Osteopathy

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What is Osteopathy?

Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions.  It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.

To an osteopath, for your body to work well, its structure must also work well.  So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery.  Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms.  They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.

Osteopaths also carry out many of the diagnostic procedures used in a conventional medical assessment and diagnosis. All our Osteopaths are Registered with the General Osteopathic Council (GOsC), which is the governing body for Osteopaths. To be registered with the GOsC Osteopaths must have graduated from a recognised college, be properly insured, and adhere to specific standards of practice much like GPs.

Most of the main Private Health Insurers, including BUPA, now cover Osteopathic treatment. If you have private health cover do check with your insurance company to see if they will pay for all or part of your treatment.

What can I expect on my first visit to an osteopath?

At the first consultation, the osteopath will compile a full case history of your symptoms, as well as asking for information about your lifestyle (work, stress, exercise) and diet. The osteopath may also observe you making some simple movements to help them make a diagnosis. You will usually be asked to remove some clothing near the area of the body to be examined.

Osteopaths are trained to examine areas of the body using a highly-developed sense of touch to determine conditions and identify the body’s points of weakness or excessive strain. Osteopathy is a ‘package’ of care that includes skilled mobilising and manipulative techniques, reinforced by guidance on diet and exercise.

The osteopath will discuss with you the most appropriate treatment plan, estimating the likely number of sessions needed to treat your condition effectively. If the osteopath thinks that your condition is unlikely to respond to osteopathic treatment, you will be advised about how to seek further care. Osteopaths are skilled in diagnostic techniques and trained to identify when a patient needs to be referred to a GP or Consultant.

What can osteo help with?

Osteopathy can help with a wide range of different conditions, and though as osteopaths we treat you as a patient rather than just the area of pain, we have proven (evidence based) success at treating:

  • generalised aches and pains
  • joint pains including hip and knee pain from osteoarthritis as an adjunct to core OA treatments and exercise*
  • arthritic pain
  • general, acute & chronic backache, back pain (not arising from injury or accident)*
  • headache arising from the neck (cervicogenic)* / migraine prevention
  • frozen shoulder/ shoulder and elbow pain/ tennis elbow (lateral epicondylitis) arising from associated musculoskeletal conditions of the back and neck, but not isolated occurrences*
  • uncomplicated mechanical neck pain (as opposed to neck pain following injury i.e. whiplash)*
  • circulatory problems
  • cramp
  • digestion problems
  • joint pains, lumbago
  • sciatica
  • muscle spasms
  • neuralgia
  • fibromyalgia
  • inability to relax
  • rheumatic pain
  • minor sports injuries and tensions

This however is by no means an exhaustive list, many of our patients find that seeing an osteopath can help with a wide range of other conditions, and helps with an overall sense of well-being where a cure is not possible. Many patients have seen an Osteopath and found relief for;

  • Pregnancy aches and pains
  • Paediatric disorders
  • Whiplash Associated Disorders (WAD)
  • Repetitve Strain Disorders (RSI)
  • Respiratory Disorders (such as the MSK effects of suffering with Asthma)
  • Neurological Disorders (such as the effects of MS, Cerebral Palsy and Post-Stroke)
  • Headache and Jaw problems
  • Bowel discomfort (such as IBS)

There seems to be different types of Osteopathy?

Every Osteopath with undertake a 4 or 5 year degree to become an Osteopath in its general sense. Osteopaths can then go on and specialise within areas of Osteopathy or different treatment approaches in Osteopathy.

These include;

Classical Osteopathy

Classical Osteopathy is a system of healing which was formulated over a hundred years ago by AT Still and then further interpreted by JM Littlejohn. It encompasses the Hippocratic concept of Vis Medicatrix Naturae, ‘the healing power of nature’, where the body is seen not as a machine, but as a vital living organism with a normal tendency towards self-healing, elimination and health. The development of disease depends on any factors which lowers the vital force or the vitalising processes of the patient and compromises the organism’s ability to recover. It follows therefore that the osteopathic lesion is not a bony lesion, but a physiological one and that any disease or disturbance must be addressed through physiological processes.

This approach of health promotion is directly in contrast to orthodox medicine, which delivers a more linear/ pathogenic approach to treatment of disease and its symptoms via the use of pharmaceuticals. In osteopathy, health is not merely viewed as an absence of disease, but as a state of complete physical, mental and social wellbeing. The osteopathic therapeutic concern is therefore to adjust the body’s capacity to deal with environmental stressors, whether these be on a mento-emotional, physical or biochemical level.

