The evidence base for osteopathy, like many complementary and alternative therapies, has been evolving over the years. From the fledgling research efforts of the early and mid-twentieth century, there has been a growing body of research supporting the effectiveness of osteopathic treatment for various musculoskeletal conditions. As registered Osteopaths we recognise that we work in the complex field of biology and our clinical reasoning is shaped by our experience and informed by the best available evidence and research.
 
Here are some key points regarding the evidence base for osteopathy:
 
1. **Musculoskeletal Conditions:** Numerous studies have investigated the use of osteopathy in treating musculoskeletal conditions such as back pain, neck pain, and osteoarthritis. Meta-analyses and systematic reviews have shown that osteopathic manipulative treatment (OMT) can provide significant pain relief and improve function in these conditions compared to no treatment or sham interventions.
 
2. **Low Back Pain:** Osteopathic manipulation has been found to be effective in reducing pain and improving function in patients with acute and chronic low back pain.
 
3. **Neck Pain:** Research has also demonstrated the benefits of osteopathic manipulation for neck pain, particularly when combined with exercise therapy and other interventions. OMT techniques such as soft tissue massage, joint mobilization, and stretching have shown promising results in reducing pain and improving range of motion in patients with neck pain.
 
4. **Headaches and Migraines:** Osteopathic treatment has been studied as a potential therapy for tension-type headaches, migraines, and cervicogenic headaches. While findings have been mixed, some studies have reported positive outcomes in terms of reducing headache frequency, intensity, and duration.
 
5. **Other Conditions:** Osteopathy has also been explored as a treatment option for conditions such as fibromyalgia, asthma, and irritable bowel syndrome, among others. While preliminary evidence suggests potential benefits in certain cases, more robust research is needed to establish its effectiveness for these conditions definitively.
 
It is important to note that while osteopathy has shown promising results in many studies, there are still limitations to the existing research, including small sample sizes, variability in study designs, and challenges in blinding participants and researchers due to the nature of manual therapies. Additionally, individual responses to osteopathic treatment may vary, and more research is needed to identify factors that predict treatment outcomes.
 
In conclusion, while the evidence base for osteopathy is growing, further high-quality research is necessary to fully understand its efficacy, mechanisms of action, and optimal application across various health conditions. Patients considering osteopathic treatment should discuss their options with qualified healthcare providers and make informed decisions based on the available evidence, their individual needs, and preferences.
 
National Council for Osteopathic Research (www.ncor.org.uk)
Centre for Osteopathic Medicine Collaboration (www.comecollaboration.org)
A.T.Still Research Institute (www.atsu.edu/a-t-still-research-institute/research-centers/research-in-osteopathic-manipulative-medicine)

What does treatment feel like?
The majority of your Osteopathic treatment will be pain free and actually quite relaxing! Techniques such as massage, articulation, stretching, and manipulation are, at worst, mildly uncomfortable to receive. Approximately half of patients may experience a little post-treatment soreness lasting up to 48 hours before going on to feel better.

What causes that clicking sound?
Spoiler alert! It’s not your bones that do the cracking. The spinal column has paired facet joints on the upper and lower surface of each vertebra that are wrapped in a water balloon-like capsule containing synovial fluid. Your Osteopath may need to manipulate one of more of your facet joints (sometimes called a correction, adjustment, or HVT/HVLA) to help ease you out of pain.  The most prevalent theory regarding what causes the ‘click’ is that the manipulation stretches the capsule, increasing its volume which, in turn decreases the pressure within it as gas leaves the synovial fluid. Similar to when one opens a can of soft drink (which we hope you don’t do that often!). Other theories which try to account for the popping noise caused by manipulation include; the recoil of the capsule, or the inception of a bubble within the synovial fluid.

How safe is it?
The evidence pooled from across multiple professions (Chiropractic, Physiotherapy, and Osteopathy) demonstrate that serious side effects from manipulation are very rare but can cause long term damage. Examples of serious reactions are; herniation of degenerated discs, stroke, nerve damage affecting bladder/bowel function, and even death. Rates of reactions across manual therapy are estimated below: 
 
Common (mild) reaction = 1 in 2 (upto 48 hrs of soreness)
Uncommon (moderate) reaction = 1 in 100 (symptoms lasting more than a few days)
Rare (severe) reaction = 1 in 36,000
 
Osteopathic manipulation is very safe to receive and serious complications are very rare. Patients are screened prior to having any manipulation to determine if it is suitable for them. For some patients, for example those with osteoporosis or cancer, it may not be advisable. At The Newtown Clinic you are in safe hands. We use manipulation regularly and have had ZERO severe reactions to treatments.

When it comes to managing musculoskeletal issues and improving overall wellness, there are several therapeutic approaches available, each with its own principles and techniques. Among the most common are osteopathy, chiropractic, and physiotherapy. Deciding which one is best for you can be challenging, so let's explore each option to help you make an informed decision.
 
Osteopathy:
 
Osteopathy focuses on the philosophy that the body has the ability to heal itself. Practitioners of osteopathy use manual techniques such as manipulation, massage, and stretching to address a wide range of musculoskeletal issues, as well as promote overall health and well-being. Osteopaths typically take a holistic approach, considering not only the affected area but also the patient's lifestyle, diet, environment, and other factors that may contribute to their condition. Osteopathic care is commonly sought for back, neck, and joint pain, disc injuries, sciatica, postural problems, headaches, and sports injuries. This approach is often reinforced by guidance on appropriate exercises.
 
Chiropractic:
 
Chiropractic care centres around the relationship between the spine and the nervous system. Chiropractors believe that misalignments in the spine (subluxations) can interfere with the body's ability to function properly and lead to various health problems. Through spinal adjustments and other manual techniques, chiropractors aim to restore proper alignment and optimise nervous system function. Chiropractic care is commonly sought for back pain, neck pain, headaches, and other musculoskeletal issues.
 
Physiotherapy:
 
Physiotherapy, also known as physical therapy, focuses on restoring movement and function to the body, particularly after injury, surgery, or illness. Physiotherapists use a combination of exercises, stretches, manual therapy techniques, and modalities such as ultrasound and electrical stimulation to alleviate pain, improve mobility, and enhance overall physical performance. Physiotherapy is often prescribed for a wide range of conditions, including sports injuries, arthritis, stroke rehabilitation, and chronic pain management.
 
Choosing the Right Therapy:
 
When deciding which therapy is best for you, consider the following factors:

1. Condition: Identify your specific musculoskeletal issue or health goal. Some therapies may be more effective for certain conditions than others.
2. Approach: Think about your preference for treatment approach. Are you more inclined towards holistic care (osteopathy), spinal alignment (chiropractic), or functional rehabilitation (physiotherapy)?
3. Practitioner: Research the qualifications and experience of practitioners in your area. Look for licensed professionals who have expertise in treating your particular condition.
4. Treatment Plan: Consider the proposed treatment plan and how it aligns with your goals, lifestyle, and preferences. Some therapies may require frequent visits over a longer period, while others may focus on shorter, more intensive sessions.
5. Cost and Insurance: Factor in the cost of treatment and whether your insurance covers any or all of the expenses. Compare the cost-effectiveness of each therapy option.
6. Patient Feedback: Seek out reviews and testimonials from other patients who have undergone similar treatments. Their experiences can provide valuable insights into the effectiveness and satisfaction of each therapy.

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Ultimately, the best therapy for you will depend on your individual needs, preferences, and circumstances. Consider consulting with practitioners from each discipline to discuss your options and develop a personalized treatment plan tailored to your unique situation. Remember that collaboration between you and your healthcare provider is key to achieving optimal outcomes and improving your quality of life.