chiro, osteo or physio...which one do I need?

[mothercourage]

I'm 35 weeks pregnant and have lower back pain that's getting worse by the day. Think it's my sacroiliac joint but at times feels like sciatica. Either way, I'd like to get it sorted before my due date but not sure whose help I should be seeking. Anyone got any suggestions?

[rebeccaben]

I am 22 weeks pregnant and put my back out completely a few weeks ago. I was recommended to an osteopath by a work colleague and he was AMAZING and sorted my back out in just a few appointments. I have been to an osteo in the past as I have always had back problems and no one has ever managed to 'fix me' so quickly. He has lots of experience with antenatal and postnatal women and works from The Birth Centre in Harley Street. His full details are on his website www.bonifaceosteopath.com.

By the way, I went to a physio first (recommended by BUPA) and it was really pointless. He practically didn't touch me because I was pregnant. I think a chiropractor is the American version of osteopath (but I could be wrong about that).

Good luck!

[Saffron]

A chiro and an osteo are not the same thing, although they use some similar treatment methods.

http://www.osteopath-help.co.uk/osteopaths/cranial-osteopathy/articles/what_is_the_difference_between_a_chiropractor_and_an_osteopath

[kristymac1]

I highly recommend Daniel at Dulwich Chiropratic clinic - not least because if its not a chiropractor you need, Daniel will be totally honest with you - he's brilliant and gets lots of recommendations on here.

Good luck! x

[chantelle]

I am 33 weeks and the pain has really stepped up this week. I've been really happy with my osteo in the City. I've also seen a physio at kings twice but it wasn't as helpful. I haven't ever seen a chiropractor in pregnancy but previously had great results with one on my sciatica. So I think you just try one or the other and see how it goes. Hope you get some relief, I am practically immobilised and can't see my osteo until next week.

[edanna]

Simon Turgoose at the Vale Practice is a brilliant osteopath - I went to him during both my pregnancies and it really helped.

[taper]

Not a chiropractor; that's Quakery. Osteopathy is legit, but has limited application(although Nb cranial osteopathy is quackery). Physios are legit. Best place to start is with your GP probably.

[Countjc]

Hiya

Sorry to hear what you are going through.

I had terrible symphysis pubis disorder from 22 weeks in my first pregnancy and had it since 11 weeks this time around. It became so bad I was on crutches and then wheelchair bound but as a result have seen some top level consultants and always been told to see physios due to their length of training and also that you need to be careful having any manipulation when pregnant as your ligaments are more relaxed.

Saying that I found nhs physios to never have enough time and so used private ones. Currently seeing Russell at dulwich Physio above DMC from recommendations on here and he is amazing.

Hope you manage to get some relief.

[mothercourage]

Lots of help from you all - thank gawd for the forum! It seems Russell and Daniel get the most positive feedback (at least locally) so I'm going to get in touch with them both and hopefully get an appointment with whoever seems best qualified to help me.

Thanks again everyone x

[Saffron]

taper Wrote:

-------------------------------------------------------

> Not a chiropractor; that's Quakery. Osteopathy is

> legit, but has limited application(although Nb

> cranial osteopathy is quackery). Physios are

> legit. Best place to start is with your GP

> probably.

Cranial osteopathy can treat symptoms which have their root cause in trapped/squeezed nerves in the cervial vertabrae (the backbones in the neck area). For example, poor alignment of these bones can put pressure on the vagus nerve bundle. Because the vagus is one of the main nerves providing input to the stomach, pressure on the vagus can lead to overstimulation of the nerve. This in turn has been linked to reflux. Osteopathy would seek to treat this by manipulating the alignment of the head and neck. It's not quackery, but the application is somewhat limited.

Over the past 2 years, I've had a lot of back pain. I've seen a GP several times. I had to really push to get a referral for physiotherapy on the NHS. It's good, but limited. I've also had sports massage to help straighten a rotated pelvis, osteopathy to reduce muscle tension and improve alignment, and acupunture for pain relief. All of these have helped some.

I've also seen a rheumatologist to confirm that there is no inflammatory condition in the vertabrae. She suggested, but I haven't tried yet, to use a TENS machine. (...which by the way, mothercourage, is a good idea to start using now if you want to get good results with it during your labour...) I now know that my condition is not rheumatological, so I've been given the all-clear to start pilates/yoga again (if I can ever find the time!). My point is that if the back pain is not caused by anything sinister, then your best bet is just to give everything a try. Probably a combination of therapies will work well. You just have to find what that combination is for you. xx

[taper]

No, cranial osteopathy is quackery. It sounds as if it's based on science, but read a little around the subject and it's clearly not.

There's a good discussion below this Ben Goldacre article, with arguments from all sides.

http://www.badscience.net/2004/09/cranial-osteopathy/

[chantelle]

taper - a lot of chiropractic methods work, and are virtually the same as osteopathic methods. to dismiss an entire discipline as quackery is ridiculous. spinal manipulation has been proven to work - the debate on chiropractic vs. osteopathy is around things like philosophy and training that are largely irrelevant to patients and pain outcomes. same goes for cranial osteopathy.

