Q. What can I expect on my first appointment?

A case-history will firstly be taken, a detailed examination is then performed. All details relating to past injuries and illnesses, operations, life-style, occupation and general and mental health are relevant, even for an apparently simple problem. It is the whole person and whole body that is addressed in osteopathy, not just the pain or the presenting problem.

For babies and children, details of the pregnancy and birth are important. Please bring your hospital discharge notes, ‘red book’ and results of any tests or educational reports along with you. Such information is helpful in making a diagnosis and in determining the treatment. Do write down your concerns on a piece of paper and bring it with you, or send information to the practice before your visit of issues that you would prefer not to discuss in front of your child. Toddlers and young children may feel more comfortable if they are told beforehand that the osteopath may touch their heads and parts of their body during the session.

The examination includes assessment of posture, gait, active and passive movements, any other relevant tests which may include a neurological or chest examination.

An osteopath is also able to glean much useful diagnostic information using very gentle listening touch on various parts of the body from the feel upwards to the head in a systematic way. This is done in the sitting or lying positions. Toddlers usually sit on their parents and are engaged with toys and books during the whole process. Infants are initially examined while being held by their parents and may lie on the treatment table if they are sufficiently settled.

The history and examination together should reveal the cause of the pain, discomfort or problem, e.g. is it a disc problem, trapped nerve, ligament or muscle injury, inflammation etc. It may also reveal why the issue has come about at that particular point in time.

Q. What does treatment involve?

Osteopathic treatment facilitates the inherent ability of the body to self-heal and self-correct. The body tends constantly towards health, but sometimes there may be barriers towards achieving health and normal function and osteopathic treatment seeks to remove these barriers. The manual techniques that are used are very gentle, particularly when treating infants and children.

It usually involves supporting or moving joints or tissues in gentle ways that allow the structures to realign naturally. It may appear to the patient or the parents that nothing much seems to be happening outwardly but the effects of the treatment may be felt for for days afterwards.

Exercises to strengthen muscles, to maintain joint flexibility or to improve sensory feedback are often prescribed.

Exercises to improve balance, tracking of the eyes, coordination and left/right brain integration may often be necessary in children who have problems in these areas. Retained primitive reflexes if present on screening, will also be addressed.

What should I wear?

Loose light clothing is helpful.

Q. How does cranial osteopathy differ from osteopathy?

Cranial osteopathy simply extends the principles and concepts of osteopathy to include treatment of the head. The techniques used are a little different in that they are more gentle and refined, rather like the difference between a car mechanic and a watch-maker. The movements and manoeuvers are scaled right down.

Additionally, treatment using the cranial approach recognizes that there is an inherent rhythm throughout the body, including the head, that is helpful in the treatment process. Research in recent years has identified this as closely related to the Traube-Hering-Mayer oscillation, which is also a whole body phenomenon and has been measured in association with blood pressure, heart rate, cardiac contractions, blood flow in the lungs and brain, cerebrospinal fluid movement in the head and blood flow. This is quite distinct from other involuntary rhythms in the body like breathing. So the physiological effects of osteopathic treatment are potentially quite wide-ranging.

Q. What is the difference between cranial osteopathy and craniosacral therapy?

Cranial osteopaths have undergone a basic undergraduate osteopathic training of 4 years in addition to their training in the cranial field. And that is the difference between these two professions.

Q. How many treatments are usually required?

Most uncomplicated problems usually resolve within 2-4 visits. Chronic or complicated conditions may require longer term treatment. Recurrent problems may benefit from periodic check-ups as prevention.

Infants and children should ideally be checked from time to time as they grow as new problems often emerge that may be otherwise missed. Developmental delay can be spotted early and exercises given to help this, any hint of structural irregularities can be detected early, and the effects of falls and other trauma can be addressed before long term adaptations to these are made. Prevention is the key, and many back problems in adulthood for example, may have their roots in childhood.

Q. Are there side-effects to treatment?

There are no long lasting side-effects to treatment, patients often feel tired or sleepy following treatment. There may be a feeling of either relief or soreness post-treatment. These indicate that the body is adjusting to the changes made during the treatment and they usually last for about a day or two. It is best to have a quiet day following a treatment session. This is to allow the body the opportunity to continue to self-correct.

Q. Are treatments covered by private health insurance?

Yes apart from BUPA, but do check you policy documents and with your insurers if you wish to make a claim with them. Patients claim direct from their insurers. Charles has decided not to register as a specialist with BUPA following their change of policy in 2012 with regard to restricting fees that are charged by osteopaths.

Q. How are osteopaths trained?

Osteopaths undergo a four year full-time course which includes supervised clinical training. Medical subjects are taught in conjunction with osteopathic subjects. Qualified osteopaths are required by the General Osteopathic Council to complete at least 30 hours of postgraduate training per year.

Q. How are cranial osteopaths trained?

Qualified osteopaths who wish to specialise in cranial osteopathy attend postgraduate courses run mainly by the Sutherland Cranial College or the British School of Osteopathy in the UK. The SCC awards the letters MSCC to those osteopaths who have completed post-graduate pathway in cranial osteopathy. Further courses are provided by the Sutherland Cranial Teaching Foundation (SCTF), the Cranial Academy and Dr. James Jealous and his faculty, all based in the USA.

A register of qualified cranial osteopaths in the UK may be obtained from the register published online by the Sutherland Cranial College.

Q. How are paediatric osteopaths trained?

The most comprehensive specialised paediatric osteopathy training is provided by the Osteopathic Centre for Children. This two-year training with weekly clinical supervision leads to a postgraduate diploma in paediatric osteopathy.

For a paediatric osteopath referral in your local area, please contact the Osteopathic Centre for Children.

References:
1. Sergueff, N, Nelson, K, Glonek, T. Changes in the Traube-Hering-Meyer wave following cranial manipulation. American Academy Osteopathic Journal 2001; 11:17.
2. Nelson,K, Sergueef, N, Glonek, T. The effect of an alternate medical procedure upon low-frequency oscillation in cutaneous blood flow velocity. Manipulative Physical Therapy. 2006: 29:626-636.