What is the Difference Between an Osteopath, Physio and Chiropractor?
I get asked this question on a weekly, sometimes daily basis.
Having choice is great but it can be overwhelming when it’s not clear who is best placed to help you.
Ultimately physiotherapists, osteopaths and chiropractors all work on the musculoskeletal system – the physical structure of the body – using a variety of approaches including manual therapy, exercise, movement, and education, amongst other things.
The label (osteopath, physiotherapist, chiropractor) gives you an idea of how someone trained originally and that they are registered with a governing body (regulated by law). It doesn’t tell you what kind of practitioner they have become – this depends on their experience, special interests and and post graduate training.
You could argue they all work with similar issues – joint/ligament/tendon/muscle problems in the back and in other areas. But they potentially approach in different ways:
Some work in very specific ways which are traditional to their training.
- For example, chiropractors are known for using spinal manipulation; physiotherapist are known for giving exercises and doing post-op rehab; osteopaths do a variety of things from gentle cranial techniques to joint manipulation on any part of the body.
But these are not mutually exclusive and there’s a lot of cross over; you’ll find some osteopaths who work like physiotherapists or chiropractors, and vice versa and so on, for example, I’m an osteopath but have learnt from some excellent physiotherapists; I know some physios who do spinal manipulation; I know some chiropractors and physios who have done the same biomechanics and pain science training as me.
So the reality is there can be huge variation even within the same profession, especially as some develop special areas of interest throughout their career. And as ‘good’ practitioners we should all be learning as new research is published in our field – regardless of our label.
It’s about the Individual
Look for someone who:
- has been recommended or has good testimonials
- is transparent about how they work and has a clear strategy for helping you achieve lasting results – they should regularly review your response to treatment to make sure you’re in the right place
- is committed to helping you help yourself to avoid dependency on treatment
Other things to make sure your practitioner is considering, especially for a long term problem or something that hasn’t resolved as quickly as hoped:
- stress levels
- amount of movement/exercise
- your ability to move well – strength and flexibility, protective movement/behaviour
Frequently asked questions:
Will my problem get better by itself?
We are brilliant at healing and we’re extremely adaptable, so yes – very often injury and pain resolves itself resolve without help: not every little twinge needs to be fixed by someone else, your body is a healing machine. If pain ongoing there is a reason for that, it may be conditioning, it may be sensitisation (what the nervous system does with longer term pain). There are very effective strategies to deal with these issues so it’s about finding the right help.
Not feeling any progress or improvement?
It is important to feel progress. Within the first 4 appointments you should experience some form of change or improvement. If not, ask your practitioner about your options and the way forward. For example:
- What is their strategy for your care from now onwards?
- Is another type of treatment or a different practitioner more appropriate for you at this time?
- Should they be referring you for further investigations?
There is no one-size-fits-all panacea, no matter how holistic a practitioner is or how much experience they have. What works for one person may not work for another. It doesn’t mean your practitioner is no good, but a different approach may be helpful.
Rapport and communication
It can be really beneficial to have a good rapport with your practitioner. You should feel comfortable asking questions and they should be good at communicating what they’re doing and why, in a way that makes sense. This can help to reduce anxiety around pain and injury which will also aid recovery.
Chronic problem? Don’t give up
If you’ve seen a number of practitioners about an unresolved issue it doesn’t mean you can’t be helped. Approaches can vary greatly even within the same discipline and it may be that you need to explore something different.
Keep researching new options and information, consider things you haven’t yet tried.
Importantly, consider whether you are making the necessary changes so that improvement is possible. Sometimes it’s more about what you do, rather than the treatment you get. But the right support can make a big difference – any practitioner worth their salt will be happy to discuss your queries.
Take responsibility for yourself. There are always things you can do to help yourself, such as exercise and lifestyle changes, nutrition and education. This should be part of the advice you receive during treatment with any musculoskeletal practitioner. It is a significant part of resolving chronic problems and avoiding recurrence.