Brief History Treatment Common Problems Cranial osteopathy Resources Self Help

What is osteopathy?

Osteopathy is the science of human mechanics. An osteopath diagnoses and treats imbalance in the musculo-skeletal structure. These imbalances often manifest as pain in the back, neck and other parts of the body.

Facilitating the natural healing process
Osteopathic treatment focuses on restoring balance and correct alignment of the musculo-skeletal system. It is believed that once the balance has been restored, then the body will begin to heal itself. In this way osteopaths facilitate the natural healing process of the body. In cases where imbalance exists, this is achieved by a combination of techniques: neuromuscular, fascial, cranio-sacral, visceral, indirect techniques and direct osteopathic manipulation.

Once balance is achieved appropriate exercise practice can help maintain postural integrity and hopefully reduce the possibility of future episodes.

Osteopathy: A brief history

The first ‘osteopath’

The founder of all modern manipulative practices was Dr Andrew Taylor-Still, an orthopaedic surgeon who it is reported lost three daughters to meningitis in the middle of the 19th century. He considered that by ensuring proper blood and nerve supply from the spinal segments to the tissues and organs of the body, the immune responses to disease would be enhanced. Still was the first ‘osteopath’ and used manipulative techniques along with his surgical knowledge to treat patients. It is important to remember that this was pre-anesthesia, before X-rays and around the time that Louis Pasteur was developing the germ theory, which has had the biggest influence on modern medicine over the past 150 years. Because Still was a surgeon most of his students followed his path, developing an American school of osteopathic surgery and those of his followers who were more interested in developing therapeutic applications moved to Britain in the 1890′s. Around this period in America John Palmer began to apply his own ideas to manipulative practice and a chiropractic school was formed.

What’s the difference between osteopathy and chiropractic?

Interestingly, ‘osteo’ and ‘chiro’ both refer to bone in Greek and Latin respectively. The differences between the two disciplines lie in the philosophy behind the practice of osteopathy and chiropractic, the former having a more European approach, the latter more American. Some of the manipulative techniques are similar, and equally beneficial, but the basic philosophy, as in European and American approaches to medicine, though similar is where the difference lies. Choosing between which approach to follow for a patient is purely personal and depends upon individual experience.

Another difference between osteopathy and chiropractic work is the frequency with which treatment is administered. Osteopathic practitioners lean toward minimal intervention with a three or more day gap between visits to facilitate the body’s own healing process. Chiropractors may want to treat patients more frequently.

An interesting article on the difference between chiropractic and osteopathy can be found in Dr Andrew Weil’s Health & Healing – see our resources column on the right for more information on the book.

Osteopathic treatment

What will a first session with the osteopath involve?

When you visit an osteopath for the first time, a full medical history will be taken and you will be given an examination.

You will be asked to perform a series of movements so that the mobility of your body can be evaluated. Your osteopath will assess the range and quality of movement of the joints to note whether the movement is restricted or excessive. He will also examine the condition of the soft tissues, the muscles, ligaments and connective tissue to see whether they are normal or stressed. Any areas of concern will then be identified for treatment. Along with the musculo-skeletal assessment, lifestyle factors such as work and sporting activities, sleeping positions, posture and stress levels will also be taken into consideration.

What does osteopathic treatment involve?

After a full assessment, an osteopath will begin treatment. Osteopaths work with their hands but there is no fixed way for treatment. Every osteopath will develop his/her own style of treatment. Treatments will often include some soft tissue techniques, with passive mobilisation of the joints, to stretch and improve the range of movement. Most osteopaths will use osteopathic manipulation techniques to mobilise specific joints. The joint may ‘click’, and the patient usually experiences relief when this happens.

The session can last for approximately half an hour.

How many sessions are needed and how frequently?

It is difficult to predetermine how many sessions are needed, as each patient is different and will experience different symptoms. Generally speaking, chronic back pain with a history of recurring incidents may take longer to treat, but a difference should be felt in 3 to 4 sessions and treatment will end when the patient feels better. With relatively “new” strains and sprains, fewer treatments are required. Most osteopaths like to leave a space of 3-4 days in-between treatments to allow for any reaction to the treatment to settle down.

