The consultation: What to expect

The initial consultation

Many people are nervous at their first visit to an osteopath. We believe that it is most important to put people at their ease, so that the experience is as relaxed as possible. The first consultation lasts approximately one hour, except in cases of chronic fatigue syndrome where the first consultation is for 1 hour and 20 minutes. This allows plenty of time for you, the patient, to tell your story. Whether your problem is something minor such as an ankle sprain, or a more serious problem such as a slipped disc, it is important that the osteopath hears your account of the events leading up to the problem. The first consultation includes a thorough case history, which also allows you to tell us about any medical problems.

After the case history, the osteopath will carry out an examination. For this you will normally be asked to undress down to your underwear. The examination includes a visual inspection, an assessment of your mobility and may include a neurological or medical examination if necessary.

A hands-on assessment of the soft tissues (muscles, ligaments, etc), combined with testing of joints is used to reach a diagnosis. This identifies which tissue has been injured and the nature of the injury. It also allows us to discover whether the painful area has become liable to injury due to problems elsewhere. For instance a painful knee may be due to problems in the ankle or hip. In that case the osteopath will treat the whole of the leg, in order to reduce the stress on the knee.

Once the examination is complete, the osteopath will arrive at a diagnosis, based upon the case history and the findings of the examination. We believe that patients should be informed of the diagnosis, so we try to explain it in such a way that you can understand.

The final stage of the initial consultation is the first stage of your treatment. The time available for treatment varies according to how much time was needed for the case history and examination, but usually there will be 10-15 minutes of treatment. However in very complicated cases, treatment will start in the second consultation. Whatever the case may be, osteopathic treatment is a hands-on form of therapy and you will need to undress down to your underwear. Towels are available for those who are shy!

Subsequent consultations

Follow-up sessions last about 40 minutes. At the beginning you will have the opportunity to tell the osteopath about your progress since the previous treatment. We will then re-assess you, and treat you accordingly.

Treatment

Treatment may consist of a number of different techniques. We work almost exclusively with our hands, as they provide us with feedback about the state of the patient's tissues and the way they are responding to treatment. Techniques used include:

Soft tissue manipulation: this includes a variety of methods for improving the health of muscles, ligaments and fascia (connective tissue which envelopes our muscles).

Joint manipulation: slow, rhythmical movements of joints to increase their mobility and to stretch muscles; and short, rapid movements to release joints that have become "stuck".

Indirect methods, which help to reset muscle tone by affecting the behaviour of the nerves to those muscles.

In any treatment there is an element of relaxation, as the brain itself has an important influence on the tone of muscles, and the health of the tissues. In patients who are very stressed, this is a more important component and is given more emphasis.