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Osteopathic Research


The quality in Osteopathic Practice report brings together existing research on the patient experience, clinical effectiveness, and safety of osteopathic practice

It is relevant to anyone who has an interest in finding out more about osteopathy and the evidence it is available. This includes:

  • Members of the public and patients of osteopaths
  • The NNHS and associated organizations
  • Other private and NHS commissioners of service
  • Other healthcare colleagues

This document is also designed to be a resource for the osteopathic profession itself, to signpost best practices and inspire excellence. Each of the research articles referenced in this document is summarized, with the name of the study provided so you can look up and read the study in full. Should you wish to do?


The UK statutory Register provides detailed information about an osteopath. This resource is freely available to the public via our website or our telephone information service on 020 7357 6655.

What is Quality?

NHS England's Five Year Forward View, published in October 2014, states that the definition of quality in healthcare enshrined in law, includes three key aspects:

  • Patient experience
  • Clinical effectiveness
  • Patient's safety

A high-quality health service will exhibit all three. The Care Quality Commission also inspects these elements of quality. We have therefore chosen to focus on the evidence available in these three key areas, to indicate to readers our commitment to providing quality in osteopath healthcare.


The osteopathic practice has a patient-centered approach that places the well-being of patients at the heart of care. Implicit in this patient-centered approach is the need to closely monitor and evaluate whether the delivery of osteopathic care is meeting patient's expectations, to examine patient's experience of care, and to evaluate patient's satisfaction with their experience of osteopathy.


The General Osteopathic Council (GOsC) is the regulatory body of the osteopathic profession. In 2010, the GOsC commissioned research to examine the patient's expectations of osteopathic care. This mixed-method study, undertaken by Dr. Janine Leach, included a qualitative study to identify patient’s expectations, before, during, and after an osteopathic consultation, and a national patient survey.

The national survey examiner 51 aspects of patient expectation and included response from over 1649 patients. The main Outcome measured was whether patient’s perceived levels of expectations were met or unmet. Results found that a total of 80% of the 51 aspects of the patient expectations met . The most prevalent among those met expectations included listening, respect for the patient and information giving.

The headline figure from this research is, however that 96% of respondents said that they were satisfied with their osteopathic care. This is powerful evidence of patient of the practitioner-patient relationship that typifies osteopathic care.

Patient's experience

Several studies have investigated patient's experience of osteopathic care. One study in the UK investigated patient's experience of osteopathy in survey of the general population and in a clinic attached to an osteopathic educational institution. The survey of general population identified that, from a sample of 764 responses 71.4% of patients reported a good experience, 19.5% reported neither a good nor a bad experience and 8.9% reported a bad experience with osteopathic care.

Patients reporting a good experience were significantly more likely to show an improvement in their symptoms. No withstanding, patients reporting a bad experience still said they would recommend osteopathy to their friends and family. A total 88.7% of patients attending a teaching clinic reported a good experience of osteopathic care.


In more recent work, Patient Reported Outcome Measures (PROMs) data collection has been taking place across the osteopathic profession. PROMs enable patients to give feedback on their care independent to osteopathic practice. The summary data from patients allows osteopaths to compare their outcomes of care to findings from others in the profession. Encouragingly, The GOsC research suggests that 9 out of 10 patients felt that it was very important to be able to provide feedback about their experience to their osteopath?

Information collected by PROMs so far indicates that at six weeks post treatment, 93.2% of patients felt that their experience of osteopathy was very good.

In terms of patients satisfactions levels, at six weeks post treatment 87.2% of patients rated their satisfaction with osteopathic care as very good.

Although the use of the PROMs data collection facility is in its infancy in the profession, the preliminary results suggest that the majority of people who use an osteopath have a positive experience and there are high levels of patient satisfaction .(For results from PROMs on the effectiveness of treatment)

Public perception

In 2014, The General Osteopathic Council (GOsC) commissioned a large programme of work to learn more about the general public's awareness of the osteopathic profession.

The first phase of this project involved focus groups with members of the public from around the country led by an independe4nt market research company. The groups consisted of participants aged between 18-80 from diverse backgrounds, some of whom had previously consulted an osteopath and others who had no prior experience of osteopathic care.

