Injections
The use of injections is not included in osteopaths' pre-registration training, but some osteopaths choose to complete additional specialised training to incorporate injections into their practice.
Osteopaths are not able to prescribe, however, so when the substance to be injected is classified as a medicine, osteopaths will typically need to obtain a referral from a qualified prescriber under a Patient Specific Direction (PSD). Before incorporating injection therapy into their practice, osteopaths should carefully evaluate the legal requirements for the specific treatments to be offered and determine whether a prescriber is necessary.
Platelet Rich Plasma (PRP) Therapy
PRP therapy involves drawing blood from the patient, processing it in a centrifuge to isolate platelet-rich plasma, and reinjecting the concentrated plasma into the patient's joint to promote healing and reduce pain.
Osteopaths are not legally able to provide PRP therapy. The Medicine and Healthcare Regulatory Agency (MHRA) has determined that PRP used for pain relief, healing promotion, or any other medicinal purpose falls under the legal definition of a medicine. Its manufacture must therefore be either licensed or carried out under a legal exemption.
While doctors and dentists have exemptions under certain circumstances to produce small amounts of unlicensed medicines under the Human Medicines Regulations (2012), these exemptions do not apply to osteopaths. PRP can only be legally administered by doctors, dentists, nurse independent prescribers, pharmacist independent prescribers, and supplementary prescribers. Osteopaths should therefore not administer PRP therapy.
Botulinum toxin and cosmetic fillers
While this will not apply to most osteopaths, if you choose to undergo training for and administer cosmetic fillers or aesthetic injections it is important to remember that the Osteopathic Practice Standards apply to an osteopath’s work in all circumstances, including when undertaking non-surgical cosmetic procedures.
For those working in this area, it is important to be aware of legal frameworks that apply, for example the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 that came into force on 1 October 2021 (in England only, not UK wide), making it a criminal offence to administer botulinum toxin (also known as ‘Botox’©) and cosmetic fillers to anyone under the age of 18 years old.
