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The first stage of osteopathic treatment is to diagnose the cause of the patient's pain or disability. In the spine common causes include slipped spinal discs, locked joints, pulled muscles and trapped nerves. Elsewhere in the body, joints may be restricted as in frozen shoulder, tendons inflamed as in tennis elbow, ligaments torn as in ankle sprains, muscles torn or in spasm and nerves trapped. As well as looking at the site of the pain, the adjacent joints and muscles are checked to see if a problem there is contributing to the cause of the pain. For example, stiffness in the neck may increase the strain on the shoulder or stiffness in the upper back may contribute to low back pain.
A detailed history of the complaint and its origin is followed by enquiry into the patient's previous medical history. The effects of their activity at work and sport or leisure are considered.
Examination involves an orthopaedic assessment looking for trapped nerves, restricted joints and areas of muscle spasm.
Treatments include massage, exercise, stretching of stiff joints, and joint manipulation. In manipulation, the joint is stretched until the restriction is reached when a small amplitude thrust is applied, which often causes a clicking feeling or noise. Most manipulations are painless and result in a better range of movement and reduction in pain.
The Tonbridge Clinic also has use of a PAMM - a Power Assisted Micro Manipulation Machine.
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