What other evidence based options do I have?

Osteopaths see patients for a variety of musculoskeletal problems, these include;

  • Low back pain
  • Neck pain
  • Sports injuries
  • Headache originating from the neck
  • Frozen and stiff shoulders
  • Knee and hip problems
  • Trapped nerves
  • Ankle and foot problems
  • Tennis elbow and wrist pain

What is the evidence base for Osteopathy in the treatment of neck and low back pain?

Low back pain

A Medical Research Council trial comparing treatment options for lower back pain found that spinal manipulation, added to GP care, is clinically effective and the most cost-efficient option for patients (UK Back Pain Exercise and Manipulation trial, MRC, 2004).

In 2006, the Department of Health published guidelines which advocated the establishment of multidisciplinary clinical assessment services and recognized that musculoskeletal disorders can often be resolved quickly and effectively by treatments such as osteopathy (The Musculoskeletal Services Framework. A joint responsibility: doing it differently, DH, 2006).

The National Institute for Health and Clinical Excellence (NICE) published guidance on the treatment of non-specific low back pain in May 2009.  Recommendations in Low back pain: Early management of persistent non-specific low back pain, include manual therapy, as practiced by osteopaths. This includes spinal manipulation, mobilisation and massage, for patients who “have been in pain for longer than six weeks but less than one year, where pain may be linked to structures in the back such as joints, muscles and ligaments”. This was updated by NG59 that recommends considering manual therapy (manipulation, mobilisation or soft tissue techniques (for example, massage)) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy.

In December 2011 the Department of Health published the Any qualified provider service specification for patients with Neck and low back pain in which it includes manual therapy as practiced by osteopaths.

Neck Pain

Strong evidence favours a multi care approach using exercise combined with mobilization or manipulation in people with subacute (> 7 days < 3months) or chronic (> 3 months) neck pain. The relative benefit of different exercise approaches and which subgroups may benefit is unclear. The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders concluded that the evidence suggests that manual and supervised exercise interventions are more effective than sham treatments, no treatment, or alternative treatments. The interventions that focussed on regaining function as soon as possible were more effective than interventions that did not have such a focus.  (Clinical Knowledge Summaries)

Other health professionals may also be able to help you. The Department of Health recommends the following types of treatment for non specific (mechanical) neck and low back pain.

Exercise class

The classes may include exercises to strengthen your muscles and improve your posture, as well as aerobic and stretching exercises. Your local outpatient Physiotherapy unit may have classes available via self or GP referral.

Manual therapy

If you choose a course of manual therapy, this may include manipulation, mobilisation and massage. Mobilisation and massage are performed by a wide variety of healthcare practitioners. Your session may include an element of education, explanation of your pain, hands on treatment and a home exercise plan. Manipulation can be performed by osteopaths and chiropractors, as well as by specially trained doctors and physiotherapists. In some areas manual therapy is available on the NHS via GP referral. Speak to your GP if this is the case in your area.


Acupuncture is a technique used by a wide variety of healthcare practitioners, including specially trained doctors, nurses and physiotherapists, as well as osteopaths, chiropractors and specialist acupuncturists. It involves inserting fine, solid needles at different points in the body. This can help to reduce low back pain. In some areas Acupuncture is available on the NHS. Speak to your GP if this is the case in your area.

If you are unsure who to see you may wish to speak to your GP or to a registered practitioner in your area to see if they can help you. A list of registered local practitioners can be found by going online or calling the relevant Regulating bodies listed below.

General Osteopathic Council

176 Tower Bridge Road




Tel: (0) 20 7357 6655


The Chartered Society of Physiotherapy

14 Bedford Row




Tel: (0)20 7306 6666


General Chiropractic Council

44 Wicklow Street



United Kingdom


Tel: (0)20 7713 5155


The British Acupuncture Council

63 Jeddo Road


W12 9HQ


Tel: 020 8735 0400