This process was termed simply as ‘Adjustment’ by JM Littlejohn and implies perfect structural adjustment, including bones, muscles, ligaments, blood vessels etc. , perfect neurological adjustment and adjustment of the individual to their environment by considering factors such as diet, hydration level, sanitation, social interactions, stress levels, sleep pattern and so on.

Applied Physiology

The notion of body as a vital living organism is fundamental to classical osteopathy. Each individual has within their body vital forces, vitalised fluids and vitalising processes which maintain the normal equilibrium of the body. A healthy body relies on ‘unity’ of the whole, or “the proper play and correct relation of all the integral parts of the organism, including the correct articulation of the entire skeleton, the proper relations of the muscles, fascia, ligaments, cartilages and tendons to one another and to their skeletal attachments, the exact anatomical structure and physiological action of the blood vessels and the nerves of the body organism, so that all these in interdependence upon one another and in correlation to the organism as a whole for the basis of the vital forces of the body”.

This concept of unity is controlled by the nervous system, whereby cerebrospinal fluid, which is highly vitalised and trophic, is produced in the choroid plexuses of the ventricles of the brain and is distributed along the spinal canal and the pathways of all the cranial nerves to the periphery and to every tissue of the body – and then back again ad infinitum. It is the neuro-endocrine system which coordinates and controls the activity of the organism as a whole in any reaction to its surroundings and itself. Hence the afferent impulse or sensory stimulation is always the starting point of the activity, normal or otherwise.

The object of osteopathy is therefore to allow the absolute or maximum activity of the vital processes. This is achieved via the vasoactive components of the nervous system by i) relaxation of contracted tissues and contraction of relaxed soft tissues, ii) adjustment of bone, cartilage tendons to each other and to the whole, iii) inhibition of overactive tissues via the nerve centres, iv) stimulation of inactive tissues through the nerve centres, and v) establishing free and uninterrupted currents of vitality.

Still recognised that there was a somatic component to disease and the intervention of the osteopath is through skilled osteopathic technique to ameliorate those aberrant reflexes. The modern term being allostatic load.

The Body Mechanics

Although the body is vital living organism, it is, as are all structures, subject to the laws of gravity. Although this gravitational stress is normal, it is the inability to sustain this stress and the subsequent malposition of the body in relation to gravity that leads to altered physiology and hence disease. As Fryette reminded us “gravity is the great killer of the body”. Ignoring the effect of gravity will therefore provide temporary relief of the lesion state only. We have to think in terms of parallel and non-parallel forces and of curved forces as they act over the spinal arches and more importantly of the problem of weight-bearing as it operates on the normal or abnormal structure. The living organism must be mechanically sound but must also be segmentally and collectively free to be able to function normally.

“Fixation at one point of the spine will find expression throughout the column.”

‘Polygon of Forces’ diagram (click to enlarge):

The effects of gravity on the body can be represented by non-parallel lines traversing the spinal column – the structural line passing from the atlas to the coccyx balanced by the functional line from the atlas to the centre of gravity at the 3rd lumbar vertebrae. Vector lines can then be drawn from the atlas to the coccyx and the acetabula, thereby forming a large pyramid, based on the pelvis and a smaller pyramid balanced and inverted on the point at the apex of the large pyramid opposite the 4th dorsal vertebra. This polygon of forces provides us with a diagnostic model to illustrate three dimensional forces on the body. It is essential that the bases of these triangles be freely operative – which is possible only if the spine is properly integrated. Treatment must therefore “appeal to the lines”.

Curved lines or spinal arches provide a dynamic representation of the spinal column whereby the four arches provide a balance between the primary dorsal and sacral arch and the secondary cervical and lumbar arches. The most important factor in spinal balance is the double arch from D5 to 2L – commonly known as the ‘power house’ of the spine – acting as a link between the upper and lower parts of the body.

It is essential to our work as classical osteopath to remember that the above discussed straight and curved lines are essential for the wellbeing of the living moving body and that any functional derangement surrounding a spinal segment will result altered afferent nervous input, reduced circulation and nutrition, toxic conditions and atrophy. This is why “no amount of correction will avail much in the treatment and recovery of the patient, unless the static and dynamic structures are brought into play, alongside the joint release and relief of soft tissue rigidity”.

The Body Adjustment

It is not possible to “adjust the abnormal to the normal”, i.e. it is impossible to deal with only the injured/painful area of the body in isolation, whether this be a particular joint, organ or nerve supply – we must address the whole body.
For this reason, classical osteopaths practice a ‘whole body’ routine, which uses palpation to provide a method of assessment and reassessment of tissue response. This approach ensures that nothing is missed in diagnosis and it deals with tissues conjointly in order to “correlate and co-ordinate the structural and functional activities of the body”. Long lever techniques through the extremities are used to allow every soft tissue insertion into the spine and pelvis to be addressed and restore blood flow where lacking. It is aimed at achieving a stable, integrated structure, thus restoring the internal environment and providing essential long term stable and stress resistant recovery of the lesion state.

