Frequently Asked Questions

What’s the difference between Osteopathy and Chiropractor?
What is Manipulation?
How do you use an Ice-Pack?

What’s the difference between Osteopathy and Chiropractor?
Osteopathy and chiropractic are both forms of treatment which can be used to treat muscular-skeletal problems such as back and neck pain. Often, though not always the techniques used are very similar and the results obtained are comparable.
One of the main differences is in the language that the practitioners use. Osteopaths talk in terms of joints not moving properly and muscles being too tight whereas chiropractors see joints as being out of position. Because of this difference chiropractors make more use of X-ray examinations to diagnose the muscular-skeletal problems whereas osteopaths assess mobility of the individual joints using their hands. The two explanations are actually describing the same phenomenon in two different ways and both forms of treatment would correct the problem to the satisfaction of the other.

Another difference is the language that each profession uses. This can sometimes lead to confusion when a patient has been to see a chiropractor and then sees an osteopath. Manipulation and adjustment, for example refer to the techniques which are actually very similar.

The professions
Osteopathy gained recognition by way of the Osteopaths Act 1993 which means that all osteopaths are now fully qualified, are registered with the General Osteopathic Council and are fully insured. Chiropractors also gained recognition shortly afterwards and are therefore also considered safe, effective and professional. Both modalities are increasingly being used by General Practitioners to refer their patients to with symptoms such as back and neck pain. Unfortunately, neither osteopathy nor chiropractic is widely available on the NHS but this is gradually changing

How long will it take?
This depends entirely on the clinic you go to. Appointment time may vary from twenty minutes to an hour and the frequency of visits will depend on the problem you have. A typically osteopathic consultation will last half an hour.

Which should I choose?
Generally speaking neither profession is better than the other but people often make a choice based on personal preference of the techniques, the results or on the practitioner treating them.

At Back to Health we are happy to offer a free assessment so that we can inform you of how osteopathic treatment can benefit your problem and answer any questions you may have about the profession or its practitioners.

What is Manipulation?
The aims of osteopathic techniques are to increase mobility in a joint and therefore to improve function of that particular area.

Manipulation (or adjustment) is used to improve the mobility of joints either in the spine or in any of the peripheral articulations such as ankles and wrists. It consists of simply gapping the articular surfaces to an extent which is within the joint’s normal range of motion.

It is common to hear a ‘pop’ or ‘click’ (similar to that heard when knuckles are cracked) when the manipulation is performed and can be a shock the first time it happens. The sound is caused by the sudden formation of a small bubble of gas, originating from the fluid within the joint, which then remains within the joint capsule. The gas only remains in the joint for a day or so after which time it is re-absorbed back into the joint fluid.

The combination of the articular surfaces being separated and the small amount of stretch on the muscles surrounding the joint allows the body to‘re-set’ that particular joint’s position and function.

Can Manipulation Be Dangerous?
Manipulation of a healthy spine is not at all dangerous as the forces used and the distances over which the joint is moved are small compared to what we demand of our bodies every day. For example, more force and movement can be applied to the neck by quickly turning the head than would be used in a cervical spine adjustment.

To ensure that the spine is healthy a thorough case history will be taken from you including general health and previous medical history followed by a relevant examination which may comprise of neurological, pathological or orthopaedic screening procedures for example.

Manipulation is never used on babies as their skeletons are obviously not fully developed and elderly patients who may be at risk from osteoporosis undergo adjustments less frequently than younger healthy adults. In these cases other techniques can be used just as effectively.

In many cases manipulation is the treatment of choice as it is quick, safe and highly effective.

Will it hurt?
In areas of the spine which are chronically hypo-mobile (have not functioned efficiently for a long time) there can be some discomfort as the manipulation is performed but this normally passes within a few seconds. Equally if the patient is in acute pain then the affected area may be painful to touch and move so may be uncomfortable during the manipulation but this also usually passes quickly.

After the treatment the patient may experience some aching similar to that felt after an afternoon in the garden or on the golf course but with relaxation and the application of ice-packs this normally subsides after a day or so. In acute situations the use of pain-killers may be appropriate and it is advised that the patient seek the advice of a G.P or pharmacist to find out which would be most appropriate.

Should you have any questions following your treatment don’t hesitate to telephone your practitioner who will be happy to discuss them with you.

How do you use an Ice-Pack?
Pain is often caused by inflammation of tissues such as muscles and ligaments. The inflammatory toxins (called prostaglandin's) which gather in the tissues then irritate the pain receptors, causing pain. Applying an ice-pack causes the small arterial blood vessels in the tissues to constrict and this discourages the toxins from gathering. After a period of approximately ten minutes the cold reverses its effect on the arterioles and causes them to dilate allowing a rush of blood to the area (this is why your hands go red in the snow). For this reason the ice-pack should only be applied for ten minutes at a time. When the ice-pack is removed, the blood vessels are allowed to relax and this allows fresh blood back into the area. The next application of ice will then take all the gathered toxins away. So the result is that the muscles are being flushed out with fresh blood. Repeating the applications allows the area to remain much freer from the build-up of the toxins and as a result the level of pain may be reduced.

Ice-pack Protocol
• An ice-pack can be used at any time.
• Use an ice-pack or a bag of frozen peas
• Wrap in a damp tea-towel
• Place it on the painful area for ten minutes each half hour
• Put the ice-pack back into the freezer between applications
• Continue for two to three hours
• Repeat this process three times per day or as directed by your practitioner

Frozen gel packs (with cover) are for sale in the clinic at a price of £8. These get very cold but remain flexible to allow them to be moulded to any area of the body. For best results, keep the pack in the freezer until required. Take the pack out and slide inside the cover. Apply the ice-pack. Between applications the ice-pack should be kept in the freezer.

Should I use Hot or Cold?
A commonly asked question is whether to use a hot pack or a cold pack.

In general, heat can be applied (a hot bath for example) if you have been exercising or doing any activity and you feel that the muscles and joints are tired. This will allow the muscle fibres to lengthen and therefore feel easier.

If you have been exercising and feel that there is a ‘twinge’ or you have ‘pulled something’ then ice should be used immediately. While the cold does not feel as pleasant as the heat, it does help to reduce any inflammation in the ffected area and therefore reduce pain.

If you are unsure then it is better to use the ice-pack - If in doubt, get your ice-pack out!

In either case, if symptoms persist or you are concerned at all, you should consult your practitioner immediately who can offer more advice or book you an appointment. Your practitioner may advise you to use an ice-pack after the treatment. This may reduce any soreness that you experience in the following day or so.

CAUTION; If you use the ice-pack on your neck, you may experience dizziness or flushes of heat or cold. This is because the blood vessels in the neck are very sensitive and can affect blood pressure and body temperature. If this occurs stop using the ice-pack immediately and retry later. If you are concerned, contact your practitioner.