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The Difference between Osteopaths, Chiropractors and Physiotherapists.

I am frequently being asked by patients what the difference is between Osteopaths, Chiropractors and Physiotherapists.  This is a difficult question as there is often big difference between individuals in the same profession as between them, also no profession likes to be pigeon holed in what they do or what they treat.  Below is a summery of the training principles and patient base. With time the traditional difference between professions is decreasing, as all are evidence led.  

Osteopathy 

4 year, degree course specialising in the diagnosis and treatment of Muscular skeletal problems.  Osteopaths only work with out patients not in hospitals.  Osteopaths look holistically to diagnosis and treat the cause of the problem often distant to the area of pain.  The aim is to get the patient pain free and rehabilitated as soon as possible.   It is a very ‘hands on profession’ using a lot of massage, stretching and manipulation to alter the patients biomechanics giving exercises as an adjunct to reinforce the treatments.  We are currently the only profession recommended for manipulation by the NHS as stated in the NICE guidelines.

Chiropractic

4 year, degree course specialising in the diagnosis and treatment of Muscular skeletal problems there is also a larger business and marketing aspect. Chiropractors also only work with outpatients.  Traditionally Chiropractic diagnose musculoskeletal problems arising from the alignment of the spine and often use x-ray as part of their diagnosis assessment. They treat mainly using manipulation therefore see patients for short visits and more frequently than osteopaths or physiotherapists. Chiropractors promote ‘Cradle to grave care’ aiming to keep correct ‘alignment’ so often see patients for maintenance rather than rehabilitation.  As time is changing the use of routine x-ray is being reduced and most chiropractors are using more soft tissue approaches.

Physiotherapy:

3 year degree course, with a broader base.  Students work in rotations doing a variety of things from treating and supporting doctors in hospital to outpatients such as Chiropractors and Osteopaths. In primary care the approach is more ‘hands off’ than Osteopaths or Chiropractors involving giving exercises to strengthen areas of weakness and the use machines such as ultrasound to treat ligament problems. Massage and soft tissue approaches are used as an adjunct to help the progress. Traditionally manipulation is not used however is beginning to get used more.

For this reason it is easier to look at the bulk of patient referrals. 

Physiotherapists treat more post-operative patients and people specifically requiring rehabilitation whereas the bulk of Osteopaths tend to be more long standing complex biomechanical problems. 

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