The pain relief benefits of Osteopathic treatment have been known and talked about anecdotally for a long time, not just amongst Osteopaths themselves, but other healthcare professionals such as Doctors, nurses and midwives amongst others.
The main thing that gets said about us is that we tend to help with back pain, including the neck, as well as shoulder pain and sciatic pain. This is very true and the evidence is mounting for this, however, it is only part of the story.
When you start to look closer at what we do, the effects of treatment are far wider ranging and the benefits to you as a patient are likely to be greater than the original complaint you came to us for help with, but more on that later. First we need to consider how getting pain relief might affect your life, the ‘real life benefits’ of Osteopathic treatment and then look at the evidence for how Osteopathy can provide pain relief.
Real life benefits of Osteopathic treatment:
| Task you want to achieve | Healthy Choice Options To Help You Achieve Your Goal |
|---|---|
| To enjoy the simple act of walking by myself/with my partner/my dog | Try Osteopathy, stretches, use as directed a hot and cold compress |
| To improve my ability to relax | Try Osteopathy as it has been shown to help people to relax |
| To have less headaches | Try Osteopathy as it has been shown to help people with their headaches |
| To play golf / football / rugby / cricket without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, strapping/support bandages or garments, strength training |
| To go for a run without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, new running shoes, possible need for orthotics (special shoe insoles) |
| To work without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, health & safety training/lifting or work postural advice, ensure you have all the correct tools you need for the job in hand |
| To pick up my children without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, temporary avoidance of picking them up until Osteopathic intervention/stretches etc. has helped |
| To ride my bike without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, strength training, adjust saddle to correct height and make sure bike is fitted to you (correct size etc.) |
| To work in the garden without pain | Try Osteopathy, stretches, use as directed a hot and cold compress, ensure you have breaks to give yourself a rest from bending and kneeling for too long, ensure you have all the correct tools you need for the job in hand |
The focus of more recent clinical research has largely been around low back pain, neck pain and headaches with the benefits as well as the risks of Osteopathic treatment being highlighted. This is reflected in the list of benefits that an Osteopath is allowed to advertise that they can offer by using Osteopathy as a treatment modality, see below for what the Advertising Standards Agency have to say about this, or click here to go to their website direct.
So according to the ASA, which medical conditions can osteopaths claim to treat?
Based on evidence submitted to CAP prior to November 2016, the ASA and CAP accept that Osteopaths can claim to treat the following:
| Arthritic pain |
| Circulatory problems |
| Cramp |
| Digestion problems |
| Fibromyalgia |
| Frozen shoulder/ shoulder and elbow pain/ tennis elbow (lateral epicondylitis) arising from associated musculoskeletal conditions of the back and neck, but not isolated occurrences |
| Headache arising from the neck (cervicogenic) |
| Joint pains |
| Joint pains including hip and knee pain from osteoarthritis as an adjunct to core OA treatments and exercise |
| General, acute & chronic backache, back pain (not arising from injury or accident) |
| Generalised aches and pains |
| Lumbago |
| Migraine prevention |
| Minor sports injuries |
| Muscle spasms |
| Neuralgia |
| Tension and inability to relax |
| Rheumatic pain |
| Sciatica |
| Uncomplicated mechanical neck pain (as opposed to neck pain following injury i.e. whiplash) |
More interesting research comes in the form of a 2013 study: “What is osteopathy? What evidence of benefit is there and how safe is it? (May 2013)“. The key messages from the article are:
This summary of osteopathic research should be treated as a very basic snapshot of past and current activity:
- Osteopathy is delivered in a variety of settings
- Patients report high satisfaction with treatment
- There is good quality evidence supporting the beneficial effects of manipulation for back pain
- The government recommends osteopathy for sub-acute and chronic low back pain
- The risk of experiencing serious adverse reaction to osteopathic treatment is very small; reports of serious adverse events are rare.
- Around half of patients may experience mild short lived resolving treatment reactions
Further information concerning osteopathic research can be found on the NCOR website, including links to our own articles about headaches and neck pain which you can read about on this website.
Other considerations for Osteopathic Treatment
Richard L. Van Buskirk (an American Osteopathic Doctor) wrote a paper worthy of note in 1990. He showed that if there is restriction in mobility in the musculoskeletal system (joints & muscles) then there is a corresponding nerve signal that travels from the muscles and joints to the spinal cord and back on to the joints and muscles again which maintains the problem unless correction is applied to the said joints and muscles.
He also found that the nerve signal passed not just back to the joints and muscles, but that it could also be sent to the body’s organs and connective tissues, thus affecting their function too, and it should be remembered that this includes the immune system, our means of fighting off disease. (paraphrased for simplicity).
It is for this reason that Osteopathy should not be thought of as just a means of loosening up your joints and relieving back, neck or shoulder pain (or pain in any other joint for that matter), but it should also be borne in mind that Osteopathy has the potential to help reduce high levels of inflammation that have been shown to lead to disease, which includes “cardiovascular disease, diabetes, autoimmune conditions and even clinical depression”.
This could be one of the reasons what the advertising standards authority (ASA) suggest that Osteopaths can claim to treat circulatory problems, digestion problems and Fibromyalgia, amongst the many pain related conditions (see here for complete list).
An excerpt from Van Buskirk’s article is shown below:
“A model of somatic dysfunction is developed in which restriction in mobility and autonomic, visceral, and immunologic changes are produced by pain related sensory neurons and their reflexes. Nociceptors are known to produce muscular guarding reactions, as well as autonomic activation, when musculoskeletal or visceral tissue is stressed or damaged. This guarding causes abnormal musculoskeletal position and range of motion. Local inflammatory responses and autonomic reflexes further reinforce nociceptor activity, maintaining restriction. Nociceptive autonomic reflexes also evoke changes in visceral and immunologic function. Finally, maintenance of muscles, joints, and related tissues in an abnormal guarding position causes changes in the connective tissues, solidifying the abnormal position. Stretching these tissues into a normal range of motion will restimulate the nociceptor, reflexly reinforcing the somatic dysfunction. This model has evolved from Korr’s neurologic model but emphasises the nociceptor and its reflexes as a source of the connective tissue, circulatory, visceral, and immunologic changes seen in the somatic dysfunction.”
The example shown above is that of a dysfunctional shoulder joint leading to an aberrant reflex signal to the heart, showing just one possible link between the joints/muscles and the internal organs.
So is Van Buskirk correct in his postulations? – with the limited research that is available these days it remains difficult to say for sure. The ASA and GOsC (the governing body for Osteopathy in the U.K.) say not, but that’s due to a lack of multiple pieces of “robust” evidence. So it looks like Osteopathy has a way to go to fully prove itself and its physiology-mediating capabilities, but the Osteopathic principles and theories that have held strong for over 150 years have been proven correct in respect of pain relief – so why not physiology and general health? Time will provide the answer I’m sure.
Benefits of osteopathic treatment
