It’s not unusual to feel slightly worse after treatment. It can take time to process the therapeutic input and self-correct toward better health. As your body adjusts and releases tensions, you may experience an exacerbation of symptoms or re-balancing reactions. Local tenderness, stiffness, achiness, headaches, diarrhea, fatigue or menstrual cycle changes are all within the range of typical responses. Here’s a look at two recent studies that investigated patients’ responses to treatment:
Adverse Events and Manual Therapy: A Systematic Review
This systematic review, funded by the General Osteopathic Council (UK), found that nearly half of patients experience minor, short-lived adverse effects after manual therapy. Most often these occur within 24 hours after treatment and resolve within 72 hours. While minor reactions are common, “the risk of major adverse events is very low, lower than that from taking medication”. (Argin et al., 2010) These findings were based on eight prospective cohort studies and 31 randomized controlled trials.
Monitoring Self-Reported Adverse Events: A Prospective, Pilot Study
This pilot study, undertaken by the European School of Osteopathy, found that 93% of patients experienced at least one adverse event which they called “additional effect of treatment”. Treatments were provided in the schools’ teaching clinic, and results based on 52 subjects. The chart below illustrates the most commonly reported events.
“Feeling more relaxed” was also noted; not sure I would consider that adverse but we’re all different! The incidence of most adverse reactions peaked at 24 hours post treatment. Light-headedness was the exception, most often reported at 10 minutes post treatment. But by seven days post-treatment, 80% of patients reported feeling ‘much better’ or ‘a bit better’.
The authors of this study suggest the overall incidence of adverse events may be overstated due to 2 reasons: potentially less refined treatments due to inexperienced practitioners (4th-year students) and higher reporting of events due to the use of a checklist versus open-ended questions. However, I believe the study captures the type of reactions I see in practice.
Be Patient. It Gets Better.
Most adverse reactions to treatment are:
- Minor in nature.
- Peak within a day or two.
- Resolve within 3-4 days.
Importantly, within a week after treatment, most people feel better!
I’ve shared this information so you can be better informed about what to expect from osteopathic treatment. “Sometimes things have to get worse before they get better” may be true, but what you do after your session can make a big difference in how your body responds. You can read my recommendations for how to help yourself in Make the Most of Your Osteopathy Treatment.
What has your experience been?
Carnes, D, T S Mars, B Mullinger, R Froud, and M Underwood. Adverse Events and Manual Therapy: A Systematic Review. Manual therapy. 15, no. 4 (2010): 355-363.
Rajendran, D, B Mullinger, C Fossum, P Collins, and R Froud. Monitoring Self-Reported Adverse Events: A Prospective, Pilot Study in a UK Osteopathic Teaching Clinic. International Journal of Osteopathic Medicine 12, no. 2 (2009): 49-55.