colic) and painful periods (dysmenorrhoea). However, there isn’t enough evidence to say that it can help with these conditions.

If you’re pregnant, seek advice from your midwife or GP before having treatment from an osteopath.

Recommendations by the National Institute for Health and Care Excellence

The National Institute for Health and Care Excellence (NICE) is a public body that provides guidance to help healthcare professionals provide the best possible care for patients. It bases this guidance on the best scientific evidence available.

NICE doesn’t give specific recommendations about osteopathy, but it does give some guidance on using ‘manual therapies’. (Manual therapies, such as manipulation and massage are used by osteopaths and other healthcare professionals, including physiotherapists and chiropractors.) Currently, NICE suggests considering only manual therapies, along with other things such as exercise, to help treat the following.

  • Lower back pain with or without sciatica.
  • Osteoarthritis, especially in your hip.
  • Neck pain – that has no specific cause and has lasted for up to 12 weeks.
  • Shoulder pain, including frozen shoulder.

I’d like to see an osteopath, where can I find one ?

You can find a registered osteopath by checking the General Osteopathic Council (GOsC) register. All osteopaths in the UK should be registered with them. It's actually against the law for anyone to call themselves an osteopath unless they are registered with the GOsC. Your osteopath may also display their registration certificate or the GOsC registration mark in their practice.

Most osteopaths work in the private sector either alone or in group practices. Some offer their services through the NHS, but osteopathy isn’t widely available within the NHS.

What happens during an osteopathy appointment ?

Your first appointment with an osteopath will usually last around 45 minutes to an hour.

Assessing your problem

To begin with, your osteopath will ask you what’s wrong and go through your symptoms with you. They’ll also ask about your health in general. They might ask you about your lifestyle, any medication you’re taking and if you’re currently having any other treatment.

Your osteopath will then do a physical examination. They’ll use their hands to examine the health of your joints, tissues and ligaments, especially in the area where you have discomfort.

Your osteopath may ask you to do certain stretches and movements as part of their assessment. They may also do other tests such as checking your reflexes and taking your blood pressure.

What should I wear?

Wear comfortable clothing which allows you to move freely. For the physical examination, you may need to remove certain pieces of clothing. If you would be uncomfortable undressing to your underwear, it’s a good idea to wear sports clothing such as shorts and a T-shirt.

Your osteopath will show you where you can get changed. This may be behind a curtain or in a separate room. During your appointment, your osteopath will want to make you feel as comfortable as possible. If you would like, you can bring a friend or relative with you to the appointment.

Treating your problem

Treatment is usually hands-on, including techniques like massage and manipulation of your muscles and joints. But your osteopath may also give you information about things you can do yourself to get or stay healthy. This may include things like eating a healthy diet and exercising regularly.

Your osteopath will explain your treatment to you, along with its risks and benefits. If you have any questions, just ask – no question is too simple or small. It’s important that you fully understand your treatment as you’ll be asked to give your consent before it goes ahead.

Depending on what the problem is, your osteopath may offer you more sessions to have treatment. How many sessions you’ll need will depend on you and your individual needs.

Sometimes your symptoms may be caused by something that your osteopath knows can’t be helped by osteopathy. They’re trained to notice these things and should advise you to contact your GP or go to hospital if necessary.

Side-effects of osteopathy

Your muscles may be stiff or sore after treatment. You’ll usually notice this around 24 hours after your treatment, but it should ease off after a couple of days. Your pain may increase temporarily after treatment and you may even have some bruising. About half of all patients who have manual therapy get these mild-to-moderate side-effects, but they don’t usually last long.

Complications of osteopathy

Complications are the more serious effects that can happen during or after your treatment. Some manual treatments have been known to cause serious problems but the chance of this happening is very low.

One serious complication which you may have heard about is having a stroke after manipulation to your neck. This procedure can cause damage to an artery there, so affecting the blood flow to your brain. However, this is thought to be extremely rare.

For more information about complications, talk to your osteopath. Ask them to explain the risks and benefits of any treatment they offer you.

