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What is osteopathy?

In Australia, Osteopaths are nationally recognised health practitioners that primarily work with the musculoskeletal system. This includes muscles, joints, nerves, bones, circulation and connective tissue.

They undergo between 4.5 & 5 years of university education with Bachelor and Masters qualifications. Besides learning about subjects specific to osteopathy, they learn about:

  • Practical hands-on treatment. This constitutes a large part of the osteopathic profession, but is evolving with more treatment options as technology & evidence changes. See treatment options for more information.

  • Exercise prescription to coincide with hands-on treatment as a way of helping with recovery.

  • The sciences of the human body including anatomy, neuroscience, physiology, pathology, pharmacology & biomechanics. This allows for osteopaths to adeptly work with other health professionals such as general practitioners when helping patients.

  • General medical examinations, such as checking blood pressure. These skills help osteopaths to screen for potential illnesses that require medical attention.

  • Radiology, which allows osteopaths to read, interpret and refer for imaging such as x-rays.

Most commonly, people visit osteopaths when they are experiencing pain in some region of their body. This is often as a result of a joint or muscle issue. However, there are many musculoskeletal conditions or associated symptoms that osteopaths aim to help with.

People that osteopaths help

We have experience helping people from all walks of life. Here are some common examples:

Conditions that osteopaths see

Below is an extensive but not exhaustive list of various conditions that our osteopaths may be able to help with. If you are uncertain of your condition then that's fine, we will discern a diagnosis and determine whether we will be able to assist you. If you have a condition or diagnosis that is not on this list then feel free to contact us. Alternatively, Osteopathy Australia has an extensive source of information on conditions and relevant evidence, click here.

Head

  • Headaches/migraines

  • Jaw problems

  • Vertigo

  • Nystagmus

Shoulder/Arm

  • Tendinopathy

  • Bursitis

  • Impingement/pinching

  • Arthritis

  • Sprains & Strains

  • Instability/dislocations

  • Frozen Shoulder/Adhesive Capsulitis

  • Post-surgery & fracture

  • Labral tear

Lower Back/Pelvis

  • Joint & disc problems

  • Arthritis

  • Muscle strains

  • Instability

  • Scoliosis

  • Post-surgery & fracture

  • Spondylolis & Spondylolithesis (splippage)

Calf

  • Compartment syndrome

  • Shin splints

  • Strains/tears

  • Tendinopathy, e.g. achilles

Ankle & Foot

  • Ankle sprains

  • Arthritis - ankle, foot, toes

  • Plantar fasciitis

  • Fat pad syndrome

  • Pisiform problems

  • Metatarsalgia

  • Sever's Disease

Neck

  • Arthritis

  • Disc problems

  • Joint sprains/ muscle strains

  • Post-vertebral fracture

  • Post-whiplash

  • Wry neck/torticollis

Elbow/Forearm

  • Golfer's/tennis elbow (medial/lateral epicondylosus)

  • Strains/sprains

  • Arthritis

  • Post-surgery & fracture

Hip

  • Tendinopathy

  • Bursitis

  • Strain

  • Arthritis

  • Hip dysplasia

  • Hip impingement

  • Labral tear

Other

  • Nerve impingement

  • Numbness/tingling

  • Shooting pain/sciatica

  • Chronic pain management

  • Anxiety, trauma

  • Digestive issues

  • Multiple Sclerosis

  • Parkinsons Disease

  • Fibromyalgia

Chest & Thorax

  • Rib sprains

  • Muscle strains

  • Costochondritis

  • Disc injuries

  • Post-vertebral or rib fracture

  • Scoliosis

Hand & Fingers

  • Carpal Tunnel Syndrome

  • Arthritis

  • Joint sprains/ muscle strains

  • Post-surgery or fracture

  • Instability

Thigh (Hamstring, Quadricep, Adductor muscles)

  • Muscles strain or tear

  • Tendinopathy

Knee:

  • Runners knee/patella pain

  • Iliotibial band friction syndrome

  • Meniscal problems

  • Ligamentous problems

  • Strains & sprains

  • Osgood's Schlatter Disease

Osteopathic consultation process

A consultation with an osteopath involves a 5-step process.

1. History

As a new patient, we have you complete a form prior to the consultation including details about your medical history. During the consultation we run through a range of questions pertaining your general medical history as well as your particular complaint/s.

Osteopathy medical history. Image of paper with medical notes.

