Written by Emily Whitton

Emily Whitton

Therapy Directory Content Team

Last updated May 2023 | Next review due November 2024

Osteopathy is a holistic treatment that involves diagnosing, managing and treating musculoskeletal and other related conditions using manipulation techniques. Here, we’ll take a look at the methods used to treat common problems and what you can expect from a session. 

What is osteopathy? 

Osteopathy is a non-invasive system that involves the detection and treatment of muscular and joint problems. Someone who is trained to offer this therapy is called an osteopath. Osteopaths are regulated by the General Osteopathic Council and are distinct from doctors, nurses and pharmacists. 

They work to identify and relieve problems in the body related to the bones, muscles, ligaments and connective tissue. This is done using a range of manual manipulation techniques. The process aims to restore balance in the body and support well-being by improving musculoskeletal function. 

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How does osteopathy work? 

Osteopathy treatment is based on the principle that a person's well-being depends on the health and synchronisation of their skeleton, muscles and joints. Osteopaths help correct problems in these areas using a range of manipulation techniques such as massage, stretching and movement. These techniques are designed to: 

  • increase joint mobility 
  • relieve tension 
  • reduce pain 
  • better blood supply to connective tissues 
  • help the body heal 

An osteopath uses their hands to pinpoint areas of weakness or tenderness in the body. From here, they can determine the most appropriate treatment option. Osteopaths are also able to refer clients to a GP or for further tests to help diagnose problems. 

In this video, osteopath Kelly McKay (BSc (Hons) Osteopathy) discusses osteopathy in more detail, including the complaints it can help treat and who can benefit from it. 

What conditions can osteopathy help with? 

Osteopathy helps to relieve problems in the muscles, bones and joints. As osteopathy uses a holistic approach and treats the whole body, many different ailments can be helped. This is often in conjunction with other treatments. Some common reasons why someone may see an osteopath include:

  • lower back pain 
  • sciatica (pain that spreads from the lower back down the legs) 
  • neck pain (though not if a result of an injury such as whiplash) 
  • shoulder pain (such as frozen shoulder)
  • elbow pain (such as from tennis elbow) 
  • arthritis 
  • muscle and joint pain from work or pregnancy 
  • joint stiffness 
  • headaches

Although osteopathy is not specifically mentioned, the National Institute for Health and Care Excellence (NICE) recommends manual therapy alongside exercise as an effective treatment for lower back pain. Manual techniques are used in osteopathy, physiotherapy and chiropractic medicine. 

What’s the difference between osteopathy, physiotherapy and chiropractic medicine? 

Osteopathy, chiropractic and physiotherapy are similar treatments for musculoskeletal problems. Osteopathy uses gentle hand techniques to restore function and improve pain. The core belief is that well-being depends on how these internal structures work together. 

Physiotherapy helps bring back as much movement as possible following an injury, illness, disability or developmental problem. 

Chiropractic stems from osteopathy, but chiropractors tend to focus on the alignment of the spine and muscles. 

There is some evidence that osteopathy can help relieve pain and discomfort of neck, shoulder and lower limb problems. It can also help with recovery after a hip or knee operation. There is no evidence to suggest that osteopathy can help with conditions outside of the musculoskeletal system such as period pain. 

As osteopathy looks to restore balance in the body and promote well-being, osteopathic medicine is thought to help reduce stress and anxiety, which can contribute to chronic pain. 

An osteopath cannot cure an illness or recurring injury, but they can make living with a condition more manageable. By using a range of techniques, osteopathy works to reduce pain, improve movement and restore the normal function of the body. Let’s take a look at some of the methods used.     

Methods used in osteopathy 

Osteopathy treatment will vary from patient to patient. Despite this, all manipulation techniques are based on the principle that the body's structure and function depend on one another. It’s believed that when the structure is changed, abnormalities occur.

