Osteopathy and chiropractic are the better known of the manipulative therapies, often recommended for people with back pain or joint problems.
How Does it Work?
Chiropractors and osteopaths both work on the musculoskeletal system – which comprises the bones, muscles, tendons and other and connective tissue, and they use their hands, often in special techniques, to treat different problems and illnesses.
One well known chiropractic technique which is sometimes criticised for being hard on the patient is called the ‘high velocity thrust,’ – a sharp motion which is normally used on the spine. The thrusts result in the loud ‘crack’ which is often talked about by people who have been to a chiropractor! The cracking is caused by tiny gas bubbles in the fluid which surrounds the joints, and is said to be harmless.
Osteopaths do use these thrusting techniques, but tend to apply them less often and slightly differently than chiropractors. They both also use other types of manipulation technique.
Some of the other techniques involve working with the soft-tissue to relax muscles, which then makes the manipulation of joints less uncomfortable. They also carry out rhythmical manoeuvres which are designed to take the joints through their normal range of movement. A visit to a chiropractor or an osteopath can sometimes lead to mild discomfort, or some stiffness the day after your treatment. You might need to have several treatments, depending on how old you are and what the problem is that you’re being treated for.
Does It Actually Work?
There have been some positive reports from trials that have looked at the way spinal manipulation works (or doesn’t work) on patients with back or neck pain. Studies carried out by the Medical Research Council, and reported by the British Medical Journal in 1990 and 1995, looked at over 700 people suffering with lower back pain. The participants were randomly referred either to a chiropractor or to a hospital outpatient department for treatment. Both groups were treated however the practitioner thought best, and there were no set methods.
The trial came to the conclusion that the group who had chiropractic received, “worthwhile long term benefit.” In some parts of the UK, you can now get both osteopathic and chiropractic treatment on the NHS, and it’s especially recommended for back pain. In 1994, the UK Clinical Standards Advisory Group also suggested referring patients with acute back pain to manipulation therapies – and they also advised GPs to liaise more closely with chiropractors and osteopaths.
A House of Lords Select Committee placed both osteopathy and chiropractic among the top five therapies, back in 2000. This was mainly because the Committee thought that the profession was well regulated, and that there was a great deal of education and research involved in becoming a practitioner.
In 1993, legislation was passed to protect people from unauthorised osteopaths, and in 1994 The Chiropractic Act did the same for chiropractors. It’s illegal for anyone to call themselves either unless they are registered with either the General Chiropractic Council or the General Osteopathic Council. To check whether someone is registered, go to:
As one of the ‘Big Five’ both chiropractic and osteopathy are becoming better understood and gaining recognition from the mainstream medical fraternity. If your back problems are getting you down and you want to try an alternative approach, you could do worse than give it some manipulation!