• What is osteopathy?
Osteopathy is a primary health care system, complementary to other medical practices, regulated by law. In the UK, osteopaths must be registered with the General Osteopathic Council in order to practise. Osteopaths primarily work through the neuro-musculo-skeletal system, mostly on muscles and joints, using holistic and patient-centred approaches. A core principle is that the body is an integrated unit, and contains self-healing mechanisms that can be part of the treatment. No part of the body works, or can be considered, in isolation. Osteopathic diagnosis is formed from listening to the patient's history, examining muscles and joints as well as observing movements. Relevant psychological and social factors also influence patient diagnosis. X -rays, scans and other clinical investigations are also used if required. A wide range of non-invasive manual techniques can be used, such as deep tissue massage, joint articulation and manipulation, trigger point therapy, myofascial release and medical acupuncture. Postural advice, stretching, and exercise guidance are often advised. Osteopaths can assess and treat without referral by a doctor. Although some patients do come for treatment following a doctor’s advice.
• What is acupuncture done by an osteopath?
I am trained in medical acupuncture. When I feel that it would be appropriate, I discuss it with my patients so the choice is theirs. Acupuncture is useful for muscle relaxation, often without the soreness that may accompany soft tissue techniques. Typically I use four or more sterile ultra-fine needles, connected to electrodes at a specific frequency. Once removed, I may then use other manual techniques to encourage the desired tissue changes.
• What is the difference between osteopaths, physiotherapists and chiropractors?
This is a question we have often been asked. I have chosen to train and practise as an osteopath, but this does not mean that osteopathy is better than other systems of health care – it simply reflects my own choice and the way I treat my patients. Osteopaths, physiotherapists and chiropractors are all manual therapists principally involved in treating musculoskeletal dysfunctions or injuries. Practitioners from all these professions are very knowledgable about human structure and anatomy. No version of manual therapy is necessarily better than any other – health practitioners can all learn from one another. Ultimately, the common goal is to try and help the patient. Chiropractors view most dysfunction as due to spinal misalignment. Osteopaths look at all the other areas of the body as well as the spine. Osteopaths and physiotherapists will tend to rely more on physical examination and will refer on to GPs and specialists for further tests such as X-rays or MRI scans. Chiropractors frequently use X-ray examination as a routine procedure and they influence the nervous system by “adjustment” which is a manipulative thrust technique to the spinal vertebra, which may result in a “click” or cavitation of the joint. Osteopaths commonly use thrust techniques, but also focus on the soft tissues with massage and stretching techniques. Osteopaths generally employ a wider range of manual techniques than the other two professions. Physiotherapists frequently use stretching and strengthening of muscles, and exercises are an important part of the therapy. Chiropractors tend to see patients more frequently on the basis that a number of adjustments over a course of time are required for the spine to settle into its proper alignment. Osteopaths tend to spend more time than either of the other two professions with their hands on, palpating and working manually. Generally osteopaths spend more time with their patients, but see them for fewer sessions.
• Do the differences matter?
Both osteopaths and chiropractors are recognised in law as primary healthcare practitioners – which means they are diagnostic and not just remedial: they have a duty to ensure a patient is safe to be treated, and that their treatment is appropriate to the diagnosis they make. Physiotherapists are not primary healthcare practitioners: patients are treated following a physician’s referral and diagnosis, or are self-referred. Based on our experience, patients get better when there is a good relationship between the patient and the practitioner. The differences in the techniques themselves, provided they are performed competently, seem to matter less. There are changes taking place within the professions, with a degree of convergence between them: many physiotherapists also perform manipulations; many osteopaths manipulate less or not at all. Exercise, life style changes and stress management are seen as increasingly important by all three professions. Perhaps the best advice for patients is for them to try different therapies and find the one that works best for them.