Manual osteopathy is a comprehensive system of physical investigation and ‘hands-on’ therapy that uses a broad range of gentle manual and movement techniques to treat people who are experiencing pain.

Manual osteopathy dates back to 1874 and was founded by Andrew Taylor Still in the United States.

Pain science is the study of pain as an output of the brain and recognizes the nervous system as primary in both perception and change of a pain experience. Pain science recognizes that though pain is perception depending on the biological, psychological and social inputs, all pain is real and each experience is unique.

Explaining pain, recognizing that multiple inputs exist and once, and education for patients about what pain is and how it can be changed may be part of treatment.

The College of Massage Therapists of Ontario describes massage therapy as consisting “primarily of hands-on manipulation of the soft tissues of the body, specifically, the muscles, connective tissue, tendons, ligaments and joints for the purpose of optimizing health.

To practice Massage Therapy in Ontario, a practitioner must be a registered with The College of Massage Therapists of Ontario. Only those registered with the College may use the protected titles “Registered Massage Therapist” (RMT) or “Massage Therapist” (MT).

As registered health professionals, RMT’s comply with competency standards of the profession as set out by the College. Competency standards refer to the knowledge, skills and abilities necessary for competent practice of Massage Therapy in Ontario.

The main potential benefits of manual treatment are relief of pain and increase in mobility. People of all ages with a variety of conditions can be treated. A diagnosed condition itself will not be affected – say diabetes or arthritis – but the experience of body and joint pain arising from the conditions can be influenced.

My focus is people experiencing persistent or chronic pain with or without a known diagnosis, but there are other practitioners who work with athletes, sport related injuries and rehabilitation or with babies and children for which I can provide referral.

Manual osteopathic practitioners (or non-medical osteopathic practitioners) provide osteopathic treatment that is largely hands-on or touch based therapy. In contrast, an osteopath or DO trained in the states now practicing in Ontario is a medical doctor who has received some training in manual osteopathic techniques but can specialize in any stream of medicine, including surgery, and usually does not treat a patient manually.

In Ontario the term ‘osteopath’ is protected and used to denote a medical doctor.

It shouldn’t. When treatment is applied to address the experience of pain, it should not itself cause you any pain or discomfort. If you experience pain or discomfort for any reason please make that known. Treatment requires your constant and continued consent.

For the most part, no. I usually ask that patients bring comfortable and loose clothing. A treatment that has a massage with lotion focus may require that clothes are removed, but this is done in private and sheets, blankets and towels are provided for coverage.

Ultimately the choice for level of clothing is dependent on your comfort and treatment modalities can be adapted as needed.

The practice of (non-medical) manual osteopathy is not yet under government regulation in Ontario. Read more about regulation of manual osteopathy here.

The Ontario Association of Manual Osteopathic Practitioners (OAOMP) is a professional practice organization founded in 1999 by a group of (non-medical) osteopathic manual practitioners and is working on a submission to the Ontario government for the regulation of osteopathic manual practitioners.

Members of the OAOMP comply with competency standards of the profession as set out by the association. Competency standards refer to the knowledge, skills and abilities necessary for competent practice of osteopathy in Ontario.

The World Health Organization (WHO) published a benchmarks document in 2010 that established systems of training, examination and licensure considered to be adequate levels of education, training and contraindications for safe practice of manual osteopathy.

For individuals who have no clinical training, a program in osteopathy should be a total of 4200 hours including 1000 hours of supervised, hands-on training in palpation. For individuals who have had clinical training, a program in osteopathy may be less than a total of 4200 hours but still should include 1000 hours of supervised, hands-on training in palpation.

The Ontario Association of Osteopathic Manual Practitioners utilizes the WHO benchmarks document to recognize study programs eligible for membership from within Canada and abroad. Currently, there are only two OAO board approved, Ontario-based educational institutions whose graduates are eligible to members – the Canadian College of Osteopathy in Toronto and the Canadian Academy of Osteopathy in Hamilton.

Group health insurance (extended health) benefits often include the services provided by manual osteopathic practitioners who are members of the Ontario Association of Osteopathic Manual Practitioners, and massage therapists registered with the College of Massage Therapists of Ontario.

Check with your insurance provider to determine if osteopathy and/or massage are a part of your plan and if your insurance provider requires a physician’s referral for coverage.

The most common length of session we provide is 60 minutes. However 45 minute and 30 minute sessions are also available.

On the first visit we discuss your experience and talk about the symptoms and relevant parts of your health history.

A physical assessment that includes active and passive mobility and the application touch will be performed. Discussion of findings, goals, development of a treatment plan and the beginning of treatment will also be part of the first session.

You may withdraw your consent for treatment either in part or in whole at any time. Although you will have signed a consent form, your consent for treatment is continual and can be altered or withdrawn at any time without explanation.

That depends on the problem, health history and how well goals are being met. Generally treatments are spaced 2 to 3 weeks apart initially to assess if changes in pain and mobility can be sustained. If treatment appears to have little effect within the first three sessions, treatment options and goals are discussed and reevaluated.

I have not recorded the data on average number of treatments, but observationally many patients experience ease of symptoms and return to activities within 3 to 10 treatments extended over three or more months.

Yes and no. I will provide different movement strategies that can be incorporated into daily activities.

Though the hands-on part of treatment can be quite passive, any decrease in pain experienced will allow easier mobility and can be followed with movement strategies that will encourage increase in movement within pain-free ranges.

For people with persistent pain these strategies start small, but are built up incrementally to encourage continued comfortable movement.

Eventually that movement will need to be challenged and progressed, and then I will refer to physical therapy or other exercise programs.

Yes. Information is stored according to Ontario’s Personal Health Information Protection Act, 2004. Information collection and disclosure requires consent, and must be secured and maintained. Any perceived breach of this act by a practitioner may be addressed to the Information and Privacy Commissioner of Ontario.

Yes. Though Monica Noy Osteopathy does not bill directly, an insurance receipt will be provided for either osteopathy or massage therapy depending on treatment provided.

You can pay using cheque, cash, credit card (via Square), or interac e-mail.
Payment is required at the end of each treatment.