A quantitative survey was conduct also by YouGov including a Nationally representative sample od 1,566 members of the UK public, The result of the survey demonstrated that patients have a high level of confidence and satisfaction with osteopathic Practice, amongst those who had no experience of osteopathy.

Amongst osteopathic patients, 96% expressed confidence in osteopathic treatment and advice.

Accessibility to osteopathic care

Demands placed on ever-stretched healthcare system means that the length of time taken for patient to be seen by a health care practitioner in the NHS can be considerable. Research taken from the National Council for Osteopathic Research , Patent reported Outcome Measurement data found that 50.4% of patient who visited an osteopath had been experiencing symptoms for 13 weeks or more, but 61.1% of people were seen within three days of requesting an osteopathic appointments.

Timely access to care is important to try ton effect as good an outcome as possible. The time dedicated to each individual patient is valued by members of the public. in the GOsC public & Patient Perceptions Research, taking time to listen to you and understand your problem was a quality that 48% of osteopathic patients value.

An osteopathic consultation lasts up to an hour and includes the taking of a full medical history, as well asking the patient about ant concern, symptoms or injuries that they are seeking help with and then undertaking a physical Examination. this consultation is very comprehensive .We also know from the Census (2017) that osteopaths spend an average of 30 minutes with their patient,(an hour for new patient) allowing them the time to develop positive patient partnership that support shared-decision making for improved outcomes

Public perception

In 2014, The General Osteopathic Council (GOsC) commissioned a large programme of work to learn more about the general public's awareness of the osteopathic profession.

The first phase of this project involved focus groups with members of the public from around the country led by an independe4nt market research company. The groups consisted of participants aged between 18-80 from diverse backgrounds, some of whom had previously consulted an osteopath and others who had no prior experience of osteopathic care.

SECTION2: Evidence of the effectiveness of osteopathic practice

The research and information detailed so far provides the reasons why someone may visit an osteopath and their levels of satisfaction after they have done so. The next section examines the evidence there is on the effectiveness of osteopathic practice.


Low back pain is the most common reason for patient to visit an osteopath and accounts for 36% of an osteopath's patient work load and around 7% of GP's work load . The prevalence of low back pain alone constitutes a burden on both individuals and the health care system alike. The National Institute for Health and Care Excellence (NICE) produced extensive update guidance for the assessment and management of low back pain and sciatica. The NICE guidelines, published in 2016 are based on extensive reviews of high quality evidence and expert consensus. This Guidance recommends manual therapy as part of an overall package of care for those with low back pain. There Package recommendations include encouraging self-management for patients, psychological support and exercise, which osteopath routinely provide.

Two particularly large height quality randomized controlled trails have also shown that the type of interventions offered by osteopaths are beneficial and have sustained effects on pain and function over one year for low back pain(UK BEAM 2004, Licciardone et al.,2013).

A systematic review involves an extensive analysis of evidence for conditions and/or therapies. A review by Claret al./,in2014 examined the clinical effectiveness of manual therapy for the management of musculoskeletal (conditions of the bones, muscles, and joints) and non- musculoskeletal conditions. The review showed that the sort of techniques that osteopaths may choose to use in a consultation (i.e. spinal manipulation and mobilization) were effective for adults with low back pain (independent of how long they have been living with the pain); migraine; headache caused by muscle and joint issues in the neck(Cervicogenic headaches) and dizziness. Other similar techniques were seen to be beneficial for several joint conditions including shoulder pain (rotator cuff disorder).

The role of self-management in patient care is being advocated increasingly. A trial with chronic low back patients included a self-management program that was delivered by clinicians including osteopaths who facilitated the development and confidence of patients to manage their long-term condition (Taylor et al., 2016). This trial showed that these patients had sustained beneficial effects at 6months for depression, social integration, anxiety, self-efficacy, and acceptance.

Osteopathy is recognized as a complex intervention involving multiple components (including manual 'hands-on' therapy, psychological support, exercise, and general health advice designed to support self-management) and, as a result, research into osteopathic practice is particularly challenging. However, these components make osteopaths ideally placed deliver the 'package of care' recommended in the earlier NICE guidelines.