- Do I need to bring anything with me to my appointment?
- Will I need to undress?
- Can I bring a chaperone?
- Should I tell my doctor that I am seeing an osteopath?
- Will I be treated on my first visit?
- How will I feel after treatment?
- How often will I need to be seen?
- Can I help myself?
- Should I take pain killers?
- Can someone come and treat me at home?
- Is osteopathy safe?
- Is it safe to have osteopathy and dry needling in pregnancy?
- Is dry needling safe?
- Does dry needling hurt?
- Can I give blood after having dry needling?
- What is the difference between an Osteopath, a Chiropractor and a Physiotherapist?
- If you have a question not featured here – please call us on 01780 480889
Please bring details of any prescribed medication or supplements you are taking. If you have any recent relevant X-rays, scans or medical reports please bring these with you. Also bring any orthotics, braces or supports you use.
Osteopathic diagnosis and treatment involves both observation and palpation, therefore you will probably be asked to undress to your underwear but it is not compulsory. Your privacy will be respected at all times. If it is important to you that you are seen by a practitioner of the same gender, please make it clear at the time of booking.
You are welcome to bring a companion with you. Please be aware that they will become party to all conversation during the appointment. Anyone under the age of 16 should be accompanied at all times by a parent or appointed guardian.
It is not necessary to advise your GP. As primary healthcare practitioners, we are clinically trained to assess patients without recourse to medical records. Occasionally we need to contact your GP about aspects of your health and medical history. We will always obtain your consent before contacting your GP or other medical carers.
The primary aim of your initial consultation is to establish what is wrong and whether osteopathy is a safe and appropriate treatment for you. Providing there are no contraindications we would normally expect to treat you on your first visit.
Most people initially feel easier after treatment. It is not unusual to then experience a treatment reaction and become more uncomfortable as the day goes on. This usually only happens after your first one or two treatments. The discomfort may last for a couple of days and is usually easily controlled. Your osteopath will advise you on post-treatment self-help to minimise this reaction. If you are concerned about how things feel after a treatment, please get in touch.
The majority patients require 3-6 treatment sessions. We often recommend 2-3 sessions in the first 10-12 days, with intervals increasing to match your progress. Every patient responds differently and your osteopath will discuss with you the anticipated course of treatment, your prognosis and realistic expectations for recovery. In some cases where the problems being addressed cannot be expected to resolve (old injuries, structural changes) it may be recommended that treatment is given at regular intervals on a long term basis to maintain the function and keep symptoms at bay as far as possible.
There is always much that a patient can do to help (or worsen!) their condition. Your osteopath will advise you if there are particular activities or exercises you should or shouldn’t do. Please ask if you have any specific activity in mind. Please see the Resources section on this website for self-help advice.
Many patients are reluctant to take painkillers for fear of masking their symptoms and thus causing further trouble. However, the judicious use of analgesic, anti-inflammatory and muscle relaxant medication can often be extremely useful, especially in the acute phases of some conditions. Your osteopath will advise on the suitability of appropriate ‘over-the-counter’ medication as well as other methods of easing discomfort such as the application of heat and/or cold packs, the use of pain relieving gels or gentle exercises. If prescription medications are required, your osteopath can liaise with your GP.
Please see the Self-help section of the website for a summary of commonly used pain killer medications.
We do not routinely offer home visits. In our experience the quality of care we are able to offer is compromised and the additional expense incurred does not offer value for money to our patients. If a patient is so disabled as to be unable to get to the practice, there is generally little effective treatment we can offer. However we are always willing to give help and advice over the telephone and treatment is usually suitable after a couple of days as the acute symptoms subside and the patient becomes a little more mobile.
Osteopathy carries few risks, and the vast majority of patients find treatment helpful. About 90% of our patients are referred through word of mouth recommendation – so there are a lot of happy patients around! Adverse reactions are not uncommon however and about half of people have the following effects for a couple of days after treatment, most commonly after the first one or two sessions.
- A increase in pain or stiffness
- A mild headache
Severe adverse reactions are very rare. Osteopaths are trained to medically screen patients to assess their suitability for osteopathic treatment. They will need to adapt their techniques appropriately or they may decide that treatment is not suitable for the patient and in this situation will discuss other treatment options, referring patients to other medical professionals as appropriate.
Rib fractures are thankfully very rare but probably the lease uncommon of the severe adverse effect to osteopathy. When they occur, it tends to be in patients who have osteoporosis or bone thinning for other reasons – radiotherapy, anorexia, long term use of steroids (for asthma control or PMR for example). These patients suffer fractures easily in everyday life – tripping up a step for example or being hugged by a loved one. It is difficult to give any treatment without the small risk of a fracture occurring – but these patients often find treatment very helpful, so we treat them – with great care!