2. Examination

We perform a physical examination, which involves looking at your posture, how your body moves & a range of orthopaedic tests. This provides us with a comprehensive understanding about how your body generally moves & more specifically the area of dysfunction.

<a href="https://www.flaticon.com/free-icons/physiotherapy" title="physiotherapy icons">Physiotherapy icons created by Freepik - Flaticon</a>

3. Diagnosis

We then explain our findings to you often involving an explanation about:

  • the injury or dysfunction

  • the factors that may have contributed to your presentation

  • areas that can be improved on or those that are doing well

  • the prognosis, i.e. expected recovery

<a href="https://www.flaticon.com/free-icons/quiz" title="quiz icons">Quiz icons created by Freepik - Flaticon</a>
<a href="https://www.flaticon.com/free-icons/quiz" title="quiz icons">Quiz icons created by Freepik - Flaticon</a>

3. Treatment & Management

We have a range of treatment & management options. See below.

Osteopathy treatment options

At Prom Health, our Osteopaths can provide a broad range of options tailored to your needs. During each consultation, we will determine which treatments are most appropriate.

Manual Therapy (hands-on treatment)

  • Massage - various types and depths. For example, inhibition, which is applying direct pressure to a trigger point in the body until it relaxes. Another example of massage is friction, which involves rapid, short movements over an isolated area.

  • Active myofascial release - a more active form of massage focusing on fascia (connective tissue) by incorporating movements by the patient. 

  • Muscle energy technique - a type of stretch in which the practitioner takes the patient into a stretch. The patient then repeatedly pushes against the practitioner & then relaxes.

  • Myofascial unwind - a gentle technique focusing on moving the patients body through muscle & fascial strain patterns.

  • Counterstrain - a gentle technique involving temporarily shortening aggravated tissues until they relax.

  • Joint mobilisation - the practitioner applies movement or traction joints in the body.

  • High velocity low amplitude (HVLA) - a technique involving a thrust to a joint generally leading to a cavitation/popping sound

With every treatment we use a range of techniques depending on your circumstances and needs. Often we will utilise most of the above techniques seamlessly throughout a single treatment, & typically we will combine multiple treatments styles together. We won't go through all of these factors during a consultation due to the time & disruption involved in explaining every element. In general, we explain that we will be doing hands-on treatment guided by our findings.

Two aspects in which we will provide warning & gain consent are when we expect part of the treatment to be more notably painful. Sometimes this is necessary to be able to achieve a particular result. Another aspect is regarding HVLA (popping) treatment. We pay particular attention to ensuring that you are comfortable with having this done & where appropriate, advise you of notable risks.

You always have a choice when it comes to the type & intensity of techniques used & you may stop treatment at any time.

Dry needling

Dry needling uses similar needles to acupuncture but it's foundations are based on Western Medicine whereas acupuncture is based on Eastern Medicine. The focus of dry needling is to insert needles in dysfunctional muscles/connective tissue.

At Prom Health, our osteopaths use a wide range of needles with lengths ranging from 30mm to 100mm and thicknesses/gauges ranging from 0.16mm to 4mm. This range allows us to treat a wide range of areas such as fine needles used to treat the jaw in cases of bruxism (clenching), to very long needles used in the gluteal region. Having a wide range of gauges allows us to pick a needle thickness to suit the constitution of the patient, e.g. someone more stressed will need a finer gauge needle.

Needles can be inserted to pretty much anywhere besides the nipples, genitals, umbilicus & eyes. The number of needles inserted is generally between 4-12 and are left in for several minutes. We tend to find needling to be most appropriate for situations in which:​

  • The nervous system is over-active/sensitised, such as stress leading to neck tension & headaches

  • The muscles are in a spasmodic state & won't respond well to manual therapy, as found particularly in an acute phase of injury

  • The muscles & connective tissue are overly developed/thickened, such as the forearms of manual labourers, as we struggle to break through all of the relevant restrictions solely using manual therapy

  • The patient is particularly sensitive to manual therapy; for example, patients with an active fibromyalgia flare

  • Dysfunctions of the nervous system, such as cramping, tics, muscle fasciculations (twitching)

We discuss the relevant risks associated with needling. Generally the needle insertion involves a sharp prick on insertion and then perhaps a dull awareness. Occasionally the experience is more intense and we will accommodate accordingly. Commonly patients will report tiredness and find spot bruising from needling. Please advised us if you are taking anti-coagulants (blood thinners).

Patient recieving dry needling to the shoulder region

Photobiomodulation (High Power Laser)

High Power Laser Therapy or more formally Photobiomodulation, involves projecting near-infrared light waves into the body.
 

