Research

Current, thorough and useful research into treatment is being undertaken on an increasing basis, although the published literature is very limited. The National Council for Osteopathic Research (NCOR) www.brighton.ac.uk/ncor works to collate and direct Osteopathic and related research.

Until the profession has built a more thorough evidence based foundation the more ‘traditional' medical physicians will remain cynical of the benefits of Osteopathic care. It is fair to say that no form of manual medicine (Physiotherapy, Chiropractic, Remedial Massage, etc...) has yet to produce research in the accepted manner of clinical trials to demonstrate a clear therapeutic benefit. Ultimately the true picture is that of the 23,000+ satisfied patients treated every day in the UK by Osteopaths:

What we do know is that early treatment and advice:

-Reduces the intensity and duration or acute pain

-Reduces medication and therefore some of the dangerous drug reactions and interaction seen (particularly from the family of drugs called non-steroidal anti-inflammatories NSAIDs)

-Reduces incapacity and time off work

-Reduces anxiety giving treatment and advice which reduces pain and improves mobility

-Reduces costs to industry and society by reducing chronic disability and extended periods of absenteeism from work.

Below are various abstracts that are currently available:

1. Royal College of General Practitioners (RCGP) 1998 from guidelines of the Clinical Standards Advisory Group (CSAG) 1993

Manipulation within 6 weeks of onset can provide short term improvement in pain and activity level

Risks of manipulation are very low in skilled hands

Radiology not indicated in simple back pain (RCR)

Bed rest for 2-7 days less effective than alternative methods

2. Van Tulder M, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: A systematic review of randomized controlled trials of the most common interventions. Spine 1997; 22(18): 2181-2156.

There is strong evidence that manipulation is more effective than a placebo treatment....

There is moderate evidence that manipulation is more effective for chronic Low Back Pain than usual care by the general practitioner, bed-rest, analgesia, and massage.

3. Roth S. Non-steroidal anti-inflammatory drugs: Gastropathy, deaths and medical practice. Annals of Internal Medicine 1988; 109: 353-354.

The use of medications was sharply lower [sometimes less than half] by the Osteopathic patients. The results of this trial suggest that it is possible to obtain similar therapeutic relief from back pain with substantially less medication, a highly significant finding in light of the well-known and sometimes fatal side-effects obtained with (anti-inflammatory drug) NSAIDs.

4. Gabriel S, Jaakimainen L, Bombardier C. Risk for serious gastrointestinal complications related to use of non-steroidal anti-inflammatory drugs. A meta-analysis. Annals of Internal Medicine 1991; 115: 787-796.

Being able to reduce the use of medications may also significantly lower treatment costs especially when the costs of side-effects and iatrogenesis are factored in. These considerations would bode well for the practice of spinal manipulation for the management of back pain.

About Patients

Most patients attend the practice because something ‘hurts'. Usually the site of the problem is easily identified and the treatment commenced on the first visit. Other examination may also be needed occasionally. X-rays for most conditions are unnecessary, waste time, money and expose you to unnecessary radiation. However, occasionally these are necessary and easily arranged.

The aim is to diagnose, explain, treat and advise patients all on the first visit. This way patients get better quicker!!

About Treatment

Osteopaths treat a great variety of conditions and regions of chronic and acute pain. Listed are only a few of the most common conditions treated:

Treatment is directed at symptom relief. It also involves making the individual aware of the probable causes of their injuries or pain and once the symptoms have settled, how they might avoid recurrence of their pain or condition in the future.

All initial appointments are 30 minutes at our clinics. We believe people should be wary of a Practitioner who tries to rush patients in and out in 10 minutes. We feel this is not sufficient time to listen to patient, make and explain the probable diagnosis and treat the problem comfortably and effectively.

He also believes that seeing someone repeatedly without any significant improvement in their symptoms is a waste of a patient's time and money. Generally if a condition is not improved 50% by 3 visits it is probable that treatment is unlikely to help in the long term. Over treating with manipulation is dangerous as it may also lead to ‘instability' of the joints being treated making the patients symptoms worse in the future.

About Fees

Unfortunately there is very little NHS funded Osteopathy available in the UK. This means patients generally need to pay for treatment themselves. This is either by paying at the time is the visit (generally between £25-65 depending on which area you live in!!) or via a Private Health Insurance (PHI) policy. Consultation costs are now reimbursed by most serious insurance companies (i.e. BUPA, PPP, WPA, Norwich Union, Cigna, Sun Alliance, plus many more). HSA for example has a very competitive monthly premium whose policy is to reimburse 50% of the fee as well as many other benefits.

As a rule you need to be referred by your GP or a Consultant with most policies. Not all Osteopaths are eligible for reimbursement - so check first.

Still, self-funding remains the most common method to date.