Concern is often voiced about the risk of neck manipulation causing a tear in the vertebral artery (vertebral artery dissection – a rare but serious condition which can lead to a stroke). This type of tear of the artery can be caused by serious or minor trauma and is a significant cause of strokes in patients under 45 years of age. Between 1 and 3 out of every million people who have neck manipulation are at risk of having a stroke, so the risk is real but extremely small. There are a number of other risk factors for vertebral artery dissection, which include doing yoga or martial arts, having your hair washed at the hairdressers, painting a ceiling, blowing your nose or turning your neck when reversing the car. Vertebral artery dissection is also more likely if you suffer with hypertension (high blood pressure), sustain neck trauma, take oral contraceptives, suffer migraines or as a result of other complex medical conditions. It is not always possible to identify vulnerable patients. Osteopaths are trained to identify patients at high risk of a stroke and if they have any concern will not perform certain neck manipulations.
It may help to know that spinal manipulation for neck pain seems to be much safer than taking non steroidal anti inflammatory medicines, according to a research review carried out by the National Council for Osteopathic Research (NCOR) in 2010.
Osteopathy can be helpful throughout all stages of pregnancy. It is important that you advise us if you are or think you may be in the early stages of pregnancy. The first trimester of pregnancy (up to 12 weeks) carries a naturally high risk of miscarriage. While there is no proven link between osteopathic treatment and an increase in incidence of miscarriage, osteopaths take great care when treating pregnant women and adapt their treatments appropriately. Manipulation of the lumbar spine is avoided until about 14 weeks gestation but other techniques can be used. Osteopathy is a very safe and effective treatment for the aches, pains and discomfort of pregnancy and many women find it invaluable in the later stages when the pregnancy places tremendous strain on the body.
There are no established risks that are specific to pregnancy, and dry needling techniques can be safely used – with due caution – in all stages of pregnancy.
In the hands of properly trained practitioners, dry needling techniques are very safe; certainly safer than many of the drug treatments we use. However, any procedure that involves inserting needles into the body has some potential problems. In addition, there are a few “side effects” produced by dry needling treatment that can be troublesome in certain people.
Here is a list of some of the side effects you may, or may not, experience:
- Momentary discomfort where the needles are inserted
- Drowsiness and sleepiness
- Minor bleeding and bruising
- Temporary worsening of your symptoms
- Onset of a migraine headache, if you are a sufferer
- Feeling faint, during or after treatment
Rare but serious risks include:
- Damage to an internal organ from insertion of a needle
- Infection in the area where the needle was inserted, or spreading through the blood system.
The needles used are solid and extremely fine, unlike injection needles which, being thicker and hollow, work a little like a hole punch – traumatising the tissues and causing damage. Injection sites are normally painful afterwards, dry needling sites are not. It is usual to feel a mild pricking sensation as the needle pierces the skin but once the needle is in position patients usually report an aching or warm sensation. It is unusual for the needles to be uncomfortable when in situ. Occasional there is a tiny droplet of blood when the needle is removed but generally there is none. Usually the biggest problem is the patients anticipation of pain! Most people are pleasantly surprised and some patients feel nothing at all when the needles is inserted.
Osteopaths are registered with the General Osteopathic Council – a statutory body recognised by government – and patients are able to give blood after receiving dry needling treatment from an osteopath. The Blood Service will need the name and GOsC registration number of your practitioner and the dates on which you received treatment, if it has been within the four months leading up to your donation. Please ask the receptionists for a card with these details.
Osteopathy and chiropractic share a common origin and although the two disciplines are superficially similar, they have quite different underlying philosophies. However, in practical terms osteopathy, chiropractic and also physiotherapy (a branch of conventional medicine) treat the same sort of musculoskeletal conditions. There is considerable overlap between the working styles of practitioners from the three different disciplines, and also considerable variation between practitioners within the same discipline!
Broadly speaking the initial consultations will be similar with practitioners from all three disciplines, involving a detailed case history, physical examination of the patient, their standing posture and the way they move, and a series of clinical tests such as blood pressure and reflexes to aid diagnosis and to help establish that the patient is suitable for treatment. The nature of the treatments are rather different:
Osteopathic treatment usually comprise massage of the soft tissues, stretches and rhythmical movements of the joints, and short corrective manipulations of the joints of the spine and/or the limbs (causing the pops and crunches for which we are known!). Treatments with an osteopath are generally about half an hour duration and patients are usually seen approximately weekly in the initial phase of treatment.
Treatments with a chiropractor are usually shorter – 10 or 15 minutes – and comprise mainly spinal adjustments (pops and crunches again!). Chiropractors generally see their patients more often – twice or three times a week in the initial stages.
Physiotherapy treatment tends to be more based around exercise therapy and the use of electrotherapy, such as interferential and ultrasound. Many physios with a special interest in musculoskeletal medicine will also have studied manipulative techniques (more pops and crunches!). Physio treatments in the private sector tend to be at approximately weekly intervals.
However the distinction is not clear-cut – your osteopath may use ultrasound, your chiropractor or physio may perform massage work. All practitioners will prescribe exercises to help in your recovery and you may be also be offered other treatment such as acupuncture or offered taping, supports, insoles, supplements etc if your practitioner feels it may be of help.
All these treatment approaches have been shown to be safe and effective and it can sometimes be difficult for patients to decide which treatment to choose. We of course are biased and think osteopathy is best (!), but talk to your friends – who do they see? And make sure that when you do go to see someone, that you feel comfortable with them, feel listened to, cared for and that you like them as a person.