Osteopathy (manipulation therapy) | Cancer Research UK
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What osteopathy is

Osteopathy comes from two Greek words meaning bone and disease. It is a therapy that involves manipulation of bones and muscles (the musculo skeletal system) to treat symptoms and illnesses. It is based on the belief that the body can be more healthy and recover from illness more quickly when the body structure is working well. Specialists trained in osteopathy (osteopaths) think that our bones and muscles are key to diagnosing and treating many disorders.

Osteopathy doesn’t involve surgery or drugs. Osteopaths use their hands to find problem areas in the body. They then treat problems by massaging or moving the relevant parts of your body. The idea is that this manual therapy can improve your circulation, reduce swelling, ease pain and help to restore movement.

Osteopathic techniques include

  • Massage
  • Stretching muscles, tendons and ligaments
  • Moving joints rhythmically
  • Muscle manipulation
  • Short sharp movements called high velocity thrusts

Some osteopaths also use very gentle movements of your skull and sometimes the bone at the bottom of the spine (sacrum). This is a form of treatment called cranial osteopathy or cranio sacral therapy.

As well as taking a detailed medical history of your symptoms, osteopaths also take time to look at your general lifestyle, including work, diet and exercise. They want to find out any underlying reasons for your health problems. They can then offer lifestyle and exercise advice to help prevent muscle and joint problems happening again.

Most osteopaths don’t call themselves complementary therapists. They are more likely to refer to themselves as primary healthcare practitioners. Osteopathy is becoming more widely recognised by the medical profession. Many GP surgeries throughout the country provide access to osteopathy.


Why people with cancer use osteopathy

Some people who use osteopathy say it can help to control pain and tension. They also say that it helps them to relax, which improves their overall feeling of health and well being. There is no evidence to suggest that osteopathy will help treat or cure cancer.

For more information look in our section about why people with cancer use complementary therapies.


Research into osteopathy

Although osteopathy is quite widely used, most of the scientific research evidence is about thrust techniques for back pain. There is now good evidence from clinical trials that spinal manipulation helps low back pain. The BEAM clinical trial in the UK in 2004 looked at how well spinal manipulation and exercise worked for low back pain. It found that manipulation worked slightly better than the standard care provided by GPs. It worked even better when combined with an exercise programme afterwards.

A review of 6 studies (a systematic review) in 2006 looked at the results from studies on osteopathic spinal manipulation for low back pain. The studies found that back pain was significantly reduced after osteopathic treatment and the benefit lasted for several months.

There is not much research into other gentler techniques (such as massage) that are more likely to be used for other illnesses, including cancer. But there is some evidence that massage helps with some cancer related symptoms such as fluid build up (lymphoedema), anxiety and tiredness. Most evidence for osteopathy in cancer care is based on reports by patients, osteopaths, and some doctors saying that it has helped. This is called anecdotal evidence.

The Cochrane Library has published reviews of spinal manipulation for asthma, chronic headaches, and period pain. Manipulation seems able to reduce the frequency of tension type headaches. But trials have found that spinal manipulation does not help painful periods or asthma. Too few clinical trials have been done to know whether or not manipulation works for other conditions.

Osteopathy is widely used, and is sometimes provided by the NHS so research into its use is continuing. The National Council for Osteopathic Research (NCOR) promotes research into osteopathy in the UK.

An international trial is looking at whether osteopathy can help to reduce pain after breast cancer surgery. It is due to close in 2015. You can find out about this trial on the clinical trials.gov website.


What osteopathy involves

On your first visit, the osteopath will ask you some general questions about your health, lifestyle and medical history. These questions aim to find out what is causing your symptoms. Your osteopath may ask about

  • Any muscle, joint or bone injuries you have had
  • Other medical conditions, such as diabetes, heart problems and asthma
  • Where and how often you have pain or other symptoms
  • How much the symptoms affect your daily life
  • The type of work you do
  • The amount and type of exercise you do
  • The type of bed that you sleep on
  • Your sleep patterns
  • Your diet
  • Alcohol, drugs and smoking habits

They will then examine you, which might include checking your heart rate, reflexes, and breathing pattern. They may want to contact your GP to check that they are happy for you to go ahead and have osteopathy. There may be some situations where your doctor recommends that you don’t have osteopathy.

