What’s the difference between an osteopath, physiotherapist and chiropractor? Who should you see for what?

Written by Carry Triggs Hodge on May 15, 2019. Posted in Blog

Overall, this question might be less about who treats what – we (osteos, physios, chiros) all ‘treat’ many types of physical problems – but rather who gets you the best result, builds your confidence in your body’s resilience and function, and helps you be healthily independent – i.e. not reliant on treatment in order to function well. This is down to the individual clinician, it’s not totally specific to their profession.

• We have done a good job when you don’t need us anymore or we’ve pointed you in the right direction to get appropriate care for best results. Occasionally ongoing help may be useful in specific circumstances, but this should be the rare exception not the norm.

• Osteopaths, physios and chiropractors all work on the same stuff: the musculoskeletal system, the physical structure of body: your joints, bones, muscles, ligaments etc. You can’t work on one or the other separately as they are all connected, impact each other and work together as one system. But we will have different approaches depending on our training and individual post graduate interests.
• There is a lot of overlap of skills and approaches. Traditionally physios work with exercise, osteopaths with various hands-on techniques anywhere in the body (joint and soft tissue mobilisation or manipulation), chiropractors with spinal manipulation. But the reality is that many osteos also work with movement/exercise/active approaches, many physios manipulate and do hands-on… etc etc! Much post-graduate development will see all three professions learning together.
• MYTH: “Osteos work with bones, physios work with muscles”. For example, I trained as an osteopath initially but have post-graduate training in biomechanics (human movement), and specialist training in chronic pain problems – I work less like a typical osteopath because my approach is geared towards what’s most effective for each individual and isn’t limited to ‘osteopathic techniques’. Again, this is individual to me, other clinicians will have developed in their own way, either sticking to their traditional roots, or learning skills from wider influences.
• Specialist services: some clinicians have specialist areas of interest, such as working with babies (cranial osteopathy is a gentle hands-on approach often effective with babies as well as things like stress for adults); women’s or men’s health (for example, pelvic floor concerns) is covered by specialist physios or osteos; post operative rehab should be undertaken with a practitioner that is movement-based. Rather than focus whether they are an osteopath, physio or chiropractor, check out the individual and their clinic.

What about the actual treatment?

A good sign is a clinician who is focused on helping you no longer need support as quickly as possible. It’s normal and expected that most injuries or issues get better by themselves – humans are very adaptable and are ‘designed’ to heal well – But sometimes it’s important to get help if you’re struggling to get over an issue, if it’s not getting better, you don’t understand why and it’s preventing you from getting on with normal life.

Any treatment you receive should:

1. Help you avoid dependency on treatment. If you feel you have to see your physio/osteo/chiro regularly to be healthy, something’s not quite right so get a second opinion.
2. Help you feel more confident in your body, your physical function and abilities, not less. If you come out of a session feeling you are a broken person and you’re going to be stuck with life-long issues like ‘weakness’, get a second opinion.
3. Be focussed on enabling you to move more, do more and feel confident about it. Rather than encouraging you to stop and be more protective, careful, or scared of doing damage to yourself – human bodies are robust and adaptable, the more we do the better we work – the less we do the more disabled we become.
4. Help you gain control over your pain or problem, so that you can carry on doing the things you value – whether that’s playing with your kids or grandkids or running a marathon. Your clinician should be a ‘coach’ as opposed to a ‘fixer’ to put you in charge and in control. This is especially import for anything that has turned into a long term or chronic problem.
5. Show that pain doesn’t automatically mean damage. It can be important to understand the difference between pain as a result of damage or injury (ie from trauma, which heals and is then no longer painful), and pain that is the result of sensitive structures (not damage), which can be due to various things like tight protective muscles (in chronic pain problems, structures are sensitive beyond the usual healing time, the reason for this is unique to the person). Understanding this can make the world of difference in getting advice that is relevant to you and gets results.

The main thing is that you feel comfortable with your practitioner, and are happy to ask questions especially if the help, treatment or advice you receive is different to your expectations, or if you don’t think it is making a difference.

Working with a practitioner should feel like a collaboration, improving your confidence and providing action plan that is specific to you and what you want to achieve.

~~ Carry Triggs Hodge is a musculo-skeletal movement and specialist with extensive training and experience in helping people overcome disabling chronic pain problems, focusing on individualised care that improves resilience and function.~~

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