Patient Information

Gerry Carter

Thank you for choosing ‘Back in Brighton’ for your osteopathic care.

The purpose of this information is to explain what will happen during your consultation.

Please read carefully the content below, so that you are familiar with the procedure before you arrive for your appointment.

The information below relates specifically to the service offered to patients by ‘Back in Brighton’ and does not necessarily reflect the same service offered by other osteopathic practices.

This information relates to patients seeking an osteopathic consultation, treatment or advice in the UK ONLY.

The Initial Consultation

Your initial consultation will last approximately one hour and 30 minutes. If you have been to an osteopathic or chiropractic practice previously, you may be surprised that this session is so long. The initial, long first consultation will enable us to discuss your problem at length; enable me to listen carefully to your concerns; give you time to feel at ease, in what can be an anxious first visit; and examine and treat you in a manner, I believe, conducive to the best results for you.

To begin I will ask you questions relating to the condition you are experiencing, such as how and when the pain started, what you were doing at the time, and what situations aggravate or relieve your symptoms. In addition I will ask some questions relating to your medical history, such as what conditions you might suffer from, what medications you take, and whether you have had any recent accidents. It is important that we ask these questions because what may appear to be a musculoskeletal problem, in some cases can be a sign of a more serious illness or injury.

The Examination


You will be invited to enter the treatment room to prepare for the examination. This usually involves a certain degree of undressing, relevant to the area to be examined. In the case of upper back, neck and shoulder conditions, the patient is required to remove upper body clothing; for the lower back, pelvis, hips and legs, the patient will need to remove lower body clothing. Patients are NEVER required to remove underwear. If you wish, you may wear shorts, leggings or tights.

Sometimes when dealing with mid back issues it is necessary to undo the clasp of a bra strap: in order that the back muscles underneath the bra strap area can be effectively treated. This is only ever necessary when patients are laying on their front and permission will always be asked before undoing a clasp. It is recommended that you do not wear one-piece ‘sports bras’ particularly if you have a mid back problem.

For similar reasons, it is sometimes necessary to move the straps of underwear slightly, in order to properly treat the lower back and upper buttock muscles. If you have any concerns about the touching of, or the small movement of underwear straps, please do not hesitate to let me know.

Patients experienced in examination by some health care professionals may be used to being given a gown to wear. This is generally not appropriate for osteopathic examination: where full observation of the relevant body area is important for thorough examination and assessment of your condition. Patients may have a towel to partially cover them during treatment if they so wish.

The examination will usually begin with an observation of your general posture standing. You will then be asked to perform various movements to assess the function of the problem area. Osteopathic, orthopaedic and neurological tests may then be carried out to help ascertain your diagnosis.

Diagnosis and Treatment

The diagnosis will be explained to you with the help of anatomical charts, computer soft-ware, anatomical models and skeleton. We will then discuss the treatment approach, the detail of what the treatment entails, and any possible treatment risk that relates to the treatment proposed.

Upon obtaining your consent, treatment of your condition will commence. Osteopathic treatment can sometimes cause discomfort at the time of treatment but is rarely ever very painful. If you experience pain during your treatment, please do not hesitate to say; treatment can usually be modified to make it more comfortable.

After the treatment

Following the treatment, we will talk at length about the way you need to protect yourself while your condition is settling. Sometimes patients do not do as well as they might, because they engage in poor posture in their home and work environments, or they further strain their condition by over-exercising, or in pursuit of their hobbies. Advice will be given to you on how to limit further strain of your condition with regard to your individual lifestyle. Failure to pay attention to such a lifestyle issue is often a significant factor in causing a stubborn problem to be maintained.


You will be asked for your consent to examine and treat you from the onset. Please remember that you have the right at any time to withdraw consent and refuse further assessment or treatment. If you suffer discomfort during treatment, or are in anyway unsure or uncomfortable about any part of your consultation, please do not hesitate to let me know.


It is quite normal for patients to feel nervous about seeing a practitioner for the first time, getting undressed in an environment that they are not familiar with, and particularly being examined by someone that they do not know. You are most welcome to bring another person to accompany you during all aspects of your consultation and treatment. It can sometimes be helpful to have someone else present, so that they can remind you later, of the detail of what was said during your consultation.

Please try to avoid bringing young children with you when you come for your consultation. Parents tend to be much less relaxed and observant when they have their young children with them: treatment rooms can be unsettling for young children and this often has a detrimental effect on the examination and treatment of the parent, who may be trying to look after an anxious child.


Examination or treatment of ‘Private areas’

It maybe necessary at times for osteopaths to examine or treat intimate or private areas of the body. These areas may include: the buttocks, groin, breasts, lower pelvic areas or mouth.

What is deemed to be an intimate area may vary from person to person depending on their cultural or religious background. To ensure you feel safe, you will be asked if you want to have a chaperone present, and you may be asked to sign a consent form; this will have a clear explanation and description of the examination or treatment being proposed.

REMEMBER it is important that you understand that you DO NOT have to consent to any procedure or examination you feel uncomfortable with.

