What is osteopathy?

Osteopathy is a hands-on therapy with the aim of helping the body to work better. The human body is amazing in its design and staggering in its complexity. By applying an in-depth knowledge of the body (physiology and anatomy), osteopaths attempt to improve the way the body functions. For example, sciatica may be lessened by reducing pressure on the affected nerve; tennis elbow may be helped by encouraging blood flow into/from the forearm and reducing the unhelpful adhesions that form between the muscles and surrounding tissues; headaches are often reduced by improving neck function and reducing muscle tension, especially at the junction between the neck and the skull. It’s all about understanding why a problem has occurred, and then helping the body to find better health.

The title “osteopath” is protected, meaning that only practitioners registered with the governing body, the General Osteopathic Council (GOsC), can use the title. Please click on the link if you would like more information on the GOsC http://www.osteopathy.org.uk/. To become an osteopath entails a rigorous, 4-5 year degree. This ensures that osteopaths are safe to treat the general public.

Peter Andrews is also a member of the Institute of Osteopathy. For more information, please click on the link http://www.osteopathy.org/.

Does osteopathy work? What’s the evidence?

There is growing evidence for the effectiveness of osteopathy. If funds were more abundant then this evidence base would no doubt be broader and more comprehensive. You can find a link to a summary of the evidence co-ordinated by NCOR (National Council for Osteopathic Research) http://www.ncor.org.uk/wp-content/uploads/2013/05/Osteopathy_summary_May_2013.pdf.

Please see the NHS’ advice with reference to osteopathy for low back pain (http://www.nhs.uk/conditions/Osteopathy/Pages/Introduction.aspx).

Isn’t osteopathy just to do with bones?

The term osteopathy (from the Greek words ostéon, meaning bone, and páthos, meaning suffering) was originally used by Andrew Taylor Still to describe the importance of structural integrity (provided chiefly by bone) in preventing disease. Unfortunately a lot of people assume osteopaths are only interested in bones. Bones and muscles do, of course, act together, as do ligaments and fascia…everything in the body is integrated, nothing exists in isolation. We are holistic, so we need to be treated as such.

Can’t you just click it back into place?

If only it were that simple. A click (or cavitation) might be beneficial in reducing the tone of surrounding muscles, hence reducing the strain that in a particular part of the spine. In some instances there can be a marked increase in movement after clicking a joint.

What’s the clicking sound and what does it signify?

The click or pop happens on movement; it can happen unexpectedly (e.g. when you move in a certain way), or deliberately, such as cracking your knuckles, or when an osteopath, physiotherapist or chiropractor does it in a treatment. The sound itself is simply a congregation of gas molecules which are in the tissues surrounding the joint; the individual molecules are pulled into the joint space when the joint surfaces are forced/stretched apart (nature abhors a vacuum), and as they join together they form a popping sound. It is worth bearing in mind the following:

  • Although it may sound dramatic and confer some expertise on the part of the person doing it, it may be of no benefit whatsoever…or, it could be exactly what is required! So, just because a joint clicks, it doesn’t mean it’s relevant to you getting better!
  • Cavitating a joint can be inadvisable, for example, with acute pain into an arm or a leg, if this is caused by a disc bulge, prolapse or herniation; in my opinion this could place potentially harmful stress on an injured structure.
  • Repeatedly cavitating the same area of the spine can result in hypermobility and irritability, and is difficult to justify clinically; I have had several patients who have received intensive and repeated spinal manipulation which has led to long-term irritation of that particular joint.
  • There is research to show that cavitation results in a reduction in the tone of surrounding muscles by reducing alpha motor neurone activity, and increasing circulating endocannabinoids, leading to pain relief.

By the way, it’s a myth that clicking joints causes arthritis.

What’s the difference between osteopathy and chiropractic?

This answer is based upon: my own experiences of receiving 6 sessions of chiropractic treatments in my mid-20s; what former chiropractic patients tell me; and my own knowledge of the history of osteopathy and chiropractic. Despite the differences in approach, it is impossible to overstate the importance of finding someone with sincerity, integrity and empathy. Most practitioners are driven by a desire to help – if you sense that this is secondary to making money, be wary.


Time – typically osteopathy sessions last 30 minutes, while a chiropractic session lasts 15 minutes.

Duration of treatment – be questioning if you are asked to commit to (and pay for!) a specific number of sessions. It is often difficult to predict how many sessions will be needed, although your practitioner should be able to give you an estimate based on the nature of your condition/problem, your age and general fitness. Some people choose to have regular maintenance treatments in order to help them with a demanding/stressful job, or to manage a chronic condition, such as spondylitis (osteoarthritis of the spine), or large joint osteoarthritis. Be questioning of special offers (“Get 10 sessions but pay for 9”) and discount vouchers.

Philosophy and practice – when Dr Andrew Taylor Still (a medical doctor) was teaching osteopathy in the mid-late 1800s, one of his students was Daniel Palmer, who later founded chiropractic. For unknown reasons Palmer decided to pursue his own version of osteopathy, and went on to call it chiropractic. “Chiropractic posits that subluxation of the spinal column and other articulations can affect nervous system function and the expression of health, which may result in symptoms, infirmity and disease”  (http://www.palmer.edu/Our-Identity/#Philosophy_Statement). In practice, most chiropractic treatments consist mostly, sometimes exclusively, of clicking joints (“adjustments”). Osteopathy is essentially a treatment informed by a philosophy which is based upon viewing the body as a holistic unit, and working with the body to find healing. It is difficult to define osteopathy as a series of techniques or manoeuvres, although to make it easy to understand, patients can expect their osteopath to use techniques to massage/stretch the tissues, mobilise/articulate joints, possibly click joints if appropriate. Some osteopaths also use what is known as cranial osteopathy, which (despite its name) is an extension of osteopathy and is used to treat the whole person and not just the head!

X-rays – most chiropractors have X-ray facilities. In my experience a thorough examination and careful questioning reveal the condition of an underlying joint. An X-ray should only be used if there is some uncertainty over the diagnosis. My advice is to think carefully about subjecting yourself to radiation, and to always ask “what will an X-ray tell you that you don’t already know?”