What reaction can I expect after osteopathic treatment?

Sometimes after the first treatment, a patient might experience some soreness as a result of the manipulation. This is quite normal, and is to be expected. A painkiller will help but mostly it is better to just treat it like muscle soreness after strong exercise. Rest and hot showers help.

Common problems

What are the most common back problems?

• Low back and neck pain caused by strain
• Poor posture
• Back and neck problems caused by poor ergonomics in the workplace
• Some sports injuries can also manifest as back pain of varying intensities.

Are some body types more prone to back problems?

People who tend to stand with a forward tilted pelvis, are prone to more lower back and neck problems than others. A tilted pelvis will cause a shortening of the lower back muscles and put more pressure on the joints in the lower back and pelvis.

Slack abdominal muscles can contribute to lower back pain as well. Some people tend to have a mechanical imbalance caused by having a long back that is not well supported by muscle. The centre of gravity for someone with a long back will tend to be higher that the person with the average-length back.

Some people have a leg length difference, which can cause the spine to form compensations such as scoliosis and muscular imbalance. These imbalances can often manifest as back pain, usually at the points of compensation.

Poor posture and ergonomics in the work place with repetitive movements in bad positions can cause back pain ranging from a mild ache to chronic debilitating pain.

What kind of exercise do you recommend?

For prevention of back pain, and dealing with incidents of pain, look at our self-help page.

There are several other exercise disciplines that can help people with back pain.

Several yoga asanas when performed correctly can help release tension from the back and neck. Learning correct technique is important, as incorrectly performed asanas can sometimes cause back pain.

Pilates is a unique system of exercise devised by Joseph Pilates in the early 1920s. Pilates exercises all originate from the lower abdominal powerhouse, thus providing total support for the spine in all exercises. For more information on Pilates (reading and related sites), move to our resources page.

Dr Moshe Feldenkrais devised a method of exercises based on reprogramming inefficient neuromuscular pathways, and muscle holding patterns. His exercises were carefully designed to re-educate movement efficiency by means of gentle yet repetitive movements. People suffering from back and neck pain find that as the old ‘tension patterns’ are broken, their pain tends to disappear as well.

The Alexander technique taught people the benefits of correct posture, and the Alexander exercises teach people maximum efficiency in the use of their bodies.

Cranial osteopathy

Cranial osteopathy works with the primal respiratory mechanism (PRM).

This movement is present throughout the body during our lifetime, and we have no control over it. A student of Osteopathy William Garner Sutherland discovered it in the late 1890’s.

While observing a disarticulated skull, (where the bones have been taken apart), he noticed that the sutures or “seams” between the bones were designed to allow some movement. The movement resembled the movement of rhythmic “breathing”, and this subtle rhythm could be felt throughout the body and in every tissue. Following thirty years of his theory, Sutherland began to teach students about this rhythmic self-regulating movement, which he called the primary respiratory mechanism.

The mechanism is characterised by the light movement of the bones of the skull and the sacrum, the membrane system and the central nervous system, with the flow of the cerebro-spinal fluid.

Cranial osteopathy involves detecting restrictions to the PRM, and restoring the rhythm with a gentle technique where the osteopath holds the head of the patient in the hands, and facilitates the body’s natural tendency towards self-correction with gentle rhythmic movements.

You can visit www.cranial.org.uk to gather further information on cranial osteopathy.

How is cranial osteopathy different from functional osteopathy?

Functional osteopathy works on the joints with soft tissue techniques such as neuromuscular massage, passive mobilisation, and where necessary manipulation. Cranial osteopathy focuses mainly on the subtle rebalancing of the PRM using gentle rhythmic movements on the cranium and the sacrum. The patient can feel the many benefits of cranial osteopathy after several sessions with the osteopath.

Many osteopaths combine both functional and cranial osteopathy in a single session where necessary.

