Physio or Osteo?

Physio.  I feel very strongly about this.

there is some bleed over between the two but given the basis of osteopathy is well proven nonsense and there is no evidence for it doing any significant good

Get a good sports physio.
I now have reoccurring appts as even if i am not injured i can get a session as preventative work

A good one of either, get some local recommendations.

Yes some osteopaths claim complete quackery like being able to cure flu, but 90% of them are just physios with a different box of tools (mostly of the hands on stretchy, manipulating, massaging kind).

Similarly there are plenty of physios who will take your expensive referral, bill your insurance and give you a photocopied sheet of stretches that may or may not solve the problem but your insurance will run out before you'll find out anyway.

I agree there is some bleed over (a local osteopath identified the 'laxity' around my pelvis which I had taken to be 'flexibility'. Now seeing a physio who entirely coincidentally has me doing a lot of work to stiffen and support area around pelvis).

Osteopath also typically does a bit of massage and soft tissue stuff to help relax tense muscles. However I could have done without all the weird popping of joints in strange twisted postures etc. I don't really believe in it and rarely felt any better for it.

Physio for the win, but it sometimes requires that you find the *right* physio

At the risk of incurring TJs wrath, I've had results from both. I've tended to find that the physio is better for nerve related issues and the osteo for musculoskeletal things.

Ask around any sporty friends for recommendations locally to get a feel for ideas

Personal recommendation from someone in your circle or runners / riders carries weight, esp if they're running at similar level / volume as you are. Matters more than physio / osteo / chiro labels.

More cash - anecdote is not evidence:-)

all the weird popping of joints in strange twisted postures etc. I don’t really believe in it and rarely felt any better for it.

It has zero evidence base for doing good and plenty of evidence of harm

Physio if you want to get to the bottom of a problem and be given a solution

Osteo if you want to be touched touched and physically

Physio. I'm with TJ. Osteopathy is quackery. Every physio I've dealt with does a bunch of deep tissue massage to help with recovery from issues.

I don't really have much idea about these things but a couple of years ago I had a lot of hip/leg pain and went to see the Osteo that my wife had recommended.

He diagnosed a Sacroiliac joint problem, did some bendy hurty stuff and it went away in about a week - it def wasn't going to go away on its own..  I've no idea if a Physio would have been better.

.... I'm not sure that really helps you TBH!

Sharkbait.  almost certainly it would have gone away in the week anyway.  that the problem with this stuff.  Much of it is self limiting and gets better in time anyway.  But if you have osteo and it goes away in a week then you get confirmation bias and believe its the osteo treatment that cured it when actually its co incidental

A big research project looked at this and found very little difference in recovery times between ostopathy for back pain and painkillers and graduated exercise

Its further confused in that some osteos use physio techniques and the occasional physio uses osteopathic techniques

Just to add to the confusion around evidence base.  accupuncture which the rationale for it working is clear nonsense to those of us trained in western medicine actually has an evidence base for working!

Evidence based practice is the key.  Osteiopathy has no evidence base ( physio is not great either 🙂 )

The difference between a physio and an osteopath or a chiropractor is that physiotherapy is derived from evidence based practice and ONLY evidence based practice, whereas osteopathy and chiropractor both have their origins is some very dodgy 18th century quackery. However, caveats ahoy: there is nothing stopping individual osteos and chiropractors adopting evidence based practice and becoming more like a physio, and it is my understanding that this does happen- anecdotally more amongst the osteos than the chiropractors, but I have no numbers to back this up. I also know that osteopathy training involves an excellent grounding in anatomy, so there is that at least. So, TLDR, it is prob worth going to a specific osteo if your friend recommends them (I think this is what the OP had in mind?), especially if the injury is the same as yours. Or, if you're the sort who prefers a faith healer type approach, then crack on

It has zero evidence base for doing good and plenty of evidence of harm

Not zero evidence. See for example https://link.springer.com/article/10.1186/1471-2474-6-43

OMT significantly reduces low back pain. The level of pain reduction is greater than expected from placebo effects alone and persists for at least three months. Additional research is warranted to elucidate mechanistically how OMT exerts its effects, to determine if OMT benefits are long lasting, and to assess the cost-effectiveness of OMT as a complementary treatment for low back pain.

