Patients often tell us, "how do you know that it hurts there?" In the same way a trained blind person can read Braille through their fingers, osteopaths are trained at reading what is happening under their fingers while treating or examining an area of the body. In a clinical context, during physical examination, palpation is the professional use of touch to assess tissue behaviour and determine their quality of movement, stability and behaviour when in pain or presented with a particular condition. Palpation is also used during the treatment to get feedback on how the tissues respond and to help decide if more or less pressure is needed.

In short, Osteopathic techniques should not be painful but sometimes may cause some discomfort when applied. Often patients describe this as "good or beneficial discomfort". Osteopathic manipulative techniques consist of massage or soft tissue techniques and joint mobilisation called articulations. The forces used will directly be proportional to the person's strength or frailty or the pain levels that you are on the day of the treatment. Sometimes we use subtle and gentle techniques called Cranial or Functional or more affirmative techniques like clicking or High-Velocity Trusts (HVTs). Your osteopath will discuss your treatment options and which techniques may be unsuitable for your particular needs. They will also discuss any possible treatment reactions that occasionally occur after treatment and will inform you on what to expect so that you can take an informed decision about what works best for you. Your practitioner will ask for your consent throughout your appointment before they perform a technique. However, if you feel uncomfortable or unsure at any stage, you have the right to withdraw your consent.

As we cannot provide a chaperone service, we strongly advise legal guardians to attend the appointment with their children under 16 for at least the first appointment. If this is not possible, please provide written and verbal consent from the legal guardian and contact the clinic before your appointment.

Typically Osteopaths begin their treatment by releasing and relaxing muscles and stretching stiff joints, using gentle massage techniques, rhythmic joint movements and muscle release techniques. The osteopath may also manipulate (click) specific joints. While manipulation can be suitable in some presentations, it is not always essential, and other techniques may be as effective as clicking the joint. Some of our osteopaths also use acupuncture as part of their treatment. If this may help your recovery, they will explain the procedure and obtain your consent before proceeding. The osteopath will always try to discuss the benefits or risks of any treatment modalities with you to help make an informed decision on what works best for you.

This depends on your condition. Generally, you would expect to see some changes in your symptoms after one or two visits, but more complex, long term or chronic conditions may require more appointments. Your osteopath will discuss this with you and provide you with an indication of what length of treatment you might expect.

Like with any healthcare appointment, it may be necessary for your osteopath to ask you to remove some clothing. This is because they may need to assess the spinal curves or ensure no signs of tissue injury are present. They will also want to touch to evaluate the quality of the tissue or apply manual treatment to the area of concern. They will explain why this is needed and will ask for your permission. Your osteopath will want you to feel at ease. Therefore if you feel uncomfortable undressing to your underwear, you may prefer to wear comfortable garments like shorts and a t-shirt that will enable them to work effectively. They will always ask you for consent, so please discuss this with them and make appropriate arrangements. If you feel uncomfortable, please let your osteopath know, and they would be happy to discuss how best to adapt to your needs. You may wish to seek treatment from an osteopath of the same sex as yourself. Just book your appointment with your preferred therapist. You are also welcome to ask a friend or relative to accompany you and be present throughout your consultation and treatment.

Your initial consultation should not take longer than one hour. During this time, your osteopath will ask questions about your current problem and general health for approximately 10-15 minutes. If it is appropriate and you are happy to proceed, your osteopath will perform a physical examination with various tests and assessments. They will then discuss their findings and agree on how best to proceed. Here they should be able to inform you of the diagnosis and the factors contributing to your complaining presentation, tell you how long it should take and what you can do to speed up the recovery process. Finally, they will explain the benefits and risks associated with osteopathy and osteopathic treatment. With your consent, they will typically proceed with manual treatment if this is appropriate for your condition and show you some movements that can help you. Occasionally, when osteopathic treatment is not indicated, they will discuss with you the best course of action and write any appropriate referral letters so that you are cared for appropriately. Any follow-up appointments should take 30 to 50 minutes, depending on what you need to do. During this time, the osteopath will re-assess your symptoms and movements to help them gauge progress before treating you.

We will ask you to continue with any medical treatments by your doctors during the course. Still, we will ask you to refrain from having additional manual therapies for the duration of the system to understand if this approach is helping you.

Research has shown that people with persistent pain can benefit from multidisciplinary healthcare and that self-management programmes can help improve emotional health and decrease medication and reliance on treatment. Over the last ten years, a group of osteopaths have been developing a new type of pain management course, which aims to help people with long-term pain to find effective coping strategies and ways to live fuller lives, despite their daily pain. Each course is for one individual patient at a time (i.e. no group work) and consists of six to twelve one-hour sessions, which combine osteopathic treatment, mindfulness-based exercises and home practice to help you to develop new self-care skills.

Sometimes, people initially report worsening symptoms during the first few sessions, which can concern some. It is often because, with our mindfulness techniques, we ask you to analyse your discomforts in more detail and increase your awareness towards these. These side effects are normal and safe and will likely improve throughout the course when you start to feel more comfortable with mindfulness. In case this pain response happens, we will support you throughout. Severe reactions to normal osteopathic treatment are rare and occur in less than one in over 100,000 consultations. However, the OsteoMAP techniques differ from our usual Osteopathic techniques. In this case, the aim is to help you recognise what your body can do instead of the typical osteopathic manual approach, which aims to do the movements for you. As a consequence, none of our patients have experienced any such reactions. It can be challenging to confront the impact of pain on our lives. It's natural to feel upset or even depressed when forced to think about these things. However, it's important to remember that this process is necessary to learn how to cope more effectively. While it may be frustrating, we can take comfort in knowing that we're taking an essential step towards healing and growth.

During the first consultation, we will explore the appropriateness of this type of approach. For example, we will take a detailed case history and read your previous medical notes to ensure that the pain is not caused by a condition that needs medical intervention. Then we'll discuss your concerns about the discomforts that you have been experiencing, further exploring how these have affected the relationships with your family and friends, work and yourself. We will identify with your help what is important in your life and decide with you on some simple daily activities that will help you live better. Each session involves a mixture of osteopathic treatment, discussions about the impact of pain in your life, and different activities to help you learn about your body, reactions to pain, what your symptoms mean and different ways of managing these. The aim is not to "fix" the pain but to understand it in all its forms. The course works best if you are willing to participate fully in the activities and explore different ways of coping with pain. Still, all activities are optional, and you do not have to do anything you do not feel comfortable with.

Research and our patients have reported coping more effectively with their symptoms and participating in some activities they did not think were possible with their pain. You will better understand how pain currently affects your life and develops.

NO. The course teaches you why pain is still present despite no clear medical reasons or when previous injuries have healed physically, but you still experience pain. Therefore, we have found that this type of intervention works best when you are willing to explore avenues not aimed at "fixing" a particular problem with an intervention or operation. Instead, if you feel you can still get help this way, you should explore these first with your doctor or consultant. We suggest booking the first consultation with your OsteoMAP consultant if you still need to determine if it is for you. We are specialists in understanding medical complexity and help you make informed decisions about your health and well-being. You can also stop whenever you feel that OsteoMAP is not for you. A lot of learning occurs in between the weekly sessions. It would be helpful if you set aside about 15 minutes each day for home practice which requires some minor commitment.