Osteopath, Chiropractor, Physiotherapist: What is the difference?

Graphic of woman standing hands on her head looking confused words osteopath chiropractor physiotherapist above her

Quite honestly - not a lot! There are far more similarities than differences, all three aiming for the same outcome, hence the understandable confusion! All want to help people get better, help bodies work better, but they use slightly different techniques to get you there.

So how do you choose which one? Often, it’s simply personal preference after a good experience with one of them, rather than picking the type of manual therapy they practise.

But that doesn’t help if you’ve never seen any of them. So, to give you a clue we need to delve a little into the some of the key differences between them.

Origins

Osteopathy was invented by a doctor called Andrew Taylor Still in 1874. After losing his wife and 3 children he decided that bleeding and purging just weren’t helping! Instead, he felt we needed to help bodies help themselves, specifically via manual therapy of muscles, joints, and connective tissue.

Chiropractic was created 10 years after osteopathy by Daniel David Palmer, after attending some osteopathic lectures. Strikingly similar to osteopathy, early chiropractors were arrested and charged with “practising osteopathic medicine without license”, so Palmer set out to separate chiropractic from both conventional medicine and osteopathy, focusing on joint manipulation alone.

Physiotherapy started as a branch of nursing in 1894 when the Society of Trained Masseurs was created, driven by the need help injured soldiers. The term physiotherapist wasn’t used until 1944 but they have continued their close ties with conventional medicine, working closely with doctors in the NHS.

Training

Physiotherapy is a 3-year degree, after which they usually join the NHS on rotations for 2 years, exposing them to multiple medical departments (intensive care, cardiovascular, respiratory, women’s health, musculoskeletal, etc…). Physios then tend to specialise in a particular area. Physiotherapy education is less about diagnosis as they usually work as part of a medical team where diagnosis is provided by a medical doctor.

Both osteopaths and chiropractors do a 4- or 5-year master’s degree usually entering private practice immediately, often joining an established clinic to gain experience. They can do further training in specialist areas such as cranial, paediatrics and women’s health.

What would treatment be like?

Patient lying face down with acupuncture needles in her back, practitioner hands visible inserting one needle

Osteopaths focus strongly on manual therapy, with a hands on approach. They first assess movement, strength and flexibility along with medical history, lifestyle patterns and hobbies, then use a combination of treatment techniques including massage, stretching, joint mobilisation and joint manipulation or ’cracking’. Some also perform medical acupuncture.

Chiropractors focus on the alignment of joints, suggesting that the correct alignment of joints will influence the surrounding muscles and nerves. They look at physical movement and flexibility but also take and interpret x-rays. Their main treatment technique is joint manipulation (cracking), though some also add to this repertoire with other techniques such as acupuncture or electrotherapy.

Physiotherapists also assess people in the same way as osteopaths and chiropractors, looking at movement, strength and flexibility. Their assessment is biomechanically focused and, within the NHS, working with a doctor’s diagnosis. Treatment is usually less hands on, instead prescribing exercises. Physiotherapists often use electrotherapy, ultrasound, and shockwave therapy alongside exercises to aid healing.

Regulation

Physiotherapists are regulated by the Health and Care Professions Council, along with chiropodists, dieticians, paramedics and radiographers.

Osteopaths and chiropractors have their own respective councils, the General Osteopathic Council, and the General Chiropractic Council.

All of these councils ensure practitioners are properly qualified and adhere to the right standards and codes of practice.

In addition to this Physiotherapists and Osteopaths joined the group of NHS health practitioners known as Allied Health Professionals (AHPs), Chiropractors are still not part of this alliance.

Costs

Osteopaths usually practice privately, however in some areas it is also offered on the NHS (speak to your GP to find out if available in your area). Treatments are usually 30min and cost £40-65, often once per week initially.

Chiropractors are mainly private practice and not generally offered through the NHS. Treatments are around 15-20 mins, and cost £40-50. X-rays can be an additional charge and treatments are often twice weekly. Chiropractors often discount block bookings.

Physiotherapy is available free on the NHS but waiting times can be long and they see patients once per month on average. Private practice physios are also available and cost £40-65 for 30 mins.

Conclusion

Essentially the small differences between these professions don’t mean much, its the individual care you receive that really matters. So if you have tried one and didn’t like it, try another, it might suit you better.

If you are looking for a Farnham based osteopath specialising in manual therapy to treat pain or simply want to improve health and wellbeing, please get in touch at enquiries@outlinehealth.com or call 01252 850814.