To book an appointment for a session of cranial osteopathy, phone 04-348 73 66 or email us at info@osteopathydubai.com

An example of a work related injury

An assistant on a dive trip found that after lifting several heavy oxygen tanks, his back began to ache. Hoping that the pain would go away, he continued lifting tanks all day. By evening he was in considerable pain, and found it difficult to stand or sit. Pain was radiating into his buttock and the back of his thigh.

By the time the osteopath saw him on the following day, his back has stiffened considerably, and he was unable to stand up straight without a compensating lean to the left side . When the osteopath asked him to describe his lifting pattern, he said that his lifting pattern had been to lift the heavy oxygen tanks from the floor on his right and to lift and place them onto a counter directly in front of him about waist high. This repetitive strain of bending and lifting throughout the day resulted in the discomfort that he was feeling.

On examination, the osteopath found that he had strained the sacroiliac joint on the right side of his lower back. As a result, there was a considerable amount of muscle spasm, nerve entrapment and movement restriction.

Treatment involved first relaxing the soft tissue that had tightened and was in spasm. A combination of heat and neuromuscular massage allowed the muscle to relax.
Osteopathic manipulation followed, releasing the restricted joint.

This patient reported an immediate reduction in symptoms after the first treatment, and was symptom free after two weeks of treatment.

An example of poor ergonomics

A student working towards her Masters degree found herself spending up to 7 hours a day at the computer typing. She noticed as she typed that the left side of her neck began to ache after a while. After a week, the discomfort started to inhibit her study time. When she came for treatment, in the initial assessment the osteopath noticed a muscular imbalance in the muscles of her neck. It seemed as if her neck was twisted slightly to the right. The osteopath asked her to demonstrate to him her sitting position at the computer. Her demonstration of her position confirmed that although her keyboard was placed directly in front of her, the computer monitor was placed on a shelf to the right, causing her to twist her neck to the right for extended periods of time. Over time this had created a muscular imbalance, and this manifested as pain with restricted movement in the neck.

This patient was treated with neuromuscular massage to relax the tension in her neck. This was followed by passive mobilisation of the neck, and stretching of the muscles. When the muscles were sufficiently relaxed, osteopathic manipulation was used to release the restricted joints of her neck, and she began to regain her full range of movement.

Once this patient was symptom free, she was given a series of simple exercises to do to maintain balance and strength in the musculature of her neck.

She was also advised on how to change certain aspects of her position at work so as to avoid any future painful episodes.

Frequently asked questions

What should I do if the pain in my back is so severe that I cannot stand or move comfortably?

In this case a few days of rest will do you good. Keep your back warm, and try to lie on your side with your knees bent up in foetal position. If you prefer, you can lie on your back so long as you make sure that your knees are bent and that you have a few thick pillows under your knees so that the hollow of you back is relaxed.

Try some of the stretches from our exercise section. These should help you with your back pain. As you lie in bed resting, you can actively participate in your own healing by using the stretches to gently assist your healing.

Ask your doctor for medication that will help you with your pain. Depending on your condition, your doctor will prescribe an anti inflammatory medication, or a muscle relaxant. It is always best to follow your doctor’s instructions with regards to medication. Avoid self medication.

Book an appointment to see your osteopath as soon as possible.

What should I avoid if my back is hurting me?

Avoid sleeping face down on your abdomen. Choose instead a position on your side with your knees drawn up as in foetal position, with a pillow between your knees. If you prefer to lie on your back, make sure that you have a pillow under your knees to enable the hollow of you back to relax as much as possible.

If you are a woman, avoid wearing high-heeled shoes.

Avoid sitting in one position for too long. Try to get up and walk to mobilize your back as much as possible.

Avoid carrying anything that is too heavy and that might place an additional strain on your back.

Try not to let your back get cold.

If you need to sneeze or cough, bend your knees and try to hold a pillow in front of you, hugging it towards you to prevent the sudden muscular contraction that can cause sudden and sharp pain.

What are good ergonomics in the workplace?

The correct use of the spine in the workplace is called correct ergonomics.

Ergonomics in the workplace is extremely important to ensure that each person is able to work with ease and comfort, without causing any discomfort or pain to the body. The correct ergonomic rules vary with each individual and the work that they do. The following examples may illustrate this point better.