How We Work

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All of the osteopaths who work at the practice believe that osteopathy is a very useful and helpful approach to a variety of problems.

Touch is an underrated sense, yet it is a very valuable means of finding out what has gone wrong in the body.

The osteopathic philosophy stresses the interconnections within the body, the way that one part affects another or the way that you move differently in response to pain or after an injury.

But we also value conventional medicine and applaud its many great strengths. If we think that you need conventional treatment or tests, at any stage, we will recommend that you return to your G.P.

In this section we aim to give you a better idea of how we work and who we are able to help.

The strength of Osteopathy lies in treating an individual as unique.

In every case we consider a patient as a person, in the context of their own physique and lifestyle, within the particular demands that their work and home-life place upon them.

All ages can benefit from Osteopathy. Babies can treated using gentle "cranial osteopathic" techniques.

Older children too can benefit from postural advice and help with strains suffered during growth spurts (see section Osteopathy for babies and children).

Many of our patients are adults of working age. Those undertaking heavy physical work (we see many builders and cleaners) could be expected to suffer strain and back pain from time to time, but sitting at a VDU all day or driving long distances can also lead to back pain, and problems such as various forms of repetitive strain injuries and headaches.

Elderly people can also benefit from Osteopathy and are often surprised that the stiffest joints can become more mobile and aching limbs eased. Research undertaken by the University of Sheffield* in which our practice took part, demonstrated that older patients who have other underlying ill-health problems (such as diabetes or respiratory disease) could, nevertheless, gain significant benefit from osteopathic treatment for their musculoskeletal problems.

Nobody’s problem is ever dismissed as something they must learn to live with at their age! Even those who have had symptoms for a long time (2 years or more) can do well.

Osteopathy is, of course, not a cure-all. If an Osteopath feels s/he cannot help in an individual case, s/he will say so. Every patient is re-assessed at each subsequent appointment and if either the Osteopath or the patient does not feel adequate benefit is being achieved, this will be discussed, treatment altered or curtailed, or further medical investigations requested.

Please feel free to discuss any concerns you may have with your Osteopath at any time.

However, the majority of patients do benefit from Osteopathy. The same research team from Sheffield* found high levels of patient satisfaction at the end of treatment and when followed-up 4 months later. Moreover, our own practice audit results suggest that patients perceive improvement quite quickly, usually within 1 - 4 treatment sessions, although full benefit may take longer.

* “GP-based Purchasing of Osteopathy and Chiropractic; an Evaluation of a Pilot Scheme 1996-1998” - Medical Care Research Unit, University of Sheffield.

If you come for treatment with one of the Fishponds Osteopaths, what can you expect?

The Osteopath will meet you in the Reception area, and take you to an individual treatment room - but already the process of diagnosis has begun: could you get up from the chair without pain? could you speak clearly? did you limp? The Osteopath will ask you to sit down (if you are comfortable to do so) and will ask you lots of questions - basic admin’ details to begin with, but then more probing questions about your particular problem, about your lifestyle and the activities you undertake, and also about any health problems you have had in the past which may affect the way your body works today.

The Osteopath will then ask you to undress - usually down to your underwear. It is very important in Osteopathic diagnosis to look at the patient in full, to see their overall shape and what movement they can achieve. For example, a feature as small as a fallen arch on one foot may result in torsion through one leg, twisting in the pelvis, curvature through the spine and neck muscles which are working so hard to hold the head level that headaches result. (If you are concerned about the need to undress, you are always welcome to bring a friend or relative with you, or a chaperone can be provided within the practice on request).

The Osteopath may then want to see particular movements in more detail - perhaps carrying out a thorough examination of your hip or shoulder, and will also want to feel the tissues. Osteopaths have been described as having thinking fingers. Palpation, (the sense of touch), is essential to feel the overall range of mobility at a spinal joint, but also its quality, and the condition of the surrounding muscles. All this information enables an osteopath to form a picture of their patient as a whole, suggest what may be going wrong, and how improvement could be made.

