Osteopathy is a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints.

Osteopaths believe that problems with the way bones, muscles and joints fit and work together can affect all other parts of the body. They believe their treatments allow the body to heal itself. Osteopaths use a range of techniques but do not use drugs or surgery.

Most people who see an osteopath do so for help with back pain or other problems related to muscles and joints. Some osteopaths also claim to treat a wide range of health conditions, including asthma, digestive problems and period pain.

Osteopathy is a complementary or alternative medicine (CAM), and is different from conventional western medicine. Osteopaths may use some conventional medical techniques, but the use of osteopathy is not always based on science.

Read more about what happens when you visit an osteopath.

Does osteopathy work?

There is evidence that osteopathy is effective for the treatment of persistent lower back pain. The National Institute for Health and Clinical Excellence (NICE) recommends it as a treatment for this condition.

There is also limited evidence that it is effective in helping recovery after hip or knee operations.

There is no good evidence that osteopathy is effective as a treatment for any other health conditions.

Serious side effects or complications have been reported, but they appear to be rare.

Read more about the evidence on osteopathy.

How do I get osteopathic treatment?

Osteopathy is not widely available on the NHS. Your GP or primary care trust can tell you whether it is available.

Most people pay for osteopathy treatment privately. Treatment costs vary, but typically range from £35 to £50 for a 30–40-minute session. You do not need to be referred by your GP to see an osteopath privately.

Only people registered with the General Osteopathic Council are allowed to practise as osteopaths. You can find a registered osteopath near you on the GOC website.

Find out more about how osteopathy is regulated.

During your first osteopathy session, the osteopath will probably ask you about your symptoms and your general health before carrying out a physical examination. 

The osteopath will use their hands to find areas of weakness, tenderness, restriction or strain within your body, particularly the spine. You will probably need to remove some clothing from the area being examined, and you may be asked to perform simple movements.

You should then be able to discuss whether osteopathy can help treat the problem and, if so, what the treatment programme should involve.

Osteopaths can identify when a patient needs to be referred to a GP or needs further tests, such as MRI scans or blood tests to help diagnose the problem.

Treatment – manipulation

An osteopath aims to restore the normal function and stability of the joints to help the body heal itself. They use their hands to treat your body in a variety of ways, using a mixture of gentle and forceful techniques. These include:

• massage – to release and relax muscles
• stretching stiff joints
• articulation – where your joints are moved through their natural range of motion
• high-velocity thrusts – quick, forceful movements to the spine

It is claimed that these techniques reduce pain, improve movement and encourage blood flow.

Osteopathy is not usually painful, although there may be some discomfort if you’re having treatment for a painful or inflamed injury. If you feel any pain during treatment, tell your osteopath immediately.

In general, the first appointment lasts about 40 minutes. Further treatments last around half an hour. Your course of treatment will depend on your symptoms. In the case of lower back pain, the National Institute for Health and Clinical Excellence (NICE) recommends that treatment should include up to nine sessions over 12 weeks.

What qualifications do osteopaths have?

Osteopaths complete a four- or five-year honours degree programme (bachelor's or master's), which involves thorough clinical training. Some osteopaths are qualified to PhD level.

Osteopathy is most commonly used to treat conditions that affect the muscles, bones and joints.

These conditions include:

• lower back pain
• neck pain
• repetitive strain injury
• arthritis
• sports injuries
• problems with posture caused by driving, work or pregnancy

Some osteopaths also claim to be able to treat conditions not directly related to muscles, bones and joints, such as:

• asthma
• headaches and migraines
• painful periods
• digestive disorders
• sinusitis (infection of the sinuses)
• stress
• depression 
• colic and sleeplessness in babies and children

NICE recommended uses

The National Institute for Clinical Excellence (NICE) provides guidelines to the NHS on the use of treatments and care of patients.

Currently, NICE recommends that osteopathy is considered as a treatment option for persistent lower back pain.

Read about the evidence for osteopathy.

Osteopathy is one of only two complementary and alternative medicines (CAMs) that are regulated under UK law. The other is chiropractic.

This regulation works in much the same way as regulation for medical doctors.

Regulation

Under the terms of the Osteopaths Act 1993, it is illegal to practise osteopathy unless you are registered with the General Osteopathic Council (GOsC).

The GOsC will only accept registration from practitioners who have a qualification in osteopathy that is recognised by the GOsC and who agree to comply with their standards of practice.

If you use an osteopath and they do not adhere to this standard of practice, you can complain to the GOsC. It has a duty to investigate the complaint.

Regulation aims to protect patient safety, but it does not mean there is scientific evidence that a treatment is effective.

The GOsC has a register of osteopaths, which you can use to find one in your local area.

Safety

Osteopathy is generally regarded as a safe treatment. Minor side effects of treatment may include:

• mild to moderate soreness or pain in the treatment area
• headache
• fatigue

These effects usually develop within four hours of a session and typically get better on their own within 24 hours.

Serious complications that have been linked to therapies involving spinal manipulation – including osteopathy – include tearing of an artery wall leading to a stroke, which can result in permanent disability or even death. These events usually occurred after spinal manipulation involving the neck.

These more serious complications of spinal manipulation are rare. Estimates of the rates of serious complications range widely, from one in several thousand to one in several million.

Special cautions

Osteopathy is not recommended where there is an increased risk of damage to the spine or other bones, ligaments, joints or nerves.

Therefore, people with certain health conditions may not be able to have osteopathy. These conditions include:

• osteoporosis
• fractures
• acute inflammatory conditions
• blood clotting disorders such as haemophilia
• cancer 

Osteopathy is also not recommended if you are taking blood-thinning medicines, such as warfarin.

To be able to judge whether a health treatment is safe and effective, we need evidence. Evidence on a treatment is gathered by conducting fair scientific tests of the treatment.

When we use a treatment and feel better, this can sometimes be because of a phenomenon called the placebo effect, and not because of the treatment itself. To find out more about this, watch a video about the placebo effect.

There is evidence that osteopathy is an effective treatment for persistent lower back pain.

There is limited evidence that osteopathy is an effective treatment for recovery after a hip or knee operation.

There is no good evidence that osteopathy is an effective treatment for conditions for which it is sometimes used. These include:

• asthma
• painful periods
• shoulder pain
• headaches or migraines
• sinusitis (infection of the sinuses)
• stress
• depression