I don't think manipulation will cure covid. I've been a couple of times in the past. My feet used to point 2 o'clock, and now they are at 5 to 1. Was quite a shock in more ways than one. After road accidents, it's been physio.

What TJ said.

Osteopathy and chiropractic are both based in quackery. Their modern incarnations include other techniques which may be efficacious (the chiropractic term for this is "mixer") but then, why not just have those other treatments in the first place? If you need some plumbing done would you go to a plumber, or go to an astrologist who does a bit of plumbing as well?

Go see a physio.

Sharkbait.  almost certainly it would have gone away in the week anyway.

Sorry TJ but absoluetly not..... I'd had it for a couple of months with no change - that said, was I treated with Physio techniques? I honestly don't know!

I'd echo the above in terms of following a personal recommendation - I've had crap physios in the past, and now see a good osteo. Does she use some physio techniques? No idea. Does she address the issues I seek treatment for? Yes.

A decent osteopath will be good for acute pain whereas a good physiotherapist will sort out chronic pain in my somewhat limited experience.

I though it was the chiropractors that claimed they could cure things other than musculo-skeletal disorders with the laying on of their (expensive) hands.

However I could have done without all the weird popping of joints in strange twisted postures etc

First time I had my neck done by an osteopath was amazing - felt I had more mobility than an owl!

Admittedly, we used to execute people in a similar manner!

I though it was the chiropractors that claimed they could cure things other than musculo-skeletal disorders with the laying on of their (expensive) hands.

they can no longer claim to cure many things following a court case which they lost because there was no evidence for the cures they were claiming

Osteopaths make all sorts of claims as well but cover their arses by saying " we can treat" not "we can cure"

sure - I can treat your bad childs colic with lemon juice and water - it won't help but I am treating it

There are a few threads on here about this.

All of TJ's issues with osteopathy (as a whole big bucket of individuals representing a field) can be just as easily levelled at physios (same.... - bucket of individuals...)
evidence base - similar
regulation - similar
support of NHS/NICE - similar
dodgy origins - similar

And we've had both osteos and physios on here saying the same. I thought we'd made some progress last time round, but apparently not! [edit: just re-read - apparently a bit!]

But you can ignore all of that, you're not seeing an entire field, you're not going to be seeing the father of physiotherapy as a concept, or the father of osteopathy as a concept, you're going to be seeing someone acceptably close to you so you can see a few times, who's had good results with people you trust to make recommendations about. Someone who cares, who's intelligent and curious in identifying the root cause of your issue and helping you resolve it.

Don't pick a label, pick a person.

An article worth reading for those thinking of this sort of stuff

https://www.theguardian.com/lifeandstyle/2015/oct/18/osteopaths-chiropractors-back-pain-whose-spine-is-it-anyway

Note what NHS choices says about it

there is a lot more and osteopathy has been shown be damaging.  Basically its bunkum.  spinal manipulation is dangerous

Jeff Cavaliere is the answer to your question.

https://www.nhs.uk/conditions/osteopathy/

https://www.nhs.uk/conditions/physiotherapy/

However, the NHS Choices website says “some uses of chiropractic treatments are based on ideas and an ‘evidence base’ not recognised by the majority of independent scientists” and “the use of osteopathy isn’t always based on scientific evidence”.

The NICE reccomendations are being reviewed and its expected to be much more critical of spinal manipulation

SMT is spinal manipulation therapy

This is the result of a meta study in the BMJ where a number of the contributor where funded by chiropractic ostopathic bodies so would expect to find a favourable result

The evidence suggests that SMT results in a modest, average clinical effect at best: future trials on the effect of SMT for chronic low back pain are not necessary, unless they contain a novel approach, are well conducted, and address any of these specific recommendations.</p>
<p id="p-85">Private or governmental agencies should refrain from funding small trials that are poorly conceived.</p>

SMT produces similar effects to recommended therapies for chronic low back pain but results in clinically better effects for short term improvement in function compared with non-recommended therapies, sham therapy, or when added as an adjuvant therapy. Clinicians should inform their patients of the potential risks of adverse events associated with SMT.</p>

</div>
https://www.bmj.com/content/364/bmj.l689

Don't have time for a long one this evening.