The elements of rhythm and balance are also considered when applying the body adjustment. “Balance is the key and it is applied in the spinal curvatures, in the distribution of the body fluids, the combined influence of inhibition and stimulation, of constriction and dilation”. Rhythm is inherent to all body functions and is lost in the majority of patients becoming uncoordinated and confused. It is our task as osteopaths to restore both these qualities without irritating the body in accordance with physiological and mechanical laws.

Acute conditions, it is essential for osteopaths to be able to recognise what stage the patient is ‘at’ with respect to their body state, i.e. whether the disease process is in acute, sub-acute or chronic phase.   In an acute phase, it is generally necessary to adopt a more specific and distinct approach than the Body Adjustment. A key feature of treating acute disease is timing and frequency of treatment, where too long a treatment will tire the patient and nullify the purpose. All treatment is performed sensitively, respectfully and delicately and with the minimum intervention possible to assist the body in its own recovery.

Cranial Osteopathy

Cranial Osteopathy is a gentle and effective therapy suitable throughout life, which treats the whole body, not just the head. 
All ages benefit, however it is particularly helpful for women during pregnancy and after the birth, for babies as soon as they are born and for children in their early years.  Cranial Osteopathy is a gentle technique applicable to the whole body. Osteopathy is a touch-based therapy, now well known for the treatment of conditions affecting muscles, nerves, bones and ligaments.

Those trained in the art of Cranial Osteopathy can feel the subtle movements between the head bones and the rhythm of the fluid movements within. We are as interested in fluid dynamics and motion as we are with bones.

Particularly appropriate for babies, early osteopathic treatment may help a baby thrive by establishing or optimising early patterns of feeding, breathing and sleeping. Re-aligning the body restores the proper head-neck-trunk relationships and therefore improves internal fluid dynamics or flow.

We have practitioners trained to a high competency in Cranial Osteopathy through teaching establishments such as the BSO, ESO, The Sutherland Cranial Academy, Upledger Institute, Dr James Jealous Biodynamics and Dr Sanet of the Osteopathic Health & Wellness Institute, USA.

Paediatric Osteopathy

Paediatric Osteopathy is the specialism of treating children. This highly skilled area of Osteopathic Practice encompasses general osteopathic knowledge as well as in depth knowledge of Paediatric Health. This includes Embryology, Birth Presentations, Maternal Health, Paediatric disorders, Child Nutrition and development, Development milestones, Treatment types and much more.

Osteopaths working in this area are likely to use a range of techniques such as cranial, inhibition and visceral work to elleviate symptoms.

In depth case histories including conception type, pregnancy, stages of labour, birth presentation, apgar scores, feeding, bowel, and sleeping habits. Further history, depending on the age and presenting issue of the child, may include drug and other treatment history, dexterity, coordination, strength, movement and so on.

Please refer to Worthing Children’s Clinic (Mother & Baby) for more information.

Visceral Osteopathy

Visceral Osteopathy is the practice of manipulation of the visceral organs and their attachment points to the musculo-skeleton. All organs are attached to the skeleton by some means. In the abdomen, the large intestines are attached by the mesentery. The heart is attached to the diaphragm and via the pericardium up into the neck and basi-occiput. The uterus is supported by the broad and round ligaments and attach to the pelvic bowl. All are accessible to treatment directly or via the attachment structures.

The basic premise is that any restrictions may cause an obstruction of flow and lead to ill health. Therefore if you influence the structure you will influence its function.

Dean Dickinson (our Principal Osteopath) has worked with many world leaders in this field such as Jean P Barral, Caroline Stone and Dr Sanet. Please see Dean’s profile here.

Sports Osteopathy

With a deep understanding of anatomy, physiology and human biomechanics Osteopaths are being used more and more within Professional Sport to help Athletes get the edge.
Many Osteopaths come from a Sporting background or have gone on to gain further knowledge in Sports Rehabilitation, Exercise Medicine and Nutrition.

An unresolving or recurrent Hamstring strain or Achilles tendinopathy could be coming from a SIJ problem. Likewise, Anterior Knee pain could be caused from decreased hip movement or a Rotator Cuff Strain could be caused by stiff Thoracic spine causing over-recruitment of the shoulder muscles.

Osteopaths in the Sporting arena are often asked to look at Athletes that are not responding to conventional Physiotherapy.

Dean is registered with The Osteopathic Sports Care Association (OSCA) and is currently working as an Osteopath in professional sport at AFC Wimbledon.