As Osteopaths one of the first things we are taught is to observe a patient, both while they are moving and when they are still. More often than not, one of the first things we ask a patient to do is to stand upright and we will look at various things from the shape of the spine, to whether a knee straightens and even for skin discolouration / rashes etc. We will note things that relate to the case history we have just taken and then move on to active and passive movements to complete the assessment and diagnosis.
As we do this all the time it is very easy to forget how disquieting this can be for the patient: To stand still in front of a stranger, potentially in less clothing than one might choose while the practitioner is behind you noting issues with your posture.
From a practitioner’s point of view this is a regular part of our work and is therefore a very normal thing to do. It plays an important part in looking for reasons why an issue may have occurred and what predisposed it. We are not judging you, we are looking for specific individual features. We all have certain asymmetrical issues and this is one of the best ways to discover them. Although making these assessments can sometimes, understandably, be a little uncomfortable, trying to do so when the patient is wearing baggy clothing is very difficult and often ineffective and it can really help with a diagnosis to be able to see skin changes etc. (for example, bruising or rashes such as shingles).
The important thing throughout this process is to make sure that there is a two-way communication – we tell you what we are doing and why and the patient should always tell us if they do not feel comfortable with the process.
Similarly, questions about a patient’s lifestyle – such as, ‘How old are your children?’, ‘What position do you sleep in?’, ‘Do you often watch television?’ and ‘Have you had a break from work recently?’ – are not designed to be intrusive or ‘nosey’, we are simply trying to establish if there is a particular reason for the pain to have started in the first place. Often it is during conversation that either the Osteopath or the patient will suddenly realise the link between an activity and the pain. Clearly this can help to resolve the issue and more importantly to avoid a repeat.
Everything we say and do during treatment is working towards a diagnosis and successful outcome. However, should a patient at any time during this process feel uncomfortable in any way, we will always appreciate you telling us so that we are able to reassure you and talk through the procedure at the time.