Informed Consent and Risk of Adverse Reactions Associated With Osteopathic Treatment.
In line with advice from the General Osteopathic Council (GOsC), the governing body of the osteopathic profession, it is the policy of the Burton Road Clinic to enable patients to make informed decisions about their treatment and their consent to it. This entails making sure a clear explanation of the diagnosis and what treatment will involve is always given to each patient. It also includes outlining adverse reactions to treatments that may occur, and what the risk is of this happening.
Adverse reactions to treatment are possible with any effective medical procedure. When associated with osteopathy they are usually mild, such as a temporary increase in symptoms or muscle soreness. Whilst most patients do not suffer with this, it is not uncommon and in the majority of cases will resolve within 24 hours (Carnes et al 2010), possibly lasting up to 72 hours.
The more serious treatment reactions such as vascular damage and major neurological incapacity are very rare. The procedure most commonly queried is cervical (neck) manipulation in relation to strokes and injury to blood vessels. Research shows that the risk of stroke or damage to blood vessels following cervical manipulation is between 1 in 120,000 and 1 in 1.6 million. The risk of lumbar disc damage following manipulation is approximately 1 in 38,000 (Carnes et al 2010). To put this in perspective the risk to the general population of the UK of a stroke for any other reason is 1 in 1000 (Carnes et al 2010), and the risk of potentially fatal bleeds from the use of NSAID drugs such as Diclofenac or Ibuprofen is as high as 1 in 4000 (Dabbs & Lauretti 1995) yet these are prescribed and bought over the counter every day.
Whilst these levels of risk are extremely small, here at the Burton Road Clinic we appreciate how serious these events are no matter how unlikely they may be, and we take patient safety very seriously. This is one of many reasons why patients should always ensure that their treatment is performed by practitioners comprehensively trained in their field.
If you have any concerns about reactions following treatment, or would like to discuss the risk further, or if you would like any clarification of your diagnosis or treatment please feel free to consult your osteopath.
Carnes, D., Mars, T., Mullinger, B., Froud, R., Underwood, M.(2010). Adverse Reactions in Manual Therapy: A Systematic Review. Manual Therapy. 15, 355-363.
Dabbs, V., Lauretti, W.J.(1995). A Risk Assessment of Cervical Manipulation vs. NSAIDS for the Treatment of Neck Pain. Journal of Manipulative and Physiological Therapeutics. 18(8):530-536.