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Frequently Asked Questions
Do I need a referral from my GP?
No. Osteopathy is a primary healthcare profession, which means you can book directly with me — and most people do. Nothing has to go through your GP first. If I think your GP should be involved, or that what you've come in with needs someone other than me, I'll tell you at the first appointment.
What happens at a first appointment?
It's up to an hour, and most of the early part is talking rather than treatment. I'll take a full case history — how the problem started, what makes it better or worse, your general health, any medication, previous injuries, your work and your training. Then I'll assess how you actually move, and test the joints and muscles involved. I'll explain what I've found and what I think will help before I start any hands-on work, and we'll usually begin treatment in the same session.
What should I wear?
Comfortable clothes you can move in — shorts and a t-shirt or vest are ideal. I need to see how the area moves, so for some assessments I'll ask you to undress to your underwear. For men that usually means the top coming off; for women, please wear a bra you feel comfortable being assessed and treated in — ideally one that unclips at the back, in case I need to work on that area. If you'd rather not, say so and we'll work around it. You're welcome to bring someone with you and have them stay in the room throughout.
Will it hurt?
Most of it shouldn't. A lot of what I do is soft tissue work, joint mobilisation and stretching, and most people find it comfortable. Working on a tender area or a muscle in spasm can be briefly uncomfortable, and I'll tell you before I do anything likely to be sore. It's common to feel a bit achy or tired for a day or so afterwards, in the way you might after unfamiliar exercise. If anything is painful during the session, say so and I'll stop or change what I'm doing. You can drive home afterwards. Whether you can train depends on what we've done, and I'll give you a straight answer at the end rather than a blanket rule.
What's that clicking noise?
It's gas moving in the fluid inside the joint — the same thing that happens when you crack your knuckles. It isn't bones going back into place, and the noise isn't what makes the technique work. Not every treatment involves it. If you'd rather I didn't use those techniques at all, that's completely fine — tell me and I won't.
How many sessions will I need?
It depends on the problem and how long you've had it, so I won't put a number on it before I've seen you — anyone who does is guessing. What I will do is give you an honest view after the first assessment and reassess at every visit. If you're not making the progress I'd expect, I'll say so and talk to you about who else might help, rather than keep booking you in.
What's the difference between an osteopath, a physio and a chiropractor?
There's more overlap than difference, and a good practitioner in any of the three will help you. Broadly: osteopaths tend to look at how the whole body is working together rather than only the painful bit, physiotherapy leans more heavily on exercise-based rehabilitation, and chiropractic focuses more narrowly on the spine. In practice a great deal depends on the individual practitioner rather than the label. I use hands-on treatment and exercise together, because most people need both.
Are osteopaths regulated? How do I know you're qualified?
Yes. Osteopaths are statutorily regulated healthcare professionals and the title is protected by law — it is a criminal offence to call yourself an osteopath without being registered with the General Osteopathic Council. Registration means an accredited four-year degree, compulsory professional indemnity insurance, annual continuing professional development and accountability to a statutory regulator, in the same way a physiotherapist or a GP is accountable. You can look me up on the GOsC public register: David Shah, registration number 12229.
What does it cost, and how long are appointments?
Initial consultation, up to 60 minutes — £80. A full case history, clinical assessment, diagnosis and hands-on treatment. Book this if you're a new patient, or if your last visit was more than six months ago. Follow-up, 45 minutes — £70. Follow-up, 60 minutes — £80. For existing patients: I review your progress, reassess where needed and treat. Choose 60 minutes if you'd like a broader look at how you're moving overall. Kaizen Full MOT, 90 minutes — £115. Open to new and existing patients. For new patients this includes the full case history, assessment and extended treatment; for existing patients it's 90 minutes of focused manual therapy.
What can osteopathy help with?
Osteopathy is most often used for musculoskeletal problems. It can help with general, acute and chronic backache and back pain not arising from injury or accident, lumbago, sciatica, uncomplicated mechanical neck pain, headache arising from the neck, migraine prevention, generalised aches and pains, joint pains, arthritic pain, joint pains including hip and knee pain from osteoarthritis as an adjunct to core osteoarthritis treatments and exercise, minor sports injuries, muscle spasms, neuralgia, fibromyalgia, rheumatic pain, cramp, circulatory problems, digestion problems, and tension and inability to relax. If what you've come in with isn't something osteopathy is likely to help, I'll tell you at the first appointment and point you towards someone who can.
Can I claim on private health insurance?
I don't take insurance work at the moment, so appointments are paid for directly. The prices above are the same for everyone. It is still worth checking your workplace benefits. If you have a health cash plan — Medicash, Simplyhealth and similar schemes — you can often claim a proportion of the cost back yourself afterwards. I'll give you a receipt with everything your provider needs on it, and how much comes back is between you and them.
What if I need to cancel or move my appointment?
Let me know as early as you can and I'll always try to move you rather than lose the appointment. You can rearrange yourself through the online booking system. Cancellations made with 24 hours' notice or less are charged in full. That isn't there to catch anyone out — at that notice it's a slot nobody else can take.
Who can have osteopathy — do you treat children?
Osteopathy is suitable for most adults, and I adapt what I do to the person in front of me — treating an 80-year-old with arthritic hips isn't the same as treating a 25-year-old runner, and it shouldn't be. The youngest patients I see are 13. Anyone under 18 must be accompanied by a parent, guardian or other appropriate adult, who stays in the room for the whole appointment. If you are pregnant, have osteoporosis, take blood-thinning medication or have had surgery recently, tell me at the first appointment. None of those necessarily rules out treatment — they change which techniques I use.