Osteopaths - Any good?

[MummyWithA1Family]

I've had a bad back since being pregnant with my DS who's now 20 months.

11 days ago I started with the latest flare up and can barely move. My lower back's so excruciating (very sharp pain) that I can't bend down, sit down or stand up without being in a lot of pain. I'm on very strong pain killers but they're doing nothing for it. The only time I get some sort of relief is laid down, even then it's painful (dull ache like tooth ache). When I go to stand up I'm nearly screaming in pain and have nearly passed out a few times because it's been that bad.

Do you think an osteopath would help? If so roughly how many sessions would/might I need? I'm just worried it'll be a waste of time as it'll cause me alot of pain to get there and it's quite expensive. If it works then I'll pay almost anything as I'm in so much pain!

Please advise of anything else that may work as I'm really desperate.

Sorry about your pain - horrid for you. I have found my osteopath very helpful over a number of years in reducing my lower back pain and recommend them. You might need 5-6 sessions. I hope it helps.

Definately yes. Mine also flared up after DSs arrival 9 months ago. Suffered on and on with it (old disc injury), but it was getting to the point I could barely lift the baby. Finally went to osteopath a few weeks ago, have had 4 sessions and am already feeling much better - don't know why I didn't go sooner!

Thanks for the advice. I went today and my back's in a right state. He did a little manipulation but couldn't do much. What he did do though made a massive difference. Even though I'm still in alot of pain I wish I'd gone before!! Why isn't this available on the NHS - better than pills!

If your osteopath is good he/she will be able to explain to you what causes your pain and how to manage your body

I have had bad back for the past 6 years with pain similar to yours including 2 incidents when I couldn't get out of bed for 2 days on both occasions - it was scary...

I recommend to lie down flat on the floor with your legs at a right angle on the chair or sofa - it eases pressure on your spine

like this
it's simple and very effective way to manage pain
even if you can do it for short time

when you are getting off the floor turn on your side and then slowly go on your fours

from that position try to sit on the back of your feet first and with help of someone, or using a chair get up

I am writing it in steps as it happened to me that I almost fainted once trying to get up to quickly (pain got to me)

Yoga helped me a lot, now if I feel pain coming I know how to stretch and relax
I learned how to correct my posture if I am in pain.

some people swear by Pilates

try both and choose exercises with a help of a good practitioner

but that would be in a few months time

hope you can get some sleep at night now
I used to sleep with pillow between my legs - that was also to ease my pain

Thanks for the advice Kayah. He seems a good osteopath (not that I have anything to compare with).

He said the muscles in my back are way too tight except for the two vertibre (spelling?) in my lower back where I get the pain. Apparently these two are too loose and over compensating for the rest of my body. He said he hasn't seen a back this bad in someone of my age in a long, long time (oh joy - has to be me). When he was gently working on my back he was shocked at some of the things he found. He thinks it's possible that I have AS (Ankylosing Spondilitis). Usually it's an hereditary man's disease and women are carriers, although in very rare cases women can get it.

I do feel better now and am very surprised as he said himself he could only do a little work today due to the severity of the pain, tension and inflammation. He did manipulate a couple of vertibre and managed to 'crack' them but another 3 were way too tight to go. I feel so achy where he's done this (basically jumped on my side with his arms and chest) like I've done a lot of exercise, is this normal?

He suggested Pilates for me but not for a while. I must admit though I'm very worried about costs as we are struggling financially at the moment so this feels like a luxury. On the other hand he did say it's a good job I came as if I didn't do a lot of work now (osteopath, pilates, tummy/back muscle strengthening exercises, etc etc) then he thinks I'd have possibly been in a wheelchair in a lot of pain at age 50-60ish, so I know I need to find the money from somewhere.

Thanks for the advice on how to get up etc. Luckily that's how I do get up already - not through skill but simply because I cannot get up any other way with the pain.

When I was younger and someone moaned about back pain I did sympathise with them but never truely understood, until recently, just how awful it really is. Think I'd rather go through labour again, no scrap that, I know I'd rather go through labour again!!!
I really do hope everyone's back gets much better soon. x

As one who is awake with SPD at 26weeks pg I can't recommend osteopathy highly enough.

I have been in absolute agony with it. Two sessions made a huge difference. I felt so much better that I didn't book another one and now I feel very sore indeed.

Is your AS under control?

I am asking as one of my close girlfriends is suffering from it so I understand totally where you coming from.

I know that sometimes is hard to find money for extra activities, but think of it as an investment for the future.
Yoga would help with your AS as you'd learn how to stretch and strengthen your muscles at the same time.
I would say you need about a year once a week classes then you can get a DVD and do it at home, but I would never advise to do it at home for beginners.

In my local Leisure Center there were Beginners courses - 6 lessons for about £35-40

Look for something like that and build on the skills for beginners. Yoga teachers are well qualified, better than Pilates instructors I think.
I would look for someone from The British Wheel of Yoga as they are not into power yoga, but a mixture of Hatha and other flavours of yoga - more common sense approach than others I came across.

