Osteopathy is a way of detecting, treating and preventing health problems by moving, stretching and massaging a person's muscles and joints.
Osteopathy is based on the principle that the wellbeing of an individual depends on their bones, muscles, ligaments and connective tissue functioning smoothly together.
Osteopaths use physical manipulation, stretching and massage with the aim of:
increasing the mobility of joints
relieving muscle tension
enhancing the blood supply to tissues
helping the body to heal
They use a range of techniques, but not medicines or surgery.
When it's used
Most people who see an osteopath do so for help with conditions that affect the muscles, bones and joints, such as:
lower back pain
uncomplicated neck pain (as opposed to neck pain after an injury such as whiplash)
shoulder pain and elbow pain (for example, tennis elbow)
problems with the pelvis, hips and legs
muscle and joint pain associated with driving, work or pregnancy
If you're pregnant, make sure you seek advice from a GP or midwife about your symptoms before you see an osteopath. You should also make sure you see an osteopath who specializes in muscle or joint pain during pregnancy.
Effectiveness of osteopathy
Most research into techniques used in osteopathy tends to focus on general "manual therapy" techniques, such as spinal manipulation. Manual therapy techniques are used by physiotherapists and chiropractors, as well as osteopaths.
The National Institute for Health and Care Excellence (NICE) guidelines on managing lower back pain and sciatica recommend manual therapy alongside exercise as a treatment option.
NICE also recommends manual therapy as a possible treatment option for osteoarthritis, although osteopathy is not specifically mentioned.
There's some evidence to suggest that osteopathy may be effective for some types of neck, shoulder or lower-limb pain, some types of headache, and recovery after hip or knee operations.
There's only limited or no scientific evidence that it's an effective treatment for conditions unrelated to the bones and muscles (musculoskeletal system), including:
excessive crying in babies (colic)
problems affecting the jaw (temporomandibular disorder)
abnormal curvature of the spine (scoliosis)
Osteopathy is available in some areas on the NHS. Your GP or local integrated care board (ICB) should be able to tell you whether it's available in your area.
Most people pay for osteopathy treatment privately. Treatment costs vary, but typically range from £40 to £55 for a 30- to 40-minute session.
You do not need to be referred by your GP to see an osteopath privately. Most private health insurance providers also provide cover for osteopathic treatment.
Only people registered with the General Osteopathic Council (GOsC) are allowed to practise as or call themselves osteopaths.
How it's performed-Osteopathy
During your first osteopathy session, the osteopath will ask about your symptoms, general health and any other medical care you're receiving before carrying out a physical examination.
The osteopath will use their hands to find areas of weakness, tenderness, restriction or strain within your body, particularly the spine.
With your consent, you'll probably need to remove some clothing from the area being examined, and you may be asked to perform simple movements.
You should then be able to discuss whether osteopathy can help treat the problem and, if so, what the treatment programme should involve.
Osteopaths are trained to identify when a patient needs to be referred to a GP or needs further tests, such as MRI scans or blood tests, to help diagnose the problem.
An osteopath aims to restore the normal function and stability of the joints to help the body heal itself.
They use their hands to treat your body in a variety of ways, using a mixture of gentle and forceful techniques.
Techniques are chosen based on the individual patient and the symptoms they have reported.
massage – to release and relax muscles
stretching stiff joints
articulation – where your joints are moved through their natural range of motion
high-velocity thrusts – short, sharp movements to the spine, which normally produce a clicking noise similar to cracking your knuckles
These techniques aim to reduce pain, improve movement and encourage blood flow.
Osteopathy is not usually painful, although it's not unusual to feel sore or stiff in the first few days after treatment, particularly if you're having treatment for a painful or inflamed injury.
Your osteopath will explain whether you're likely to have any reactions. If you feel any pain during or after treatment, tell your osteopath.
You may be given advice on self-help and exercise to aid your recovery and prevent symptoms returning or getting worse.
In general, the first appointment will last about 45 minutes to an hour. Further treatments last around 30 minutes. Your course of treatment will depend on your symptoms.