What is osteopathy and why should you see an osteopath?

Priscilla Chellaram is an Osteopath who runs osteopathy clinics at the Specialist Medical Clinic in Gibraltar, three days a week.
Many people misunderstand the scope of osteopathy and don’t understand how osteopaths differ from other practitioners such as physiotherapists and chiropractors, so we spoke to Priscilla to find out more and present her with some commonly asked questions.

Can you start by explaining what osteopathy is?

I think the best description of osteopathy can be found on the General Osteopathic Council website, “Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.”
The common assumption is that people visit us for back pain, however, we treat many problems of all the joints, including tendonitis, muscle injuries and neuropathies. As an osteopath I am also qualified to carry out workstation assessments to advise on changes which can prevent, help or alleviate problems.

What’s the difference between what you do and a physiotherapist or chiropractor?

Generally, we work in similar ways in the field of musculoskeletal health. However, osteopaths always look at the body as a whole as part of our treatment plans. We also practice visceral and cranial work, not carried out by others. We are also involved in helping the body to heal following birth trauma.

Can you give me an example of a common problem and how you would treat it?

I treat a lot of people with musculoskeletal pain. If a patient, for example, came with a painful wrist, I would not only assess the specific area of pain, but also the rest of their arm and back, neck etc.
The initial session involves an in-depth conversation regarding the problem as well as a hands-on examination. Patients are given “homework” between sessions to continue to improve strength and function. Commonly, between two and six sessions are required.

How do you help people with back pain?

Studies conducted in the UK and the US have shown that osteopathy significantly reduces lower back pain compared to active treatment or placebo control. Research also revealed that significant pain reduction was observed during short-term, intermediate, and long-term follow-up.
When a patient comes to me with back pain, I try to ascertain the root of the problem using questioning and physical examination. The treatment very much depends on this, but can include soft tissue work, ultrasound, dry needling, electrotherapy and manipulation when required.

How can you help people with arthritis?

Arthritis can be helped by gentle soft tissue work, ultrasound and sometimes dry needling. The aim is to calm everything down and then work on strengthening the muscles and improve function at home, to try and prevent future exacerbations.

Can you help with migraines?

Yes I can! Depending on the reason for the migraine, manipulation, dry needling or cranial work may all help.
A recent study published in BMJ Open reviewed the results from five clinical trials and concluded that osteopathy can be a safe intervention for the treatment of headaches and our experience with patients certainly backs this up.

What should a patient expect from an appointment with an osteopath? Does it hurt?

Your first appointment will be around an hour and will involve an in-depth conversation regarding the problem as well as a hands-on examination. Most people will be asked to partially undress to assess the problem.
The treatment may hurt, although I try to avoid this as much as I can. When there is inflammation, being treated for this can be uncomfortable.
Following treatment there may be a flare up, which then calms down.
However, we try to be as gentle as possible and reduce any discomfort as much as we can.

Are there any things you wouldn’t treat and that would be better treated by another speciality?

Not really, it’s a case of assessing each patient and deciding on the best approach to their particular issue.
If, after working with a patient for a number of sessions, I could see that the patient was not progressing as expected, or that a problem was identified that needed further investigation, I am in the fortunate position of working as part of a multidisciplinary team.
I can refer patients to Specialists or Physiotherapists in the clinic whenever necessary and discuss their cases with my colleagues to find the best solution. We are also able to organise referrals for further investigations if required.

Are there any risks to osteopathy? Can it make back problems worse if not carried out correctly?

In order to minimise issues and potential risks, it’s vital that the correct examination is performed, including neurological checks. If manipulation is carried out when contraindicated, damage can also be done. This is why an initial case history assessment is very important, and why the initial appointment is around an hour.

Do people need to come and see you regularly?

Not usually. On average a patient will need around three sessions with me when a problem occurs, but this will obviously depend on the individual and their specific issue, people don’t normally then need to come to see me regularly. Although, some patients find it useful to visit around every six weeks to prevent problems from occurring.

Meet the Expert

Priscilla Chellaram is an Osteopath in Gibraltar who trained at the British School of Osteopathy, qualifying in 1993. She then worked in London and Munich before returning to her home in Gibraltar, where she has worked ever since. She offers a full osteopathy service in Gibraltar, with a particular interest in cranial osteopathy as well as visceral work, fascia release and whiplash.