If you feel uncomfortable about any aspect of the examination or treatment, please do let me know. If necessary, the examination and/or treatment can be postponed to give you a chance give some consideration to it and possibly return with someone of your choosing, to be your chaperone, on another day.

It is also possible for me to refer you to another osteopath or even to your doctor, who may be the same gender as yourself, if this is a concern.

Examination and Treatment of young persons

Young people 16 years old or younger must be accompanied by their parent or legal guardian and NOT a friend (this is stated as a requirement under Rules and Guidance on Conditions of Practice.) People aged 17 years old must be accompanied by another person who is themselves aged 17 years or older.

Following your consultation

Sometimes patients experience some pain or soreness after their treatment and this is completely normal. Unfortunately, it is impossible to tell who will feel sore, or for exactly how long. Soreness or pain from treatment rarely lasts for longer than 3 days. If you are coming for a course of treatment, often the soreness levels reduce after each subsequent treatment session. If you have soreness lasting longer than 3 days, or if you are concerned in any way, please feel free to contact me.

Soreness felt after treatment can depend on the type of condition that you presented with and for how long you have had it. Some patients naturally feel more pain or soreness than others. Sometimes activities patients engage in, both before and after the treatment session can make soreness more noticeable. If you are planning on traveling, exercising or engaging in anything strenuous or different to your normal lifestyle immediately following your consultation, please do mention it BEFORE your treatment commences.

After treatment try to find time to rest for a while as you may be a little more vulnerable to further strain. In addition, your muscles may be a little more reactive. Try to avoid excessive activity following your consultation.

Sometimes the application of heat (hot water bottles, blankets, baths, etc.) or cold (ice packs, packets of frozen peas, etc.) or indeed a mixture of both (contrast bathing) can be of benefit, but please follow the advice you were given during your consultation and if you are unsure about what to do, please do not hesitate to contact me.

Prescribed medications

Patients suffering from musculoskeletal conditions often suffer from pain, inflammation and muscle spasm.

These symptoms can be relieved by taking analgesics (pain killers,) non-steroidal anti-inflammatories and muscle relaxants. If you have been prescribed these medications by your general practitioner or doctor and you choose to take them, please follow the instructions you were given. If you have any side-effects from taking these medicines you must seek urgent medical advice.

DO NOT take medicines prescribed for someone else. They may cause you to become suddenly ill and you may have a reaction to them that could be potentially very serious.

Over-the-counter medications

There are many analgesic and anti-inflammatory medications that can be purchased over-the-counter at pharmacists, supermarkets, confectionary shops, and even at petrol stations.

As an osteopath working in the UK, I am not licensed to prescribe medicines and so I am unable to give patients specific advice to take any medication, including over-the-counter medicines. However, I am able to give general information as to what medicines are available for treating various conditions, and in fact I often advise general practitioners on these medication matters. Nevertheless, you MUST first seek advice from your general practitioner or doctor, before taking any medication, to ensure that it is safe and appropriate for you to do so.

Taking over-the-counter medicines can be contra-indicated in some cases: individuals with other health problems, or who are taking other medications, may cause themselves serious harm by taking them. If you are unable to speak with your general practitioner then you should either call ‘NHS Direct’ or speak with your local pharmacist in order to get more detailed advice.

DO NOT take ANY medication unless you have specific medical advice to do so.

Interruptions to treatment

As much as I try to keep interruptions to a minimum, please do keep in mind that on occasion I may be disturbed during a treatment session by someone at the door. Please also remember that I work without a receptionist. Experience has shown me that it is far less of a disturbance to attend someone at the door, than it is to ignore the person ringing the door bell over and over!

Please accept my apologies for having to leave you for a very short while in these circumstances. Unfortunately, deliveries and postal services cannot be counted upon to occur at a definite time of day.

I always endeavour to keep such interruptions to a minimum and to recommence treatment as soon as possible. Interruptions such as these are rarely longer than a minute or two.

Appointment arrivals

Please try to be on time for your appointment. I work to very strict appointment times and the practice rarely ever runs late. This policy benefits all patients because they can plan their sessions precisely around their work and other commitments knowing that they will not usually be kept waiting beyond their appointment time.

However, inevitably there will be times when I will run late, for some unforeseen circumstances. I ask that patients take this fact into consideration when booking their appointments.

Please try not to be too early for your appointment. Because I usually run back-to-back with appointments, when a patient arrives very early it can disrupt the treatment session of the patient currently being seen.

An important part of the osteopaths’ duty of care is the writing of notes following a treatment session. If you are early for your appointment and I am completing notes on the previous patient please remember that this is an extremely important part of the consultation process. Keep in mind that I should be finished by the time your consultation is due to begin.

Missed appointments and late cancellations

Please give a minimum of 24 hours notice if you need to cancel an appointment. This allows me sufficient time to offer that vacant appointment to someone else. It is not unusual for me to experience several no-shows or late cancellations in one day. This will often mean that I am unable to offer another patient an appointment because every appointment had been booked for that day.

The FULL FEE may be charged for these late cancellations or missed appointments.

Unhappy with the service

If for any reason you find that the service I provide falls below your expectations, please do not hesitate to bring it to my attention. I would value any comments you might have, as it may help me to improve the osteopathic care I provide.