Your practitioner will usually use some or a combination of the following methods: 

Soft-tissue technique

This osteopathy method is performed on the areas of soft tissue, such as muscles, ligaments and tendons, rather than the bones. This differs from traditional massage as massage tends to focus purely on the muscles. It involves rhythmic stretching and deep pressure movements which dislodge and move excess fluids. This relaxes hypertonic muscles and myofascial (fibrous tissue) layers. Osteopaths may use the soft-tissue technique to treat conditions such as back and shoulder pain, sporting injuries, and anxiety and stress.  

Cranial osteopathy

Cranial osteopathy is a specialist area of osteopathic medicine that concentrates on the cranial bones. These are located in the head and surrounded by cerebrospinal fluid that protects the brain, nearby tissues and the spinal cord.

In a healthy craniosacral system, this fluid will pulsate at a rate of six to 15 times a minute. Osteopaths are trained to monitor this rhythm in order to detect any imbalances. Then they gently manipulate the head and spine to improve the circulation of the fluid and restore harmony.

Baby cranial osteopathy 

Because cranial osteopathy is very safe and gentle, the technique can be used on babies and children as well as adults. There are many reasons why cranial osteopathy is thought to be particularly beneficial for babies. For example, it can help relieve pressure at the base of the skull which can occur during delivery. It’s also thought to support swallowing and digestion which can help overcome feeding problems. The most common use of cranial osteopathy for babies is to help them sleep, thanks to its calming and comforting nature. 

Osteopaths undergo specialist training to treat the cranial area. It is very safe but if you are worried about your baby or child undergoing this therapy, speak with your GP or discuss your concerns with an osteopath beforehand. They will be able to reassure you and outline exactly what’s to be expected from the session. 

Lymphatic drainage  

The purpose of this technique is to relieve associated conditions by improving lymphatic fluid circulation. The lymphatic system is a type of drainage system in the body that maintains our levels of fluid. Osteopaths use their hands to apply pressure to the swollen area and encourage the extra lymph fluid to move away and drain normally. 

Lymphatic drainage can be used to promote the healing of fractures, sprains and torn ligaments, reduce the appearance of scars and stretch marks and relieve fluid congestion (such as swollen legs), amongst other benefits. 

As osteopaths take a holistic approach to treatment, the techniques used may differ from that of a manual lymphatic drainage therapist. They will look beyond the restrictions within the body to ensure lymph fluid continues to move freely after treatment.

Thrust technique 

This involves the application of a high-velocity/low-amplitude thrust to the joints and muscles. The aim is to restore movement and reset natural reflexes. 

Muscle energy technique   

The muscle energy technique (MET) is an osteopathic procedure in which the patient is asked to use their muscles in a specific position and a specific direction. The osteopath will then apply a counterforce. This restores motion and decreases tissue and muscle changes. This technique is normally used when clients present with a reduced range of motion in the joints or muscular hypertonicity (tightness or stiffness). 


Practitioners use the counterstrain technique to identify tender points of a muscle spasm and reposition the body. This is to encourage changes in muscle and fascia surrounding muscles and organs. Counterstrain aims to help patients move away from a restricted motion barrier towards the position of comfort. This gives relief to physical dysfunctions that are too sensitive or acute to treat with other procedures.  

Myofascial release 

This technique aims to release tension in the muscles using deep massage. The dysfunctional tissues are guided along a path of least resistance until free movement is achieved. 

Find out how MET and myofascial techniques can help prevent recurring injuries

History of osteopathy

Dr Andrew Taylor Still 

Osteopathic medicine originated in the 1870s and was first used by American physician, Dr Andrew Taylor Still. As the son of a surgeon, Still realised that to achieve optimum health, all parts of the body should work together in harmony. He began researching alternative forms of healthcare that could treat the body with minimal invasion and a high degree of safety.

