Frequently asked questions

Find some answers here and don't hesitate to ask as anything!

What is the Pain Puzzle approach?

Deborah uses her osteopathic perspective to assess patients and provide hands-on treatment. She also uses active treatment approaches to support you with improving movement and exercising.

Pain is more than a physical condition. The Pain Puzzle approach doesn’t just consider the physical but takes a much wider look at your health and well-being – piecing together the puzzle to find your solutions for better health.

You may have seen the term “coaching” mentioned several times on this website. Lifestyle or well-being coaching is really a way of saying that we consider you as a whole person rather than just a pain problem. This will be through discussion and support to help you find ways of moving forwards towards better health.

Areas we may consider according to your preferences:

  • Nutrition
  • Physical activity
  • Stress management
  • Work place wellness
  • Mental wellbeing
  • Sleep quality
  • Spiritual concerns

What happens if I am a new patient?

Before your first appointment you will receive a phone call to check whether you need a face to face appointment or if a virtual appointment would be more appropriate. If face to face is required you will be screened for risk of coronavirus for yourself and your household.

A lot of the first appointment will be spent listening to your story and pieces together your pain picture – what’s happened, how it affects you and your life. These details may be taken by telephone.

A full assessment will take place to understand the impact of the pain on your movement and your body. This may include some simple clinical tests such as taking your reflexes. You will be asked to do different movements to help make a diagnosis.

All the findings will be discussed with you and a full explanation of your ‘pain puzzle’. Together we will make a plan to identify solutions that will improve your well-being and help you return to living life again.

What can I expect at an appointment?

Before each visit a screening call will be made to screen for coronavirus risks for you and your household.

Each appointment will include an update on your progress and any concerns you may have. A reassessment of your condition. Treatment which we plan together. It may include hands-on treatment or exercise and movement or coaching or a combination of all of these.

What changes have you made due to coronavirus?

Before each visit a screening call will be made to screen for coronavirus risks for you and your household.

You will receive full details of our procedures in your appointment confirmation email. You can also read our risk assessment here. Needless to say it involves gloves, mask and sanitiser!

Can you treat with gloves on?


I’ve treated for a couple of weeks in gloves in Kenya and it worked really well. It is surprising how well you can still feel with gloves on.

For regular patients the treatment may feel a little different but the response to treatment should feel the same.

Why do you use questionnaires?

Pain Puzzle is committed to evidence-based practice. Gathering information by questionnaires helps us to contribute to national research as well as monitor and  improve the Pain Puzzle service.

Is treatment safe?

Osteopathy is a very safe treatment. 8 out of 10 people feel better after their first treatment.

People often feel some tenderness after treatment and occasionally a headache or dizziness. These symptoms may last 24-48 hours.

More serious risks are rare but will be explained to you at your appointment

Will I have to undress?

It is usually necessary for you to remove some clothing so the affected area can be assessed and for hands-on treatment. You are very welcome to wear shorts and a vest or T-shirt if your would feel more comfortable.

Are there people who don't improve with treatment?

Yes sometimes. Our success measure is not freedom from pain but that you can live well, purposefully and meaningfully and the majority of people will change their pain experience or have an improved quality of life.

Your case history and assessment may indicate that your condition is not suitable for treatment or needs further investigations. With your agreement you will be referred for appropriate help elsewhere and a referral letter will be written.

With some people we agree a trial of three treatments and if no progress is being made we will agree with you to refer for alternative treatment or investigations. We always aim to help you have a greater understanding of your symptoms and the different aspects that may be causing those symptoms.

If you do not make progress with treatment we will not continue.

We support people to reach and maintain their goals, not providing endless ineffective treatments.

How much does treatment cost and how can I pay?

Our fees are £50 for new patients, £42 for follow-up treatments.

We only take card payments.

Can I claim on insurance?

If you have private insurance you can often claim back your osteopathic treatment. You may need approval from your doctor.

We no longer provide treatments for BUPA or AXA PPP but all other insurance cover is provided.