Frequently Asked Questions

 How soon can I be treated?
I aim to offer treatment as soon as possible (1 - 3 days).

• Do I have to be referred by a doctor to visit an osteopath?
No, osteopaths can assess and treat without referral by a doctor.  Although some patients do come for treatment following GP advice.

• How many treatments will I need?
The number of treatments will vary depending on the problem and individual.  After taking a detailed case history, we will discuss your treatment plan.  Some patients need only one appointment, others may have a course of therapy or return periodically for the long-term management of a condition.  Normally the treatment of a patient is determined according to their progression rather than the prescription of a set number of treatment sessions.

• What does an osteopathy treatment consists of?
The treatment I offer depends on the patient' condition. Normally the treatment consists of soft tissue and muscle energy techniques, gentle to firm joint manipulation, aiming to improve the range of movement in restricted joints. 
A wide range of non-invasive manual techniques, such as deep tissue massage, joint articulation, trigger point therapy, myofascial release and if appropriate medical acupuncture are widely used to help the treatment goals.  Patients are strongly recommended to follow postural advice, stretching, and exercise guidance.

How much is the charge for an osteopathy visit?
Initial consultation is £95. Follow up appointment (45mins) is £65.  You can pay by card or cash.   I also offer concessionary fees for patients aged over 65 years, and disabled people.

• Would my health insurance cover the cost?
Osteopathy is a recognised health profession in the UK and is widely accepted by the major health insurance companies.  Please note that I do not work with any insurance companies and I invoice my patients directly.
I can send you an invoice at the end of your treatment/s and then you can recover your cost directly from your health insurance provider.
Some insurers require a GP letter, and some require you to pay an excess depending on your cover.  It is recommended that you check with your individual health insurance provider to determine the extent of your cover.

• What should I bring along?
Be prepared to provide your previous medical or surgical history.  If you have them and if they are relevant bring X-rays, scan / MRI reports, any referral letter and list of any medication.  Loose fitting clothing is recommended (although treatment gowns are available for all patients).

Where are you located?
My practice is based in Parkshot House opposite Richmond station. I also treat patients in London at 1 Harley Street.

How do I make an appointment?
Call 020 8892 6155 or send an e-mail

• What is osteopathy?
Osteopathy is a primary health care system, complementary to other medical practices, regulated by law. In the UK, osteopaths must be registered with the General Osteopathic Council in order to practise.
Osteopaths primarily work through the neuro-musculo-skeletal system, mostly on muscles and joints, using holistic and patient-centred approaches.
A core principle is that the body is an integrated unit, and contains self-healing mechanisms that can be part of the treatment. No part of the body works, or can be considered, in isolation. 
Osteopathic diagnosis is formed from listening to the patient's history, examining muscles and joints as well as observing movements. Relevant psychological and social factors also influence patient diagnosis.
X -rays, scans and other clinical investigations are also used if required. A wide range of non-invasive manual techniques can be used, such as deep tissue massage, joint articulation and manipulation, trigger point therapy, myofascial release and medical acupuncture. Postural advice, stretching, and exercise guidance are often advised.
Osteopaths can assess and treat without referral by a doctor. Although some patients do come for treatment following a doctor’s advice.

• What is acupuncture done by an osteopath?
I am trained in medical acupuncture. When I feel that it would be appropriate, I discuss it with my patients so the choice is theirs.
Acupuncture is useful for muscle relaxation, often without the soreness that may accompany soft tissue techniques. 
Typically I use four or more sterile ultra-fine needles, connected to electrodes at a specific frequency. Once removed, I may then use other manual techniques to encourage the desired tissue changes.

• What is the difference between osteopaths, physiotherapists and chiropractors?
This is a question I have often been asked. I have chosen to train and practise as an osteopath, but this does not mean that osteopathy is better than other systems of health care – it simply reflects my own choice and the way I treat my patients.
Osteopaths, physiotherapists and chiropractors are all manual therapists principally involved in treating musculoskeletal dysfunctions or injuries. Practitioners from all these professions are very knowledgable about human structure and anatomy. 
No version of manual therapy is necessarily better than any other – health practitioners can all learn from one another. Ultimately, the common goal is to try and help the patient.
Chiropractors view most dysfunction as due to spinal misalignment. Osteopaths look at all the other areas of the body as well as the spine. Osteopaths and physiotherapists will tend to rely more on physical examination and will refer on to GPs and specialists for further tests such as X-rays or MRI scans. 
Chiropractors frequently use X-ray examination as a routine procedure and they influence the nervous system by “adjustment” which is a manipulative thrust technique to the spinal vertebra, which may result in a “click” or cavitation of the joint. 
Osteopaths commonly use thrust techniques, but also focus on the soft tissues with massage and stretching techniques. Osteopaths generally employ a wider range of manual techniques than the other two professions.
Physiotherapists frequently use stretching and strengthening of muscles, and exercises are an important part of the therapy.
Chiropractors tend to see patients more frequently on the basis that a number of adjustments over a course of time are required for the spine to settle into its proper alignment. Osteopaths tend to spend more time than either of the other two professions with their hands on, palpating and working manually. 
Generally osteopaths spend more time with their patients, but see them for fewer sessions.

Do the differences matter??
Both osteopaths and chiropractors are recognised in law as primary healthcare practitioners – which means they are diagnostic and not just remedial: they have a duty to ensure a patient is safe to be treated, and that their treatment is appropriate to the diagnosis they make. 
Physiotherapists are not primary healthcare practitioners: patients are treated following a physician’s referral and diagnosis, or are self-referred.
Based on my experience, patients get better when there is a good relationship between the patient and the practitioner. The differences in the techniques themselves, provided they are performed competently, seem to matter less.
There are changes taking place within the professions, with a degree of convergence between them: many physiotherapists also perform manipulations; many osteopaths manipulate less or not at all. 
Exercise, life style changes and stress management are seen as increasingly important by all three professions.
Perhaps the best advice for patients is for them to try different therapies and find the one that works best for them. 

HOME PAGE  Kosta Kolimechkov phone: 020 8892 6155; e-mail: