What happens when you first see an Osteopath?

I understand that when you're in pain, it can be a nervous experience seeing an osteopath or other health practitioner for the first time. I hope that by explaining what happens in a typical osteopathic consultation, I can de-mystify it a little!

I allow up to an hour for the first visit to allow plenty of time to discuss your symptoms, perform an examination and allow time for treatment if I think it's appropriate. I take a history of the symptoms and problem you come to me for help with. I then ask lots of questions about your medical history. Some people are surprised that osteopaths need to know the medical history, but it's important to help us decide if osteopathy is the best treatment for you, if it's safe, to identify any symptoms that may need further investigations and ultimately help you get the best possible care.

It's helpful to bring a prescription list and a copy of any medical investigation reports to your first session.

After the medical history, I then do a physical assessment. This usually requires you to undress down to your underwear, but I always encourage patients to wear shorts if they would be more comfortable and chaperones are always welcome to be present during appointments. It's important to note that for patients 16 years and younger, we need a parent's consent and a parent or guardian needs to be present for the whole session.

The physical examination usually involves:

- Postural assessment.

- Checking the movement of your joints and muscles.

- Orthopaedic tests, that doctors use as well.

- Neurological tests, such as reflexes, muscle strength and nerve sensations.

- General health checks, such as blood pressure and pulse.

Osteopaths won't just assess the area where you're experiencing pain for three reasons:

1. Sometimes a problem in one area can cause 'referred pain' to another area.

2. Particularly if a problem has been going on for a long time, you can have changes in other areas of the body that would benefit from treatment.

3. It's possible to have more than one issue at the same time, so it's important to assess the whole body.

After the assessment, I fully explain everything that I have found and often use drawings and models to demonstrate. I think it's really important that we understand our body and how it works, especially when there's an injury or problem. If you understand what's going on and why, this often reduces the anxiety around the pain and you can be actively involved in the recovery process.

I only have 30-60 minutes with a patient, so I have to give you the knowledge to make the right choices for your health outside of treatment. If you understand what's going on, you're better equipped to do so.

If I am concerned about any symptoms needing further investigations or if I feel osteopathic treatment isn't the best treatment for you, I will always refer on to the correct person. When referring you to your GP I always write a letter to explain what I assessed and why I feel osteopathy isn't suitable. I strive to give the best possible care for my patients and understand that sometimes that is to refer you on quickly.

If osteopathy is helpful for you, I will explain my treatment plan and roughly how many sessions I believe you will need. Obviously with the human body it can be difficult to predict precisely, sometimes people respond faster than expected, but also sometimes issues take longer to resolve. I always explain how I expect things will progress and what I would do if the symptoms aren't responding as I'd expect.

My aim is to get you back to the activities you enjoy and free from pain as quickly as possible. I also give lots of advice about exercise and lifestyle to help you stay well without the need for osteopathic treatment. When treating people with long-term conditions, I think it's especially important to teach you techniques to help yourself, rather than need regular treatments. However, I feel osteopaths can play an important role in the 'health team' of patients with long-term conditions and be on hand when needed (no pun intended with "on hand"!)

Consent is a really important part of the assessment and treatment, so I always explain what I'm going to do before I do it, why it is necessary and get your informed consent. Before starting any treatment I always ask for your consent and encourage you to ask as many questions as you wish- there's no such thing as a silly question!

Once we've discussed everything, if you're happy to proceed then I usually start treatment. Osteopathic treatment varies depending on the area of the body and the problem, as well as your shape/posture and preferences to treatment. Techniques I can use include:

- Soft tissue massage.

- Muscle stretches.

- Muscle energy techniques (MET), using your movements to aid muscle stretches.

- Gentle joint movements (mobilisations).

- Joint manipulations, the 'clicking' (manipulations).

- Dry needling (medical acupuncture).

- Sports tape.

I use a programme called 'Rehab My Patient' to create tailored exercise plans that are manageable, including photos and videos. Patients have told me that it's really helpful because they can print the exercises out and place them somewhere they will see regularly as a reminder to do the exercises, but they also have them on their phone so they can check to do them correctly when they're at work or away from home.

I hope this has given you an idea of what your first osteopathy session involves. Please do let me know if you have any questions!

Zoë Clark is a registered osteopath trained at the British College of Osteopathic Medicine in London. Practicing in Howe near Norwich (01508 558373) and Burston, near Diss (07543 557746) in Norfolk.

Email zoeclarkosteopath@gmail.com

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