Except in the most complex cases, treatment will be commenced at the first visit, once the Osteopath has discussed his/her findings with the patient and what needs to be done (Initial examination and treatment may take up to any hour, with follow-up visits lasting 30 minutes). At Fishponds Osteopaths we strive to use the very gentlest techniques that will achieve the required results. Rhythmic articulation of the joints will often be done, gentle stretching or massage of tight muscles undertaken, or the very gentlest “cranial” osteopathic techniques used in which patients are aware of little more than the Osteopath holding the appropriate area of the body.

Sometimes more vigorous techniques are advised - these are the manipulations which cause a joint to click or deep, soft tissue work to release shortened muscles. Even these are not usually painful - although they may be if a patient has a lot of severe inflammation present. Manipulation will always be discussed with a patient, but it can be highly effective in restoring movement to a locked joint with rapid relief of associated pain. Feedback from patients about how they are feeling during treatment is encouraged.

After treatment, a patient will be reassessed and any appropriate advice given such as changes to be made in seating at work, or exercises to be done. A further visit is almost always necessary - to check progress and make sure that balance has been restored to the body. In many cases a course of treatment is necessary to gain the required improvement. A few patients, whose pattern of dysfunction has become set in with their occupation or age, may require treatment at regular intervals to sustain improvements in the way they feel and function.

Case Histories 1

Trevor

... is 70 years old and is keen on bowls, which he had played all his life until he developed pain in his low back and buttock last year. It was clear from examining him that he had considerable osteoarthritis (the “wear and tear” type of arthritis) in his low back, making him very stiff. He thought this was something he would just have to live with and meant the end of his bowling career. In fact, after 2 treatment sessions, he felt better than he had done for years and he has resumed bowls. He needs treatment to keep him “loosened up” from time to time.

Barbara

... is a 58 year old hairdresser, who developed upper back and right shoulder pain so severe that she could not do her job. Examination demonstrated that she had become very round-shouldered over the years, so that her shoulder joints could no longer function in their proper alignment, making tasks like blow-drying very difficult. Her attempts to continue with her job despite the pain – most hairdressers are self-employed and cannot afford time off – led to further strains through her neck and at the joints where her ribs meet her breast bone.

When treatment began her body felt very brittle, as if it would snap if too much pressure were applied. Treatment could only, therefore, proceed gently and slowly. Gradually the pain began to recede and she became better able to do her job. After a while her body felt much more flexible, and Barbara needed only top-up treatment sessions every few months. After about a year, she became independent of treatment and keeps herself flexible and less round-shouldered with exercises prescribed by her Osteopath.

Sarah-Jane

... is the mother of 2 little girls and works in an office part-time. 2 years ago she suffered a “whiplash” injury in a road traffic accident, which led to strains through her neck and upper back. She also developed severe headaches.

Although Sarah-Jane underwent a course of Physiotherapy, her pain did not fully resolve and her headaches became more frequent. Examination showed that she still had a locked joint in her neck. Manipulation of this joint quickly improved its movement and her symptoms resolved very quickly. She has not had any headaches since treatment.

Tina

... began to develop pain to the left of her mid-back, which became so bad that it made her vomit. Examination showed that she had a marked curvature of her spine (“scoliosis”) causing muscle imbalance which tightened up even more when she came under a lot stress at work. The nerves which come from the spine at the back of the chest control sub-conscious functions and, when they are irritated by inflammation at the joints nearby, symptoms such as sickness can occur.

Although treatment cannot get rid of a congenital anomaly like scoliosis, it can make the affected joints move much more easily and relieve the inflammation putting pressure on the nerves. Treatment rapidly eased Tina’s pain and she stopped being sick. She also sought to change her own life by finding a new job which she now thoroughly enjoys.

Frances

... has a very deeply arched lumbar spine. Most of the time the spine has enough adjustability in it that this kind of anomaly causes no problems, but if some mild strain, for example, occurs, the muscles will tighten and exaggerate the arch which already exists. This puts considerable pressure on the lowest joints of the back which, in Frances’ case, became inflamed and painful.

Osteopathic treatment to stretch out these joints and advice to encourage Frances to stand with better tension through her abdominal muscles, rapidly relieved her symptoms.

Maggie

... came to the practice having suffered 6 months of severe back pain, radiating into her abdomen. She had had scans of her abdomen through her GP, which showed a cyst on one ovary. This was thought to be the cause of the pain and was removed by surgery, but the pain was unchanged.