Try to start your exercise regime with strolls, just a few minutes at a time.

I heard from friends that those shoes are amazing in helping to improve posture and teach good habits. Very expensive, but also top quality and would last forever.

I am planning to get them for myself sometime this year.

Did he really say this?

"On the other hand he did say it's a good job I came as if I didn't do a lot of work now (osteopath, pilates, tummy/back muscle strengthening exercises, etc etc) then he thinks I'd have possibly been in a wheelchair in a lot of pain at age 50-60ish, so I know I need to find the money from somewhere."

What an irresponsible and disengenous thing to say.

Even if you frank AS (which you don't) this sort of outcome would be very unlikely.
That's not to say that people with AS don't have symptoms but wheelchair/pain ridden is unsupported by the evidence.

I would not return.

Go to your G.P (if you haven't already) and get involved in the evidence based back care pathways, physiotherapy for example.

Although osetopathy has some evidence for efficacy, I would not use this individual.

Speaking as a retired GP, I feel that the problem with osteopaths is not what they do, which is great, but what they say, which is not. A properly qualified osteopath (D.O.)has really valuable manipulative skills and manipulating the lower back can be very beneficial in some cases of back pain. Hence the above recommendations. It is entirely natural that being so impressed with the pain relief, one tends to take what the osteopath says as gospel truth. Sadly there is little evidence that their comments about the state of the vertebrae can actually be verified. Mostly, IMO, it's tosh. Don't give up on the NHS, there's lots available for back pain.

LGC, what about upper back pain? I know I have postural problems with my shoulders & spine & I plan to take up Pilates to help with that but any tips on what to do/who to see first to sort out the pain? Are osteopaths or physiotherapists able to help with that?

Decor, first check with your GP, this always applies with chronic pain. Upper back pain is often postural and a physio could help you. You always have to pay osteopaths but there are private physios too if NHS is too slow.

Sorry to hear about your back pain. I've had quite a lot of pain (and osteopathy) myself after 2 slipped discs and associated problems.

Definitely agree with what people have said upthread about Pilates when you're up to it - it really is an investment teaching yourself how to retrain your muscles to help your back.

Also, does your osteo also do acupuncture? Mine does and I find it to be pretty miraculous at getting those rock-hard tight spasmed-up muscles to relax. It might be effective on you if you're too tight to do much manipulation.

I wouldn't hesitate to recommend my osteopath if you're near south london.

There's no harm in going down the NHS/physio route (I got a course of Pilates on the NHS too) and at the same time seeing an osteopath - in my experience it's the osteopath who is able to sort out really intense pain fast.

Hope you start to get better soon. Look after yourself and make sure you get as much help as you can in the meantime.

DBennett I mentioned my dad had AS but never said to what extent. In all honesty what he's said about severe pain, wheelchair route etc is exactly how my dad was. I don't know much about AS, other than it's rare in women and they are often carriers, but I must say after watching what my dad went through I hope I don't get it (he was in a lot of pain and even lost 6 inches in height with AS). I do think I need to research it more though.

LGC Although my GPs are excellent with everything else all I've been offered is a sheet of back exercises which have been of no benefit at all. I'm not saying I wouldn't go to drs if needs be but they've just said there's not much that can be done for backs! I'm assuming from what you've said that's not strictly true? What should I be asking for?

Quodlibet yes my osteopath does do acupuncture and has said he'll be doing some on me. I had it a few years ago when my back was bad. At the time I was having physio on a recurrent dislocated patella and mentioned my back so she gave me a few sessions and it helped.

I must say I'm impressed with what the physio has done as my back's alot easier and I can actually bend over a little! I'm looking forward to next weeks results.

Thanks everyone for all your advice it's definitely given me food for thought.

Kayah I think you're right that I def need to do yoga or pilates but unfortunately there's no way I can afford both at the moment so will stick with the osteopath short term and go the other route longer term.

Funnily enough I've just ordered a 'fake' pair of Earth Shoes with the negative heel technology to give them ago around the home. They sound great if they work especially as a bonus is the fact the help to tone, lose weight and improve celulite. Fingers crossed they work. Although I didn't pay £90 for them, only £20!!

Just to say mine is amazing. I had phisio which helped a bit, but the osteopath was AMAZING! With the amount that he improved my back I would have gladly paid him treble

PS Quodlibet I'm in Leeds. Thanks anyway.

Quodlibet - I can also reccomend an amazing osteopath ,she works in Ewell

she was the only one who was prepared to do a home visit for me when my back was so bad I could not walk for 2 days, ex had to drag me to the toilet and to have shower and Iwas faining in pain on the way there and back (walk of about 3 m in total)

no other (and Imust have phoned about 10 of other local ones) was prepared to do that for me
I thin kthis is what unfortunately for me gives bad impression of that profession apart from Sarah of course, whom I visited many times since

but know I know my body well enough so luckily can manage my back problems myself

Mumm, clearly there's a lot of support here for osteopaths, which shows how effective they are, and that's good. I would feel happier if you had a referral to the local orthopaedic dept. just to get a diagnosis.

