Osteopaths treat principally by using their hands. Treatment varies from the barely perceptible feeling of cranial osteopathy via the stretching of muscles and ligaments, to the slightly more dramatic joint manipulation. This is called a “low amplitude high-velocity thrust” treatment (HVT) and may produce the infamous click in the joints. A popular misconception is that the joint has been out of place, and the click puts it back in. This is not the case at all.
Each synovial joint in the body has fluid in between the bones which facilitates easy movement. If the joint becomes jarred, or the overlying muscles go into spasm, the bones encroach on each other, squeezing the fluid to the edges. This can create a suction effect similar to two wet plates sticking to each other.
The HVT treatment puts the joint in position and then applies a very quick pressure to it, over a very short range of movement. The speed of the movement opens the joint space, releasing the pressure and this may produce the characteristic popping noise. Any “pop” is a by-product of the manipulation – in other words, it does not have to happen for the treatment to be effective. Much more importantly, there is a reflex relaxation of the surrounding muscles, so the result is a much more mobile joint whose surrounding muscle is no longer in spasm. The whole process is very quick, either entirely painless or only moderately uncomfortable, and produces a dramatic improvement.
Some other techniques are very gentle, involving placing you in a position of comfort (or “ease”) for a while, to allow tissues to relax, or applying almost imperceptible pressure to support your tissues in specific directions, again to allow tissues to relax and, very gradually, be stretched back to their normal length.
‘Cranial’ techniques are extremely gentle and are not restricted to the head – they can be used anywhere on the body. They are particularly useful for treating children and babies, but are also used for adults. Some patients respond better to one treatment approach than another and we will aim to tailor the treatment to you.
We may also give you exercises to do. These are an integral part of the treatment – this is how you can treat yourself. They may be used, for example, to stretch shortened muscles or to strengthen weak ones, as part of a treatment programme, or they may be something that you will need to do long-term in order to manage a problem yourself rather than having to keep coming back for treatment.
To ‘Cure’ or Not to ‘Cure’…
The word ‘cure’ has become rather loaded down with TV images of heroic doctors in white coats with stethoscopes around their necks, saving lives: it is the doctor’s skill in choosing the right drug or performing the surgery that ‘cures’ the patient. Real life is rather less glamorous.
Osteopathy has no ambitions of heroism – the aim of the Osteopath is far more modest: it is to help create the conditions that will allow the patient’s own body to recover normally (what medics refer to as ‘spontaneous resolution’) as quickly and completely as possible. It has been said that; ‘The only thing an Osteopath cures is bacon!.” But our treatment is all about enabling you to return to full health, and what word should we use for ‘a return to full health’ if not ‘cure’?
This means that once your condition is improving we want to allow it to get on with the job itself. We only want to get involved if you are not improving. So at this point we will trust you to monitor your own progress (it is, after all, your body, and you are the person best placed to know whether you are improving or not) and make another appointment if things do not resolve completely. We are happy to assess, treat and advise you at any time if you want us to, but the decision should be yours not ours.
Realistic Expectations of Osteopathy
It is not uncommon for symptoms to improve about 80% and then stop – leaving you with an irritating, but not disabling, niggle. It is worth coming back for more treatment at that point. The ‘niggle’ indicates that something is not quite right and your body may need more treatment at that stage to allow it to recover completely and a return to full health is our aim. For some patients 80% better may be as good as it is going to get – there are permanent changes that no amount of treatment is going to change. If we think that is the case we will tell you and we will look at lifestyle changes and exercises that might help you to manage any remaining symptoms as well as possible.