| Chiropractic and osteopathy
are both manipulation-based therapies used for treating problems
associated with bones, joints and the back. The two therapies
have much in common, but chiropractors tend to focus on the joints
of the spine and the nervous system, while osteopaths put equal
emphasis on the joints and surrounding muscles, tendons and ligaments.
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| How they work |
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| Chiropractors and osteopaths
share conventional medicine's view that the human body is like
a machine and that any disease is due to a breakdown of part of
the machine. However, they also believe that many health problems
can be traced to poor posture and to misalignment of muscles and
joints (and, with chiropractic, particularly the spine). They
suggest that, if the structure of the body is improved and the
spine put back into alignment, its function will improve, problems
will be alleviated and good health restored. Misalignment is usually
thought to be due to an external cause, such as a fall or other
accident (even one that happened years before), or to long-term
poor posture. |
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| What they are for |
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Osteopaths and chiropractors
both mainly treat back and neck pain. But they are also treat
other health problems, such as headaches, migraines, vertigo and
tinnitus (ringing in the ears).
Some practitioners also treat a wider range of diseases, including:
- heart and circulatory problems
- arthritis
- sports injuries
- digestive problems
- asthma, and
- period problems
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| Are they effective? |
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While osteopathy and chiropracty
are well accepted by many conventional medical practitioners,
the scientific evidence for them is relatively sparse, and very
few medical studies have compared the two therapies with each
other. However, the evidence is stronger for chiropractic than
osteopathy, with a few studies showing that chiropractic is effective
in treating lower back pain.
There have also been several studies of spinal manipulation and
mobilisation techniques (by osteopaths, chiropractors, physiotherapists
and doctors) for lower back pain. They suggest that the techniques,
whoever does them, do provide short-term relief from pain, and
improvement in mobility. There have not been as many studies of
manipulation and mobilisation techniques for neck pain. |
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| At a consultation |
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A first consultation with
a chiropractor or osteopath generally takes about an hour. The
chiropractor or osteopath will ask detailed questions about your
general health, lifestyle, emotional state, and medical and family
history. He or she will also perform a physical examination, with
you sitting, standing, walking and possibly carrying out other
movements. He or she may test your reflexes with a reflex hammer,
and measure your blood pressure. Some chiropractors (but not usually
osteopaths) also use X-rays and other conventional medical tests
to help them make a diagnosis.
Later sessions usually last about 30 minutes. The number of treatments
you will need and how often you need them will depend on your
problem. However, the practitioner should give you an idea of
this at the first treatment session.
Treatment is usually carried out with you lying down in various
positions. Chiropractors mainly use a manipulative technique on
the spinal column and pelvic area consisting of short, rapid forceful
movements called high-velocity thrusts. These are designed to
realign and mobilise the spine, and may result in an audible sound
- a clicking similar to knuckles being stretched.
Osteopaths also carry out high velocity thrusts on the spine,
but these play a much smaller part in treatment than in chiropractic.
Osteopaths also use a wide range of other techniques, from stretching
of soft tissues and massage to rhythmic joint movements and manipulation,
on other parts of the body as well as the back. And, they may
use only gentle 'release' techniques with some people, particularly
children and older people. These are called muscle energy techniques
and are used to release tension in specific muscles. Some osteopaths
also do cranial manipulation (see below). |
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| Related therapies |
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Physiotherapists and doctors
sometimes use spinal manipulation and mobilisation techniques
similar to those used by chiropractors and osteopaths.
Some osteopaths do cranial manipulation, also called cranial osteopathy.
This consists of gentle manipulative techniques on the cranium
(skull). A belief underpinning cranial osteopathy is that childbirth,
an accident or long-term muscle tension can cause compression
of the cranium. This, in turn, can affect how fluid called cerebrospinal
fluid flows in the spine and around the brain, and so can result
in disease. Practitioners claim that gently manipulating the bones
of the cranium can correct the flow of cerebrospinal fluid, by
restoring the skull to its natural shape.
Craniosacral therapy is similar to cranial osteopathy. It differs
in believing that the flow of cerebrospinal fluid affects every
cell in the body. |
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| Side effects and risks
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The most serious potential
risks of chiropracty and osteopathy are spinal cord injury or
stroke after manipulation of the neck. These are rare, though
there have been calls for research to establish how significant
the risk is.
There is a general consensus that osteopathy is less risky in
terms of spinal injury because osteopaths usually use less forceful
manipulation techniques on the spine.
Less serious, but more common, side effects include discomfort
or mild pain at the point of manipulation, mild headaches or tiredness,
which should disappear within 24 hours of treatment.
There are certain situations where forceful manipulation can be
dangerous and should never be done. These include if you are pregnant
or if you have osteoarthritis of the neck, or osteoporosis of
the spine.
However, chiropractors and osteopaths are trained to check patients
for these and other risk factors. |
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| Further information |
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American Chiropractic Association
http://www.amerchiro.org/
American Osteopathic Association
http://www.am-osteo-assn.org/
General Chiropractic Council
http://www.gcc-uk.org/
General Osteopathic Council
http://www.osteopathy.org.uk/ |
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Healthwise (Health Information Resource
Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own
doctor |
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