In order to plan osteopathic or targeted physiotherapeutic treatment, it is necessary to collect a number of information from medical history taking, complete examination of the patient, correlate the results of patient evaluation with additional tests (X-ray, MRI, USG, EMG, etc.) and create a treatment plan that will be dictated by the patient’s condition in relation to his realistic expectations.
In addition to the initial interview, which is basically the same as the medical interview at the first visit, we perform a diagnostic examination (most often a combination of orthopedic and neurological examination) extended with osteopathic diagnosis.
Osteopathic diagnosis is based on the identification of key somatic dysfunctions, i.e. tissue movement restrictions that impair the ability to self-heal the body. In addition, during the first visit, we usually also perform therapeutic treatment to help improve patient’s symptoms.
How long does the first consultation take?
As much as needed to do what is necessary. Usually it is about 60 minutes. In cases of simple injuries such as sprained ankles it is usually 30-45 minutes.
How many visits will you need?
The number of planned visits is determined at the first consultation. It is highly dependent on the type of ailment and general health condition, the severity of the symptoms, response to other forms of treatment and the extent of the disease process that contributes to the persistence of symptoms.
In simple cases, it can be 2-3 visits. In general, I accept the principle of 4-6 visits. This means that if there is no significant improvement after these treatments, we usually need to reconsider working diagnosis, refer patient for additional diagnostic testing, refer the patient to another specialist or verify the patient’s expectations in relation to the real possibilities of self-healing.
A simple example of the latter state is severe degeneration of the peripheral joint (hip, knee) with the expectation of significant improvement while not agreeing to surgery (e.g. endoprosthesis).
How should you prepare for the first visit?
Please arrive on time and bring all the documentation related to your condition (medications, hospital stay, additional tests) and a list of medications taken permanently. In osteopathy, the human being is seen as a dynamic unity of function in which structure and function are connected at all levels and which has the potential for self-healing.
Such a holistic approach is associated with gathering a wide interview regarding not only to complaint or disease but also in addition information about physical activity, type of work, nutrition and general well-being. Depending on the ailment, be prepared to examination of the adjacent, functionally related area (if the complaint relates to the foot we will examine at least the entire limb).
For complaints of the lower back, the entire spine and lower extremities will be examined, while neck problems necessitates examination of upper extremities. You should wear clothing that is comfortable and not restrictive to movements, enabling manual examination. In the case of the spine, you should often be prepared to take your clothes off to the level of underwear.
Depending on the nature and location of somatic dysfunctions, we correct them using various types of osteopathic techniques.
It can be, for example:
- joint manipulation (so-called adjustment)
- soft tissue mobilization
- inhibition of muscle tone
- muscle energy techniques
- release of painful trigger points
- cranial osteopathy
- visceral osteopathy