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
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:
soft tissue massage
muscle resistance training.
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.
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.
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.
In recent times, the chiropractic profession has come under fire for promoting and practising unsubstantiated therapies that have not been subjected to rigorous scientific testing.
While some chiropractors claim to "treat" non-musculoskeletal conditions, such as infantile colic, bed wetting, asthma, ADHD, autistic spectrum disorders, period pain, ear infections and high blood pressure, there is no evidence to support these claims.
Critics argue these claims have the potential to be dangerously misleading.
The notion that spinal adjustment can improve or rectify a host of health conditions is based on a belief held by some chiropractors that misalignments (or "subluxations") in the spine can impair nervous system function, leading to all kinds of human ailments.
By locating and "correcting" these misalignments, some chiropractors believe they can unblock so-called nerve flow and eliminate disease, infection and childhood illness.
This premise does not fit within current scientific understanding of disease (or how to eradicate it).
It is important to note, however, that many chiropractors reject this approach.
"The more evidence-based chiropractors are really limiting their scope of practice to muscular-skeletal conditions and specialising in the spine," Dr Leaver said.
The chiropractic profession has also attracted criticism for the promotion of anti-vaccination views, and just last year, The Royal Australian College of General Practitioners discouraged its Fellows from referring to chiropractors.
Chiros work in private practice and do not require a referral. Expect to pay $100 on average for an initial consultation and between $60 and $80 for subsequent consultations.
A chiropractic degree takes five years to complete, and practitioners are regulated by the Chiropractic Board of Australia, which is part of the Australian Health Practitioner Registration Agency.
Osteopaths work on the premise that posture, injury, or negative lifestyle patterns compromise anatomical structure and lead to poor health. As practitioners, they look at the relationship between the structure of the body and the way in functions.
According to Osteopathy Australia, practitioners "focus on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a holistic unit".
For example, if you see an osteo for a sore knee, they may also take a look at your ankle, pelvis and back. The practitioner might also ask about your medical history, as well as factors that don't appear to be directly related to your current injury.
Like physios and chiros, osteos diagnose and treat injury using non-invasive, manual techniques; orthopaedic and neurological testing, soft tissue manipulation, massage, stretching muscle groups and spinal adjustments. They may also recommend exercises and dietary modifications.
Similar to chiropractic, osteopathy's proven benefit is fairly limited; there is scarce high-quality research investigating the effectiveness of its "holistic" approach.
There is some evidence for its treatment of lower back pain, typically through spinal manipulation and manual techniques, but the benefits appear to be modest.
"With back pain, one of the things to stress is that we don’t have a cure for it — nobody does," Dr Leaver said.
"A good osteopath will work under an evidence-based paradigm and use interventions on the basis of their proven efficacy."
Patients of osteopaths commonly include those with back and neck pain, sciatica, headaches, joint pain, work-related and repetitive strain injuries and sports-related injuries.
Osteopaths work in private practice and do not require a referral. They typically charge $100 for an initial consultation, which is likely to last between 40 and 60 minutes.
An osteopathy degree takes five years to complete, and practitioners must be registered by law with the Australian Health Practitioner Registration Agency.
Finding the right practitioner
Whether you see a physiotherapist, chiropractor or osteopath, Dr Leaver says the most important thing is that you find a practitioner who "operates under an evidence-based paradigm".
"So physiotherapy is not a treatment — it's the person who provides the treatment. And similarly, chiropractic is not a treatment — it's the person who provides the treatment."
What you want to avoid, he says, is somebody who makes false promises of a cure and takes too much credit for natural recovery.
"You want to see someone who empowers you look after your own body, and to look after yourself, who teaches you good strategies for dealing with day-to-day pain," Dr Leaver said.
"You don't want to be seeing somebody who is holding out a false promise of a cure with lots of interventional treatment — so somebody who does lots of things to you, rather than teaches you to do things for yourself."
I'd think that neck and shoulder tightness is our 'bread and butter as massage therapists. We see if all day every day which makes are really good at treating it!! I am positive there isn't a person on Earth who hasn’t had sore shoulders at one time in their life! The question is what can you do about it when they do get sore?
Stretch and/ or Trigger?
The main muscles you need to focus on are your traps, levator scap, pecs (chest muscles) and the the muscles between your shoulders blades. Improving your mobility through your thoracic spine (upper back) always works wonders to loosen up those tight shoulders. Our last blog was all about how to stretch our your neck and shoulders plus we also have a whole guide of upper body stretching and triggering available that includes how long to hold each exercise.
Just remember that even if you are sore between your shoulder blades or on the tops of your shoulders it could be caused by other areas of your body being tight and/ or weak. That is why we recommend not only focusing on the areas that feel sore but targeting areas that could be causing the tightness in the first place, such as your pecs, which help pull your shoulders forward.
Think about how long you are sitting and your posture while seated.
We know! We harp on about sitting! However we spend most of our time doing it so we should spend most of our time harping on to you about it! On average a person will only be standing up for 1 hour each day!! (CRAZY!) If we sit with terrible posture, we will inevitably get tight. Set the clock and be diligent about moving every 45mins. There is research that shows that the brain works best in less than 45 minute blocks. So you are practically helping yourself to be more productive by getting up and switching the brain off every 45 minutes! Future, more productive you, with less shoulder tightness shall thank you!
Obviously we recommend getting a massage! Neck and shoulder tightness is something we are really good at! It’s important to work out the underlying causes of your neck and shoulder pain. Plus there are just some trigger points that are really difficult to loosen off yourself! We also need to work out if there is stiffness from your thoracic spine contributing to our discomfort. Why are those trigger points there in the first place? What things at home or work are contributing to your discomfort? Is there some underlying weakness that needs to be addressed to help stop this from always happening? A good massage therapist will help to get to the bottom of what is going and get you there a lot faster than trying to do it all on your own. They can also set you up with a plan for home so you can manage it yourself in the long term and we can hold to account!
Stress and neck and shoulder tightness go hand-in-hand. On a scale of 1 – 10 how stressed are you right now? What things are stressing you at home or at work? (Aka coming back from holidays!) What things can you be doing to relieve this stress? What things are you putting into your week to help manage that stress, if the situation is unavoidable?
We undervalue the importance of making time for ourselves. However the benefits are exponential and it is an easy way to help relieve your neck and shoulder tightness.