Frequently asked questions

  • There's no fixed price for osteopathy treatment. How much it costs will likely depend on where the osteopathy practice is and your osteopath’s experience. Ask your osteopath what the costs are likely to be in your particular circumstances.

  • Yes, osteopaths offer treatment to babies, children and teenagers as well as adults. They are trained to treat children, and some osteopaths choose to focus on paediatric (child) osteopathy.

    For some conditions such as excessive crying in babies (colic), there isn’t enough evidence to show that it can help. If your child does have osteopathy, the techniques used will be very gentle.

  • The Institute for Osteopathy suggests that osteopathy can help to treat minor sports injuries. These include injuries to your knee, shoulder and elbow. It’s known that touching a person can reduce pain, but it’s not clear yet how well the techniques of osteopathy work alone to treat sports injuries.

    If you get a sports injury, you can contact your doctor or physiotherapist for advice. They’ll usually advise you to follow the advice shown in our PRICE and HARM infographics below.

    An image describing the acronym PRICE

    An image describing the acronym HARM


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Related information

    • Complementary and alternative medicine. PatientPlus. www.patient.info/patientplus, last edited February 2016
    • Massage, traction and manipulation. Medscape. www.emedicine.medscape.com, updated October 2017
    • Neck pain – non-specific. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2018
    • Shoulder pain. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2017
    • Sprains and strains. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2016
    • Lower back pain and sciatica in over 16s: assessment and management. National Institute for Health and Care Excellence (NICE). Published 2016. www.nice.org.uk
    • Osteoarthritis: care and management. National Institute for Health and Care Excellence (NICE), published 2014. www.nice.org.uk
    • Dobson D, Lucassen PLBJ, Miller JJ, et al. Manipulative therapies for infantile colic. Cochrane Database of Systematic Reviews 2012, Issue 12. Doi:10.1002/14651858.CD004796.pub2
    • Proctor M, Hing W, Johnson TC, et al. Spinal manipulation for dysmenorrhoea. Cochrane Database of Systematic Reviews 2006, Issue 3. Doi:10.1002/14651858.CD002119.pub
    • Page MJ, Green S, Kramer S, et al. Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews 2014, Issue 8. Doi:10.1002/14651858.CD011275
    • About osteopathy. General Osteopathic Council. www.osteopathy.org.uk, accessed February 2019
    • Visiting an osteopath. General Osteopathic Council. www.osteopathy.org.uk, accessed February 2019
    • About osteopathy. The Institute of Osteopathy. www.osteopathy.org, accessed February 2019
    • What we treat. The Institute of Osteopathy. www.osteopathy.org, accessed February 2019
    • About osteopathy: osteopathy for health. The Institute of Osteopathy. www.osteopathy.org, accessed February 2019
    • Subject benchmark statement: Osteopathy. Quality Assurance Agency for Higher Education (QAA), 2015. www.qaa.ac.uk
    • Osteopathy. NHS. www.nhs.uk, last reviewed May 2018
    • Risks of osteopathic treatment. National Council for Osteopathic Research (NCOR). www.ncor.org.uk, accessed February 2019
    • Carnes A, Mars S, Mullinger B, et al. Adverse events and manual therapy: a systematic review. Man Ther 2010;15(4):355–63. doi: 10.1016/j.math.2009.12.006
    • What is paediatric osteopathy? Osteopathic Centre for Children. www.occ.uk.com, accessed February 2019
    • Pain: The clinical aspects. Brukner & Khan's Clinical Sports Medicine (4th ed, online). McGraw-Hill Medical. csm.mhmedical.com, published 2012
    • Treatment of sports injuries. Brukner & Khan's Clinical Sports Medicine (4th ed, online). McGraw-Hill Medical. csm.mhmedical.com, published 2012
    • Personal communication, Mr Rohit Dhillon, Osteopath, February 2019
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, February 2019
    Expert reviewer, Mr Rohit Dhillon, Osteopath
    Next review due February 2022



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