What is an Osteopath?
Osteopathy is a type of physical therapy which promotes a holistic, ‘whole body’ approach to health. Using physical manipulation, stretching and massage, osteopathy aims to improve joint mobility, relieve muscle tension, increase blood flow and encourage healing.
The study of biomechanics (how each part of the body interacts and affects every other part) is a key part of osteopathy. If you see an osteopath with a sore knee, they may also look at your ankles, hips and back, and ask you questions about your medical history. That’s because osteopaths work on the premise that posture, injury, or poor lifestyle habits can have a negative impact on the anatomical structure of our body, which in turn leads to poor physical health.
Osteopathy is a complementary therapy, which means it’s not part of conventional medicine, but may be used alongside it to help manage certain issues.
What qualifications do osteopaths have?
Osteopathy is one of a number of regulated healthcare professions in Australia. Before they can practice, osteopaths must register with the Osteopathy Board of Australia and agree to comply with their rules and regulations. To become a registered, an osteopath must have successfully completed an accredited five-year, full time university program.
Can osteopathy help me?
Osteopathy promotes services which may help treat the following conditions:
- back and neck pain
- joint pain
- arthritis
- tendonitis
- sprains and strains
- work and sports related injuries.
What do osteopaths do?
Osteopathic treatment is based on an understanding of the human body, its structure and function. An osteopath will use touch to investigate the underlying cause of your injury or issue. The treatments usually involve hands-on techniques for the muscles and joints, including:
- spinal manipulation
- soft tissue massage
- joint mobilisation
- stretching
- muscle resistance training
- Dry needling.
You may also be given information about steps you can take yourself to help improve or maintain your health and wellbeing, including healthy eating and regular exercise, as part of your osteopathic treatment.
Does research support the use of osteopathy?
Similar to chiropractic treatment, the evidence-base for osteopathy is limited. There is very little high-quality evidence on osteopathy, and the evidence that does exist is not robust and does not clearly prove that osteopathy is effective as a ‘holistic’ approach to certain health conditions.
Osteopathy does use spinal manipulation, as does chiropractic and physiotherapy, and this has been shown to be effective for lower back pain. However, it has also been found to be no more effective than other commonly used treatments such as exercise therapy.
Some osteopaths claim the therapy can help treat non-musculoskeletal conditions such as asthma, painful periods, headaches, glue ear, jaw problems and scoliosis (abnormal curving of the spine). However there is limited to no evidence to support these claims.
It is true there are people who find osteopathy helps them feel better. However, it is possible that this is a result of the ‘placebo effect’. This happens when a person feels better from a treatment because they have the expectation that it will work, not because of the treatment itself.
If you’ve ever had a sore back, neck or knee, there’s a good chance you sought some kind of treatment for it — most likely from a physiotherapist, chiropractor or osteopath.
The distinction between the three can be extremely confusing at the best of times.
Without knowing too much, it can seem these allied health professionals practise much the same thing: non-invasive, drug-free, manual techniques, which aim to improve physical health and wellbeing.
But scratch the surface and you’ll find claims and counter-claims about which method is most likely to work for you.
So who and what do you believe? We take a closer look at each profession to find what they do and how their approach differs.
Physiotherapy
Physiotherapists specialise in the diagnosis, management and prevention of movement disorders.
The aim of physiotherapy is to rehabilitate and improve a person’s ability to move and function, and physios use their expertise in anatomy and physiology to assess and treat people with a range of health conditions.
While physios are mostly known for their treatment of sporting injuries and neck and back pain, they also work with premature babies, people recovering from stroke, those with brain or spinal cord damage, and people with conditions like Parkinson’s disease, arthritis, osteoporosis and cystic fibrosis.
What you can expect in a standard physio consultation
A ‘typical’ physio session may involve:
- Assessing and diagnosing the patient’s condition and needs
- Working with the patient to set and attain goals
- Developing a treatment or prevention plan that will take into account lifestyle, activities and general health
- Prescribing exercise and physical aides if required
Source: Australian Physiotherapy Association
Physios use a combination of manual therapy, movement training and physical and electro-physical agents. According to the Australian Physiotherapy Association, a physio “helps repair damage, reduce stiffness and pain, increase mobility and improve quality of life”.
Physiotherapy is an evidence-based clinical health science, and practitioners are required to use treatments only if their effectiveness has been demonstrated in scientific research. But as Dr Andrew Leaver, Senior Lecturer in Physiotherapy at the University of Sydney, points out, evidence-based practice is “not a black and white proposition”.
“True evidence-based practice is using the best available evidence that you have, and the best available evidence for any intervention is sometimes not that good,” Dr Leaver said.
“We don’t have robust clinical trials that prove the efficacy of every single thing that we do, but neither does any profession — a lot of medicine is not backed up by robust randomised controlled trials.”
Dr Leaver says physios use the best available evidence, apply “clinical reasoning and wisdom” and take into account the patient’s individual needs.
As part of physiotherapy, a practitioner will often prescribe a personal exercise program tailored to meet your body’s specific needs.
There is no charge to visit a physiotherapist in a public hospital (a GP’s referral is needed for outpatient visits) but waiting lists can be as long as several months, the number of visits may be limited, and there are fewer services in rural areas.
For private physios, no referral is needed. An initial consultation is likely to cost about $80.
In Australia, physiotherapists must complete at the very minimum a bachelor degree (usually four years) in physiotherapy, however many practicing physios have a masters or professional doctorate.
All physiotherapists must be registered with the Australian Health Practitioner Registration Agency.
Chiropractic
Chiropractors’ core focus is the diagnosis, correction and prevention of disorders of the musculoskeletal system (spine, pelvis, muscles, ligaments and joints).
Chiropractic is nearly always associated with spinal and neck manipulations, but it involves a combination of hands-on care, physical therapy modalities (ultrasounds) and exercise.
Despite chiropractic’s surging popularity, its proven benefit is fairly limited. The only really strong, often-cited evidence is for lower back pain — and a review of spinal manipulation found that it could alleviate back pain, but that it was no more effective than other common therapies, such as exercise therapy.
When it comes to back pain, however, Dr Leaver says this same critique could be levelled at physiotherapy and osteopathy, given the same mobilisation and manipulation techniques are employed across all three disciplines.
“We draw from the same pool of evidence … and you can oversimply things but equating a single intervention (such as spinal manipulation) with the name of one profession,” Dr Leaver said.