For me at that time, I wasn't sure how best to approach this patient, as pain was the chief symptom and function loss (due to pain) was the sign which directed lines of questioning to conjure up a diagnosis.
Without either, at the time, I felt flustered that such a patient would present at all.

I remember assessing the patient and locating restrictions of axial movement, which I affected by using spinal manipulation and soft tissue massage.

Even though I had made improvements in function, this patient was extremely insistent about my treatment approach, which made me feel as if I had lost touch with my osteopathy.

In hindsight, and looking into the future, the way to overcome such an obstacle, would involve heavy management of patient expectations of what I, as an osteopathic practitioner, would do for him.
In clinical practice, I would first and foremost never want to sacrifice my osteopathic philosophy to become a generic manual therapist.

In this example, it is clear the key theme is communication, and the rigorous lack therof, which inevitably strayed the treatment session into a patient-led rather than patient-centred approach.

(OPS: A1-5, B1-3, C1-5,7, D4,7,14,17)