What are the common symptoms that your patients tend to present with?

The majority of patients who come and see me are presenting generally with pain and stiffness. More commonly, it's pain and stiffness in the spinal regions. Very often, it's the low back and hips or upper back, neck, and shoulders. I treat a lot of people who come in with headaches, usually resulting from issues emanating from the spinal areas.

I also see a fair number of patients having problems with their knees, feet and lower extremities. Quite often, it's posture-related or injury-related, anything from sporting injuries to car crashes to simply bending down and experiencing sharp pain. Hence, I see lots of spinal-related and joint-related symptoms.

As an osteopath, I'll see anybody for anything, from headaches to back pain to ankle pain. More often than not, it is spinal, but I do see patients presenting with other issues emanating from other areas of the body.

What are the treatments that you're able to offer your patients?

Treatments start out with detailed case history including the medical background. We then do standing or sitting examination of spinal curves, posture, et cetera. We then do active movements, like neck movements, upper back/low back movements, shoulder movements or any movement which is directly related to the issue and also sometimes movements that aren't directly obviously related, but maybe are having a knock-on effect.

We then do a hands-on examination where we will assess the movement of the spinal segments and joints. It may be that we go through a full range of movements passively of the elbow or the shoulder or the knee or wherever it is that we are looking. We do a hands-on examination of the local tissues, trying to identify what is causing the pain. Normally, it's an area of pain that we find. The treatment is generally a combination of soft tissue massage work and general articulation of the joints through rhythmical movements to increase their range of movement and reduce any local neurological sensitivity or inflammation. Then – quite often, but not always – there will be spinal manipulative joint movements, from the neck to the ribs to the low back and even into the feet. At the same time, I'll generally do an examination from head to toe on the first appointment to make sure that there are no obvious influences, anything from leg length difference which could be causing spinal curve changes to an ankle that doesn't move or other things like that. There's generally an initial gait analysis, but more of a passive than an active one.

Treatment proceeds after a discussion of findings and options with the patient. As long as they're happy with it, we carry on.

What are your areas of sub-specialist interest?

I have a particular interest in working with necks and jaws, and getting my hands on the inside and the outside of jaws is quite a common thing for me. I'm obviously interested in spinal areas – low back and hips – and a lot of gait, movement, mechanics type work. I have a particular fondness for identifying things like Morton's foot and using functional movement exercises to re-train people into moving better, helping them run better and just move more. I would say, in this clinic, I'm probably the one most likely to perform manipulations to joints of the high velocity, low amplitude thrust nature. Hence, jaws, necks and headaches, low back and hips, and gait mechanics would be my main areas of subspecialist interest. I do a lot of soft tissue, posture, and injury prevention work.