Physios use SMT too.

If that's the same meta-study we've talked about before, there were plenty of physios included in it. Any questions, valid concerns about SMT should be asked of anyone who's looking to do anything with your spine.

Edit. None of this ever helps the OP in these threads.

@lunge - Ask for recommendations from people you trust near you. Don't go and see a shit physio with a track record of non-help or making things worse over an excellent osteo, or vice-versa.

Thats a meta analysis of many studies  Its a very high level of evidence

I have put the info up.  folk can make their own mind up but the evidence base for spinal manipulation is barely there at all, It can cause strokes, most actual doctors will recommend against it.  people have been left crippled by it

Its not based on anything scientific at all

Any questions, valid concerns about SMT should be asked of anyone who’s looking to do anything with your spine.

Only if they have a proper medical qualification.otherwise it has no validity

Glad to say my osteopath fixed my sciatica pretty quickly. He was also the European Golf Tour Osteopath for a while and now runs a clinic in Muscat. I would be quite happy to let him fix me any day. ...The same would not be said for the local NHS Physio who had first shot at me....

Edit. None of this ever helps the OP in these threads.

Really?  all data is good in deciding and if it prevents one person being damaged by SMT or wasting their money its good enough for me

I hope that helps provide some good quality evidence from high level research which shows the evidence base for osteopathy is poor and that it can be crippling and dangerous

I hope that helps provide some good quality evidence from high level research which shows the evidence base for osteopathy is poor and that it can be crippling and dangerous

No. High-level research studying effectiveness of one set of techniques used by physios and osteos alike is not especially helpful to someone trying to decide between 2 or 3 individuals near them. Certainly much less useful than them asking around about who's helpful and who isn't.

@lunge a sports physio or a registered Sport Rehabilitator would be a good bet, there are lots who specialise in running related issues too. Whereabouts in the country are you? If I know of a clinic in your area that I’d be happy to send patients to for this kind of issue, I will drop you a message… 🙂 If it seems to be lingering with treatment then a good SEM Dr will be able to help, although hopefully that won’t be needed!

Re osteopathy, there have been some interesting thoughts on this recently, refs and links for further discussion are in the post:

https://m.facebook.com/story.php?story_fbid=pfbid02n1ExP8tDjP8P5RT2pr8c2g2rop81D6SrqvH7uRbPy2FJzjuxoZN9U3Xa9PA83rCql&id=571450524

ned has also pointed out to me that some physios use spinal manipulation.  IN my book that makes them also someone to avoid and of course there are poor physios as well.

There are also people working under the "osteopath" label who use physio techniques and not the potentially dangerous spinal manipulation.  Ned certainly seems to be a conscientious practitioner tho I do not know his techniques

That a bit fairer ned?  🙂

Bit fairer, yes. Thanks for actually reading what I've written. Maybe the OP doesn't have anything wrong with his back.

But if you go to see someone for help with a bad back - shock horror - chances are they'll touch your back. Doesn't matter what they call themselves. It's probably quite rare that you'll find someone who'll say they're not going to touch you at all and send you away with a box of ibuprofen and suggestions of nearby walks.

If they do touch your back, it may help a bit or it may not. If you're unfortunate, you might end up worse off. If you're very unfortunate and see someone reckless, you might be seriously injured.

So find recommendations for someone good, talk to them about what they're suggesting as treatment.

Same goes whether you've got a problem with your back, your hip your knee or your elbow.

Ned certainly seems to be a conscientious practitioner tho I do not know his techniques.

I am, thank you. My techniques are related to insurance underwriting and are predominantly in spreadsheet manipulation - I have told you that before, TJ!

memory of a sieve. 🙂  i thought you were an osteo.    Do'h!