Kayah, I had a similiar experience as you. I had to phone for an ambulance as was on my own. To be honest the hospital was shit. Pumped me full of drugs and told me to get a taxi home in the early hours even though I was only in my dressing gown and had no money. The drugs made me feel totally out of it and in the morning I was vomiting.

One visit to an osteopath and my back is on the mend.

We have two osteopaths and our GPs surgery.

LikeGarlicChicken said:

"clearly there's a lot of support here for osteopaths, which shows how effective they are"

No, unfortuantly it doesn't.

It would be nearly impossible for an individual undergoing a treatment to account for all the confounders which will effect their response during the treatment.

Natural History
Regression To The Mean
The Hawthorne Effect
Limitations of Memory
Variable Attrition
Placebo Effect

We have to account for all those things in order to be accurate in our understanding of a treatments effectiveness.

The best evidence for osteopathy would indicate it has a good benefit/risk balance for lower back pain (similar to standard treatment) and slightly less effective for shoulder pain.
It is also relatively safe an intervention.

Now, if we are talking about AS in particular, that information becomes irrelevent.

NASS, the AS charity do not recomend soft tissue massage as they have a variety of proven exercise programmes to help those with the condition.
These are mostly done by physiotherapists, who have a group called AStretch to guide them in this.

I would also say that NASS don't consider wheelchair use a likely outcome of AS, it is mentioned four times on there website, twice with regards to the criteria for the Blue Badge scheme.

Could someone explain what an osteopath does exactly & how it differs from what a physio does?

DBennett - what do you suggest for shoulder pain if an osteopath is less sucessful in treating that?

Well, conventional treatment like physiotherapy seems to be more effective than alternative therapies on this issue.

But as alternative therapaies go, oseteopathy seems to have the best benefit/risk balance.

Osteopathy can differ from physiotherapy in matters both conceptual and practical.

A lot of osteopaths seem to be taught that the muscleskeletal system has disproportionate influence on vascular, nerve and lymph function.
It was born from the same stock as chiropracty in this regard.
As a result of this, some go beyond what is plausable with regards to conditions treated.

Physiotherapists, as well as having a much more regulated legal enviroment have very much a science/evidence based approach.

Thanks. I was a bit sceptical about going to an
osteopath as a friend who goes in for homeopathy is keen on osteopaths too!

The bit about women being carriers of AS and only rarely suffering from it is crap. About 3x as many men suffer from it as women, that still means 1/4 of patients with AS are women. It is however, primarily an inheritable disorder as it is heavily linked with a cell marker called HLA B27. Over 95% of the caucasian population with AS also carry HLA B27, although simply having HLA B27 does NOT mean you will automatically get AS, it just increases your likelihood of it.

I don't know what the general theory is on osteopathy and AS but I would have thought any manipulation in the region would be a bad idea.

However, AS is a condition that can go into remission during pg, as many chronic inflammatory conditions do - so it may not be your AS that is causing most of the pain.

My osteopath was a godsend when the medical profession, including physiotherapists, failed to deal with my transient vertigo and basically told me to get used to it, it wasn't going away - 2 sessions with the osteopath and it was gone.

Oh and the difference between my osteopath and my experiences with physiotherapy:

• the physio for my shoulder pain did nothing, made it worse if anything.
• the physio for my neck pain/stiffness and migraine improved the neck pain but never addressed the underlying cause, which was a visible side-shift of C7 in my neck, caused by a bike accident in which I also fractured my collarbone
• the physio for my upper back pain, which restricted my breathing when it got really bad, eased the muscular tension for a while but never resolved the underlying issue - a torsion in my thoracic vertebrae caused by a strain some time previously

All sorted by osteopathy. I also grew half an inch as all the lateral curves in my back were corrected.

I didn't get physio for my lower back pain - I'd had it so long it didn't seem to be worth treating but having my pelvis straightened (unrotated and untilted) made a huge difference.

Further - physiotherapy relies quite heavily on patient compliance with exercises. If these exercises are not done, or if they don't seem to help, then the patient doesn't improve as much, if at all. I had a client (I do deep tissue massage therapy) who had been seeing a physio for a year after having a Collis fracture in her R wrist. They set it with her hand curled and all the tendons in her hands shortened. The physio suggested she see an osteopath for her shoulder pain - he in turn suggested she see me and we worked on the cause of it, which was tension in the lower arm, caused by the shortened tendons and awkward movements (the lady's hand was like a mannequin's, almost no movement). One year of treatment later and her fingers were all straight again, she had near full rotation in her wrist again and the shoulder pain never returned after the second week of treatment.