Osteopathy is a holistic treatment that involves diagnosing, managing and treating musculoskeletal and other related conditions. Osteopaths use a range of manual techniques in their work. They will massage soft tissues and manipulate problem areas of the spine and joints. This helps to strengthen the musculoskeletal framework of the body and improve function.

Osteopathy treatment is based on the principle that a person's well-being depends on the harmonious synchronisation and good health of their skeleton, muscles, connective tissues and ligaments. Osteopaths believe their work helps to restore balance to the body. This in turn promotes overall good health and well-being.

On this page we will look into osteopathic medicine in more detail. We will explore its history, what happens during treatment and the methods used.

History of osteopathy

Dr Andrew Taylor Still 

Osteopathic medicine originates in the 1870s, when American physician Andrew Taylor Still started researching alternative forms of healthcare. Following the untimely death of close family members, Still had become frustrated and confused with conventional healthcare.

Still strongly believed that the human body functioned like a machine. He proclaimed that human bodies only function well if everything is mechanically sound. On this basis, he began devising treatments that involved certain manipulations of the muscles and ligaments to improve circulation and correct altered mechanics. Still found this treatment particularly useful for alleviating his frequent headaches. 

During this time, magnetic healing, bone setting, hydrotherapy and homeopathy were growing in popularity. It is believed that Still came across these on his quest. He eventually adopted several components and applied them to his own practices. 

By the late 1800s Still had established a reputation for his non-invasive therapy. In 1892 he opened the American School of Osteopathy. 

Dr John Martin Littlejohn 

John Martin Littlejohn is recognised for bringing osteopathic medicine to England. Following a bout of ill health, in 1892 Littlejohn set sail to America to seek a warmer climate. 

During his visit he heard about Dr Still's reputation and decided to travel to Kirksville where the American School of Osteopathy is located. At Still's hand, Littlejohn's ailments disappeared. This inspired him to take up the study of osteopathy.  

Eventually Littlejohn and Still formed a partnership, and began to research osteopathy treatment further. After leaving Kirksville, Littlejohn founded a new school and hospital in Chicago. 

In 1913 Littlejohn returned to the UK and brought with him everything he had learned about osteopathy. He settled in Thunderly, Essex and this is where he established the first Osteopathic College in England. This is known as the British School of Osteopathy. Littlejohn continued to teach up until his death in 1947, as did Still, who passed away in 1917 at the age of 89.

What does treatment involve?

Initial consultation

You will need to undergo a full medical assessment before osteopathy treatment can begin. Your osteopath will want to know more about your symptoms and will ask questions about your health and lifestyle. You will also be required to provide a full medical history and may be given a basic check up. Your osteopath may check your pulse, reflexes and blood pressure. 

It is important that your practitioner has a detailed medical history from you. This is what helps he or she 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 then need to do a few simple exercises or movements. This is so your practitioner can assess your mobility, the way your body functions and its limitations. 

Overall, 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 tissues twist and contort then the flow of fluid might be reduced and normal movement could become restricted. 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. Usually they will begin at weekly intervals, but may be spaced further apart as the condition or problem heals. 

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 repeating 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.

Methods used

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

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

Soft-tissue technique

This osteopathy method is performed on the muscles surrounding the spine. 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 minute movements of the cranial bones. These are located in the head and surrounded by cerebrospinal fluid that protects the brain, nearby tissues and the spinal chord.

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 manipulate the bones of the head and the face to improve circulation of the fluid.

Baby cranial osteopathy is a variation of this technique, and is useful for helping babies sleep better. The treatment is soothing and comforting and can help to relieve infant colic as well as sleep problems.  

Lymphatic technique   

The purpose of this technique is to relieve upper and lower respiratory infections through improvement of lymphatic fluid circulation. Osteopaths use their hands to apply pressure to the affected chest wall. When the force applied reaches its maximum expiration, the practitioner will quickly remove their hands. This process increases negative pressure of the chest, helping the body's respiratory mechanism to move lymphatic fluids.

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 re-set natural reflexes. 

Muscle energy technique   

During this procedure the patient is asked to use their muscles from a specific position in a specific direction. The osteopath will then apply a counterforce. This will restore motion and decrease tissue and muscle changes. 


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 treat the myofascial structures. Osteopaths work by applying constant force to the myofascial tissues until release occurs. The dysfunctional tissues are guided along a path of least resistance until free movement is achieved.

Does osteopathy work?  

Osteopathic medicine has been proven effective for treating persistent lower back pain. In fact, the National Institute for Health and Care Excellence (NICE) recommends it as a treatment for this condition. 

Although there is limited evidence that osteopathy can treat other conditions, some research suggests otherwise. Osteopathic medicine can help relieve pain and discomfort of neck, shoulder and lower limb problems. It can even help with recovery after a hip or knee operation. 

Generally osteopathy is sought as a treatment for a range of health conditions. Many patients notice a significant improvement in how they feel after treatment. Several sessions may be needed to experience the benefits, but this will vary from person to person. 

How can osteopathy help? 

Osteopathic medicine can help people of all ages and abilities. Patients seek treatment for numerous ailments including back pain, postural problems (including repetitive strain injury), sporting injuries, muscle and joint problems, pain during pregnancy and growing pains. 

When treating patients, practitioners will aim to promote better movement and enhance the structural mobility of the body. In turn, patients are expected to see an improvement in the nervous, circulatory and lymphatic systems. Improved function delivers a more balanced body and better overall health.  

Many patients report improved sleeping patterns following osteopathy treatment. This is because pain and discomfort can lead to restless nights and exacerbate the body's inability to function properly. Osteopathy also improves our ability to cope with pain and this in turn leads to improved sleep.

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. 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 of 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. 


One of the most common misconceptions is that osteopaths can only treat back problems. The therapy can be used to treat many different conditions, illnesses and injuries, sporting or otherwise. Because osteopathy uses a holistic approach, and treats the whole body, many different ailments can be helped. This is often in conjunction with other treatments. 

Unsurprisingly, many people think that the methods used will cause pain. This is not the case. Osteopathic medicine should not be painful, although there may be slight discomfort as joints and muscles, which have remained unused for a long time, are stretched once again. 

An osteopath cannot cure an illness or recurring injury, but they can make living with a condition more manageable. Equally, they can also suggest ways of helping to prevent a recurring injury. Many will assist with the rehabilitation process during recovery. 

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