He soon developed an approach that used manual techniques, which officially became known as ‘osteopathy’. The name comes from the Greek word ‘osteon’ (bones) and ‘pathos’ (suffering). By the late 1800s, Still had established a reputation for his non-invasive therapy. In 1892 he opened the American School of Osteopathy (now the Kirksville College of Osteopathic Medicine). 

Dr John Martin Littlejohn 

John Martin Littlejohn is recognised for bringing osteopathic medicine to England in 1913. After studying at Still’s school and researching osteopathy together, Littlejohn returned to the UK and brought with him everything he had learned about osteopathy. He established the first osteopathic school in England, known as the British School of Osteopathy. 

What does osteopathic treatment involve?

Initial consultation

You will undergo a full medical assessment before osteopathy treatment can begin. Your osteopath will detail your symptoms and will ask questions about your health and lifestyle. It is important that your practitioner has a detailed medical history from you. This is what helps them decide if treatment is suitable and if so, what kind. Your osteopath will also need to know about any previous injuries, strains, inflammatory diseases, surgeries and stress. 

You may be asked to remove some clothing so that the area can be closely examined and to demonstrate some simple movements. This is so your practitioner can assess your mobility, the way your body functions and its limitations. 

This assessment allows your osteopath to better understand what influences your body. Anything from major trauma to minor illness may be disturbing your body's tissues and causing a misalignment of your musculoskeletal structure. If left untreated, this could remain present for the duration of your life. 

Osteopathy treatment plan 

The next stage of osteopathic medicine involves the implementation of a treatment plan. Your practitioner will discuss this with you, letting you know how many sessions you'll need and what techniques may be used. 

Your first appointment will last around 45 minutes. Subsequent sessions will be shorter, typically lasting for 30-40 minutes. The frequency of sessions will depend on the severity of your problem but the average number of sessions required is around four to five. 

As part of your treatment programme, you may be given exercises to do at home. You will also receive advice on how to minimise damage to the body and the impact of the problem. It is important to carry out any exercises given, even if they need to be repeated several times a day. 

Though treatment is generally very gentle, there will be situations where a small amount of force is required. This will help to reposition the tissues. Overall, most patients report feeling comfortable throughout.

Will it hurt? 

Many people think that the methods used in osteopathy will cause pain. This is not the case. Osteopathic medicine should not be painful. There may be slight discomfort as joints and muscles - which have remained unused for a long time - are stretched once again. 

Who is osteopathy suitable for?

As mentioned, osteopathic treatment is very safe and gentle, so it’s suitable for people of all ages, including babies. However, some people may be advised against osteopathy if they have any of the following conditions:

  • osteoporosis 
  • cancer
  • multiple sclerosis (MS) 
  • infections 
  • haemophilia 

It is also not recommended if you are undergoing radiotherapy or are on blood thinners. If you are pregnant, check your symptoms with your midwife or GP before treatment and ensure you seek an osteopath who specialises in pregnancy-related pain.  

If you’re unsure whether osteopathy is right for you, we always recommend contacting your GP or speaking with an osteopath who will be able to identify if treatment is suitable. 

Is it a preventative treatment? 

Osteopathy treatment in itself is not preventative. Practitioners can only treat patients when pain or discomfort is present. Despite this, osteopaths can offer preventative advice, such as suggesting ways of helping to prevent a recurring injury. This may include stretching exercises, breathing exercises, lifting techniques and posture. Patients are encouraged to practice these regularly to maintain their health following treatment. 

Early intervention in osteopathy can help patients to better understand the sources of their pain. It can also identify how certain lifestyle changes can make it easier to prevent and cope with pain later on. 

How do I find an osteopath? 

Practitioners of osteopathy must be registered with the General Osteopathic Council in the UK. At Therapy Directory, we ensure our listed osteopaths have verified their proof of membership, so you can be sure that you’re contacting an experienced and qualified professional. 

Some osteopaths offer services through the NHS, but you can also seek treatment privately. To find an osteopath near you, use our search tool to browse our profiles and simply get in touch to arrange an appointment or find out more. 

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