This should be a pleasant and relaxing experience, with confidentiality maintained at all times. The first session includes a full musculo-skeletal & medical case history, physical assessment and evaluation for a diagnosis, and treatment plan to be agreed.

 This is important to;

• Establish the nature & location of the complaint

• Establish time & nature of onset (when & how it started)

• Possible causes i.e. lifting, gardening, road traffic accident (RTA)

• Full medical history of recent & historical injuries, operations, current general health, etc.

• Asses the appropriateness of certain techniques i.e. someone with osteoporosis (thinning of the bones) would be treated much more conservatively & more gently than, say a 20 year old male rugby player.

• Any need for possible tests or referral elsewhere

As thorough as we try to be, it is important that you tell us of any diagnosed medical conditions before any treatment is given. It may even be possible that we can help with these too. Check A-Z of osteopathy page.

Having said that it is important that you allow the osteopath to lead you through the case history to enable them to prioritise what information is most relevant. We can always add any additional information at the end. It is important that you be as honest and as frank as possible, which will mean that we can provide the best health care that we can and can get on with the job of treating you.  

Also, don't be afraid to ask if you have any concerns, such as regarding manipulation. Check Articles page for a research article on this subject.

Assessment of both active & passive movements

• Active movement is where you move yourself around;- sitting, standing, bending, etc. 

• Passive movement is where the practitioner moves you about, such as, your neck, hip, knee, etc.

This is because the body behaves differently when actively contracting muscles to move itself, as opposed to when it is been moved.

Further Tests

May include;

• Checking reflexes, muscle strength, etc, to test integrity of the nerves if nerve injury or compression is suspected, such as, from a vertebral disk injury.

• Blood pressure, various arterial pulses, examination of the retina of the eye, when vascular disease is diagnosed or suspected.

• An examination of the abdomen if, say the pain is thought to originate from one of the internal organs (viscera) i.e. appendix,  ovarian cyst, etc. 

• Further tests elsewhere may be indicated i.e. blood tests, or Imaging (X-Ray, MRI). For this you would be referred to your GP or elsewhere, as appropriate. We do not routinely X-Ray!

With osteopathy assessment & treatment tend to merge into one another. We work with our hands on people every working day & it's only with such regular use of our hands for assessment & treatment that a high sensitivity to touch develops. This is known as palpation, on which osteopaths are very reliant for diagnosis & treatment. The sort of things that would be palpated would include joint health & quality of movement, muscle tone (poor, good, excessive, spasm) & so on.

The osteopath should have a wide range of approaches & techniques that can be adapted, as appropriate for the individual. Some osteopaths treat only people with structural, orthopaedic problems & others do further study & practice cranial & visceral osteopathy, that covers a much wider range of problems. See A-Z of Osteopathy Page.

Normally treatment is included in the first consultation, unless the problem is particularly complex or further investigations are required. The fee is for the consultation, advice and/or treatment, not for the time period involved. It is possible to over treat people and it is said that - less is more - in osteopathy, as the body needs time to adjust to changes.

Occasionally people experience ‘flare ups’, this is most likely to happen the following day. If this does happen, and we have not advised otherwise, then it is important to do your best to keep moving generally, without over-doing it. This will reduce the build up of inflammation and little & often is the key. Hot & cold compresses (5 mins each) will also help. Other self help advice is often given that may include stretching, strengthening, relaxation exercises, posture, etc., as appropriate. This is to aid recovery and avoid re-occurrence. Follow-up treatments are shorter and charged accordingly.

Generally speaking, the older the problem - the longer it will take to resolve. It is important to be realistic about the outcome and that you need to do your bit, such as;- stretching exercises, maintaining mobility, etc  - we can not do these things for you.

Once the problem has settled it may be recommended that an occasional maintenance or preventative treatment is given to help avoid a further crisis. This also keeps your record open and avoids having to do a re-assessment, with a new case history. Otherwise, we can only keep your record open for 18 months - this is for reasons of legality & safety. If we don’t see you in the meantime, then you have another flare up or another problem, then we need to start with a new case history & re-examination and charge accordingly,.