To have the treatment you will usually need to take off your clothes down to your underwear. Then the osteopath can see and work on your muscles and joints. Your osteopath might give you a gown to wear. They then use their hands to stretch, massage and improve movement in your spine, joints and muscles. Sometimes they use a rapid thrust type action, which can cause a popping sound due to the sudden change of pressure in the joint space. This might sound alarming, but it shouldn’t be painful.

Treatment sessions usually last about 30 to 40 minutes. Tell the osteopath if you are in any discomfort or want them to stop. Most osteopaths suggest that you have between 3 to 6 sessions to get the most benefit. Your osteopath may suggest exercises that you can do at home to help prevent further problems.


Possible side effects of osteopathy

Using osteopathy is generally safe. About half of people may have mild effects afterwards that normally go away within a couple of days.

The effects may include

  • A slight soreness in the treated area
  • A mild headache
  • Tiredness

If these symptoms don’t go away, contact your osteopath for advice.

There have been some concerns about the possible risk of having a stroke (an interruption to the blood supply to the brain) because of manipulation to your neck. Between 1 and 3 out of every million people who have neck manipulation are at risk of having a stroke. But if you are at high risk of stroke, your osteopath will follow strict guidelines about the kind of neck manipulation they can and can’t do. 

It is important to tell your osteopath if you have

  • A history of heart or circulation problems
  • Had a recent trauma or injury
  • Sudden or unusual headaches or neck pain

It may also help to know that spinal manipulation for neck pain seems to be much safer than taking non steroidal anti inflammatory medicines. This is according to a research review carried out by the National Council for Osteopathic Research (NCOR) in 2010. You can read the review on the NCOR website.


Who shouldn’t have osteopathy

If you have cancer it is important that you let your cancer specialist know before you have osteopathy. Let your osteopath know that you have cancer too. In most cases it will be OK for you to go ahead. But most doctors and osteopaths wouldn’t recommend using any forceful techniques, such as the high velocity thrust technique for people who have

You also shouldn’t use osteopathy

  • During a course of radiotherapy
  • If you are taking drugs to help thin your blood (anticoagulants)
  • If you are between 8 and 12 weeks pregnant

Your doctor may recommend other situations where you shouldn't have osteopathy, such as during a course of chemotherapy, so always ask them before having treatment.


What osteopathy costs

If you have osteopathy privately, it usually costs from £35 to £50 for a 30 to 40 minute session. Your first appointment may cost more (between £40 and £60) because it generally takes longer. 

Some GPs can refer people for osteopathic treatment on the NHS, although this varies between primary care trusts. The General Osteopathic Council website has information about osteopathy and the NHS.

If you have private health insurance your policy might cover osteopathy. Your insurance policy provider will advise you.


Finding an osteopath

It is very important that your osteopath is properly trained and qualified. People can only practice as osteopaths if they are registered with the General Osteopathic Council. You can go to their website and use the ‘find an osteopath’ search. Or you can phone them and ask for a list of osteopaths in your area.

Before having treatment, ask the osteopath

  • How many years of training they've had
  • How long they've been practicing
  • If they have treated people with cancer before

Osteopathy organisations

The professional body that regulates osteopaths is the General Osteopathic Council (GOC). By law osteopaths have to register with this organisation in order to call themselves osteopaths. This means that they have to meet the correct set of standards for training, professional behaviour and skills. And they must have insurance. The GOC website has information about their code of practice. There are about 4,300 osteopaths registered with the General Osteopathic Council.

General Osteopathic Council
Osteopathy House
176 Tower Bridge Road
Phone 020 7357 6655
Email: contactus@osteopathy.org.uk
Website: www.osteopathy.org.uk

Other osteopathy organisations include

The Institute of Osteopathy (iO)
3 Park Terrace
Manor Road
Phone: O1582 488455
Email: enquiries@osteopathy.org
Website: www.osteopathy.org

The iO website gives information about osteopathy and can help you to find a qualified osteopath.

National Council for Osteopathic Research (NCOR)
Based at the Centre for Primary & Public Health
Blizard Institute
Barts and the London School of Medicine and Dentistry
Yvonne Carter Building
58 Turner Street
E1 2AB
Phone: 020 7882 6131
Website: www.ncor.org.uk

The NCOR carries out research into osteopathy in health care. It has summaries of the research on its website.

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Updated: 5 February 2015