Main area of target the energy producing part of cells calls 'mitochondria'. Energy (photons) from the light waves interact with the parts of the mitochondria that lead to an increase in cellular metabolism which promotes tissue healing & a reduction in pain.

To ensure that the infra-red light waves target the relevant tissues with the right dosage, we input into the machine aspects such as the location & duration of condition, skin & body type. The light used is between a spectrum of 650-1300 nanometres in length which allows for penetration of deeper tissues.

 

The machines that we use are up to 25 watts in power. This is a more advanced machine and it ensures that sufficient amounts of energy can be transmitted to the deeper structures as much is reflected or absorbed superficially at the level of the skin. It also helps reduce the length of time for a session down to 2-10 minutes, allowing for other treatments to be used as well.

Photobiomodulation can be used for a wide range of conditions. We have found it most beneficial for speeding recovery of acute injuries & after surgery as well as assisting in the improvement of chronic/complex conditions, especially when other avenues have been tried such as exercise prescription, manual therapy & dry needling. We have also found it to be particularly helpful when treating achilles tendinopathy & plantar fasciitis in conjunction with radial shockwave therapy.

Lightforce photobiomodulation (high power laser) device.

Radial Shockwave Therapy

Radial Shockwave Therapy involves delivery of intense sound waves in short bursts.

Despite being widely used and validated for effectiveness, the exact mechanism of how shockwave therapy works remains unclear. Nevertheless, the general consensus is that physiological changes are created which lead to a chronic injury becoming more acute in nature. This then gives the body an opportunity to heal the area more adequately.

We have found shockwave therapy to be particularly beneficial for chronic injuries involving thick or stubborn connective tissue. Conditions include:

  1. Plantar fasciopathy or fasciitis

  2. Achilles tendinopathy

  3. Patellar tendinopathy

  4. Gluteal tendinopathy

  5. Calcific bursitis

Often we can adequately address connective tissue/tendon issues adequately using other methods such as manual therapy, however, we sometimes find creating change difficult due to the depth of restriction of this tissue. For example, the average thickness of an achilles tendon is 6mm, making it a very robust structure in the body. We have found shockwave to be an ideal means for creating change in such dense tissue.

At Prom Health, we use radial shockwave in conjunction with other treatments such as manual therapy, exercise prescription & photobiomodulation as tailored to the individual.

Chattanooga shockwave device at Prom Health.

Braces

Braces can be a very useful adjunct when recovering from injury or when maintaining a chronic condition. Braces can be used to provide support & offload an injured site. They can also be used to compress an area which enhances circulation & therefore healing. At Prom Health, we have tested products from a range from suppliers and know which ones work best for which condition. Our stockists include Bauerfeind, OAPL, BioSkin, Serola, Mueller & Thermoskin.

The slideshow demonstrates some of the products sold at Prom Health. Our practitioners ensure that the product is an ideal fit and if not, they will source another product for you.

At Prom Health, our osteopaths also offer Exercise Prescription, Taping, Massage Devices, Topical Creams & Supplements.

FAQ

  • When do I need a scan such as an x-ray, MRI, CT or ultrasound?
    Only when it is appropriate. Much of the time, osteopaths can diagnose an injury or complaint without having to refer for a scan. We generally send patients for imaging only if a diagnosis is not clear. When referred by an osteopath, full and partial rebates on x-rays are available. The specific amount is dependent on the part of the body imaged and the type of imaging used. Rebates are also available from your local GP & for a wider range of types of imaging. If imaging is needed, we will discuss which option is best.
  • Do osteopaths prescribe medication?
    No, osteopaths do not have prescription rights. We commonly recommend speaking to a doctor or pharmacist in relation to finding the best pain-relief options for your needs.
  • How long does an appointment go for?
    Initial consultations: 40 minutes Standard consultations: 30 minutes Urgent consultation: 15 minutes
  • Do I need a referral?
    No, you do not need a referral.
  • Can I bring a carer, partner or my children?
    Yes, you are welcome to bring another person along to the consult when necessary.
  • What do I wear to a consult? Do I have to undress?
    To adequately assess and treat a condition, we may ask that you partially disrobe to expose the area of interest. For example, this means removing a t-shirt or jeans, however, undergarments remain on. ​ Your comfort is most important. If you are sensitive about your body, an option is to wear a singlet with fine straps or loose fitting shorts. Gowns are also offered as an option & we always use towels for draping.
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