An Osteopath’s Perspective on Back Pain

Invited to take part in the Royal United Hospitals Bath and Bath Institute for Rheumatic Diseases (B.I.R.D) ASCAM (Ankylosing Spondylitis Complementary and Alternative Medicine survey) available at:

If you have Ankylosing Spondylitis and would like to know more about this study you can email them: If you wish to know more about B.I.R.D: This is a registered charity working to improve treatment for patients with rheumatic diseases.

The survey asked an interesting question, I thought the answer might be of interest to our patients and provide a ‘snap shot’ of An Osteopath’s perspective on Back Pain.

Tell us about your experience of diagnosis and treatment of back pain?

In this question we are interested in the different types of back pain clients have presented with and what approaches you take to help them manage their symptoms.

To which I answered the following:

A Huge question:

Firstly, different types of back pain:

1. Traumatic onset

2. Inflammatory/Rheumatic onset

3. Emotio-somatic onset

4. Physiologic adaptation ie. growth phases in children/teenagers –  additionally important where scoliosis/kyphosis may also be developing; the management and treatment of scoliosis is a really important aspect of an Osteopath’s work.

5. Physiologic adaptation ie.  pregnancy


Secondly, what approaches do I take to help clients manage their symptoms?

Careful detailed case history taking typically takes over one hour plus which includes a life events chronological study of how the health has responded to certain life events.

Thorough examination of the patient – postural assessment, gait analysis; careful and thorough musculo-skeletal examination, systems exams ie., GIT, respiratory, neurological etc., careful screening and triage which may trigger onward referral for further investigations through the GP via Letter to the GP with patients informed consent to do so.

Osteopathic assessment of the patient through palpation skills – a huge part of what we do – enabling discrete and specific information gathering through our hands which furthers our understanding beyond the scope of the case history, which may dovetail beautifully with the information acquired through case taking but which also elicits further information.

Osteopathic treatment – ability to ‘know normal’ in the patient’s tissues and what represents a deviation from the individuals’ health. A huge and complex area of Osteopathic palpation – a discussion beyond the scope of this remit. But from which informed understanding is gained of the health and therefore enables the practitioner to evolve a working treatment plan/diagnosis/prognosis/further questions and may trigger the need for onward referral. Most but not all my A.S (Ankylosing Spondylitis) patients have received a formal diagnosis. This is not generally the case for most of my patients – they are largely presenting as without formal diagnosis or previous investigation, so onward referral can be an important role for an Osteopath to take with their patient and for which we are highly trained and competent to do so.


Patient management of their condition and understanding of also takes an important part of the consultation process and may involve:

1. Onward referral;

2. Referral to other therapies alongside Osteopathy;

3. Discussion of diet; life-style; emotio-psychological state;

4. Additional exercise programme or refining and helping managing patient’s expectations/ instigating new understanding and new exercise programme.

5. Attain a relationship with patient where patient realizes that they can contact the practitioner for further support and guidance especially during acute phase flare up’s to help manage their condition.

For further information regarding Osteopathy/Homoeopathy and managing Ankylosing Spondylitis and other rheumatic diseases, please contact Carolyn McGregor Registered Osteopath Registered Homoeopath.


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