[taper]

"...proven to work"

Links?

[Saffron]

Hartman et al (2002) appeared to demonstrate that inter-examiner reliability is low in assessments of the efficacy of cranial osteopathy, and they therefore concluded that this invalidated all such investigations. However, in their meta-analysis, they used the terms cranial osteopathy and cranial-sacral therapy interchangeably. There is a confound herein b/c not all practitioners would consider that cranial osteopathy is the same practice as cranial-sacral therapy.

In contrast, a recent controlled study by Hayden and Mullinger (2006), concluded that cranial osteopathy had a beneficial effect on the treatment of colic in infants. (Indeed they felt their results were important enough to justify further investigation.) Here is a summary of their conclusions from the 2006 paper:

"A progressive, highly significant reduction between weeks 1 and 4 in crying (hours/24 h) was detected (P<0.001) in treated infants; similarly, there was a significant improvement in time spent sleeping (P<0.002). By contrast, no significant differences were detected in these variables for the control group. Overall decline in crying was 63% and 23%, respectively, for treated and controls; improvement in sleeping was 11% and 2%. Treated infants also required less parental attention than the untreated group."

To call it "medicine" may be incorrect, but likewise to call it "quackery" is equally incorrect. There is actually very little research on osteopathy (cranial or otherwise). The jury is still out on this one scientifically.

[Saffron]

taper Wrote:

-------------------------------------------------------

> No, cranial osteopathy is quackery. It sounds as

> if it's based on science, but read a little around

> the subject and it's clearly not.

>

> There's a good discussion below this Ben Goldacre

> article, with arguments from all sides.

>

> http://www.badscience.net/2004/09/cranial-osteopat

> hy/

I generally like Ben Goldacre, but he's gotten his facts somewhat wrong when he says that the actin-myosin complexes in brain cells do not generate significant movement. In their 1998 paper for the Journal of Cell Science, Evans et al demonstrated that vesicle-associated brain myosin-V played a significant role in catalyzing actin-based transport. Vesicular transport is crucial to cellular function. Although I agreee with Goldacre that Dr Toby Murcott is an idiot, nevertheless Goldacre's own article is improperly referenced and badly written.

I had rather better advice from Dr Louise Pollard, consultant rheumatologist at University Hospital Lewisham. Instead of commenting on methodology, she said simply that 'Some people do find osteopathy helpful [for pain relief]'.

[taper]

The Jury is well and truly out. There remains no evidence that it works. The Mullinger study was very preliminary and as far as i can no further (double blind?) investigation has been carried out.

[MGolden]

This will add no value at all to what is turning out to be an interesting discussion but it made me smile. My dad always referred to a chiropractor he saw as a 'quack' but that didn't stop him making (and paying for!) regular appointments! And that was well over 30 years ago. I see an osteopath regularly and get great relief from my chronic neck pain.

[taper]

Saffron

Aren't you confusing your osteopathies? It's cranial osteopathy that looks very quacky to me. There's more evidence that osteopathy has its uses. As for Evans et al, buggered if I know.

[Saffron]

No. Dr Pollard's comment was related to either type of osteopathy.

The two cited studies on osteopathy (Hartman 2002; and Hayden 2006) both looked at cranial osteopathy.

And the Evans paper was simply looking at actin-myosin activity in nerve cells, thus disputing Goldacre's claim that there is no significant role for actin-myosin in nerve cells. I only offered this as evidence that Goldacre sometimes doesn't get it quite right.

I would agree that the jury is still very much out on cranial osteopathy, but I wouldn't dismiss it outright because it does appear to have an effect even if we don't understand the reasons why. Hayden and Mullinger thought this effect was interesting and significant enough to warrent further investigation, but I can imagine it's quite difficult to get (a) funding for this type of work and (b) a good patient population free of confounds.

MGolden your comments are brilliant and hillarious, btw!

[mothercourage]

A bit of feedback...

I saw Daniel Harvey at Dulwich Chiro on Friday. Two days on from my 45 min treatment and I'd say I'm 90% 'cured'. I have another appointment tomorrow, which will probably be my second and last session.

So call chiropractic work whatever you like, it has definitely had extremely positive results for me.

[chantelle]

Taper - I don't understand how you can say osteopathy is legit but chiropractic is not, when both rely on spinal manipulation. I'm no expert, the research seems mixed to say the least but I have had relief from both therapies.

I was just at my osteopath today, and she did several adjustments to my spine and hips that have made the difference between me walking comfortably and me hobbling in pain. Previously I went from someone debilitated from sciatica, unable to sit comfortably or exercise for any length of time, to completely pain free and training for a marathon. This was while seeing a chiropractor regularly - the adjustments were minor but seemed to be just enough to keep me in alignment.

i too don't really care if its quackery as long as it works!

[taper]

Chiropractors make claims well beyond the fact that spinal manipulation can help with backache. That 's where the quackometer goes off the scale. Google Simon Singh. Plenty of background around that case.

[chantelle]

fine but the original question is about pain relief. false claims are one thing, happy patients another.

most users of chiro could care less about some failed libel suit if they are happy with their practitioner.