When she came to the Fishponds Practice she could not straighten up and could not bear her own weight (though she was of slight build). She was referred privately for X ray of her spine which showed that one vertebra had collapsed and suggested a much more serious problem. In this case osteopathic treatment would not be useful and Maggie was referred back to her GP, with full information about the spinal fracture, for further investigations and appropriate treatment

Case Histories 2

Sylvia

... is a 32 year old teacher with a long history of back pain originating from a car accident twenty years earlier. When I first saw her she was ten weeks pregnant and experiencing such bad mid and low back pain that sleep was becoming difficult.

Treatment began using gentle cranial techniques to release the pelvic area and a combination of mobilisation and manipulation to restore movement to the mid back. These areas improved rapidly, but her neck became stiff, as her posture began to adapt to the growing size of the baby. This area also responded rapidly to treatment. Further maintenance treatment to keep her spine mobile may be advised as the pregnancy progresses. A lot can be done to ease back and neck pain in pregnant women.

David

... is a sporty 10 year old boy who has suffered from chronic asthma from the age of one year. In his early years he had a couple of very severe attacks. Also as a younger child he suffered from chronic ear infections.

Having had a moderate attack just a few months ago, David was very afraid of having a recurrence. Clearly osteopathy cannot cure asthma, but I believe it can help, often quite a lot. David had quite severe cranial tightness, and some tightness in his upper back and ribs. Treatment began by releasing the spine and ribs to improve the mechanics of breathing. Then over several treatments the cranial tightness was reversed. It certainly seemed to help and David gradually became less apprehensive about his asthma

Patrick

... is a 45 year old accountant who was experiencing intermittent headaches which were becoming more frequent. His headaches had been worse since he fell onto his back and head five years previously. When experiencing a headache the pain was mainly located on the right at the back and side of his head. He had some difficulty in turning his neck to the right. A one-sided restriction in neck rotation is often a useful clue that the upper part of the neck is not working properly. Problems in this area can frequently cause headaches.

Tests confirmed that the movement of the upper part of the neck was abnormally reduced and manipulative treatment rapidly restored it to 90% of normal. His headaches improved, being less frequent and less severe. Further treatment to release the cranial movement at the back of his head helped to improve the headaches even more. Not surprisingly given his work, Patrick needs to return for follow up treatment about twice a year.

Steve

... is a 52 year old businessman and keen golfer. In recent weeks the nagging pain which he “just put up with” in his lower back had become worse and he had stopped playing golf.

Despite a history of arthritis in his left knee and mild psoriasis, his pain did not seem to be arthritic in origin. His back had become very tight and this was worse in the low back on the left. Mobilisation and manipulation of his mid and low back soon began to restore some of the lost motion (so essential for golf). Soon he was able to play nine holes, then a full eighteen. Then he relapsed and in addition to further treatment I advised some stretches to do at home and some postural advice about home and car. This seemed to help and though Steve may have to accept that he is not 30, he is playing a full round again.

Carmen

... was a 25 year old mum who has suffered from persistent pain since a very serious car accident the previous year. Her neck and upper back were constantly stiff and painful. She experienced frequent generalised headaches, poor memory, poor concentration, lack of focus and tiredness. The cranial movement was very disrupted and it felt as though her body was fighting itself, pulling in different directions, possibly from the magnitude of the forces which acted on her body in the accident.

Treatment began with the release of this deep physical conflict. Initially after this session Carmen became very emotional and her low back felt very sore. Then after a few days she felt more relaxed. Further treatment began to release the tightening of her back and neck – each stage produced a strong emotional reaction and frequent tears as the physical effects of the accident held in her body began to release. After several weeks her back and neck were improved though still occasionally stiff. Her concentration and energy levels were improving and she clearly felt more able to engage with the world again.

John

... came to the practice complaining of pain in his low back and through the front of his right thigh. It was very clear from examination that his hip joint was badly affected by osteoarthritis and so he was advised to return to his GP to seek referral to an Orthopaedic Surgeon for hip replacement.

Waiting lists for this operation on the NHS are very long and so, a year later, John is still coming to the practice on a regular basis. Osteopathy helps to keep his hip joint as mobile as possible and, in so doing, relieves his pain and keeps him going.