Osteopath physiotherapist chiropractor whats the difference

Osteopathy vs Chiropractic vs Physiotherapy

The Difference between Osteopathic, Physiotherapy and Chiropractic Care

I frequently get asked what’s the difference between an osteopath, a chiropractor and a physiotherapist. Which one is better for me and which one will get me moving and feeling pain-free the quickest.

Most therapists will get asked this at some point. As a former registered osteopath I tended to be biased towards osteopathic care, but having trained with other therapists to help me  improve your treatment results I’m better able to see where each part fits in to make the best treatment plan for you.

But still when I hear this question, I think, “this sounds like the start of a joke” I keep trying to create a punchline that’s funny, but haven’t come up with one yet (suggestions in the comments section). Another therapist did once attempt a humorous answer, but it was just that, an attempt.

This can be quite a hard question to answer without bias because my initial training was in osteopathy, although I’m no longer a registered osteopath.

This is a go at an oversimplified differentiation of the differences (I hope)


Osteopathic techniques used within an osteopathic framework treat the bones, muscles, ligaments, and joints. Osteopathy can, therefore, treat any part of the body directly. When treating I personally also look at how these different areas connect together. This helps us find predisposing and maintaining factors, i.e. trying to find the real cause of your problem and make sure it doesn’t come back. What I mean by this is you may have pain in your knee that is caused by twisting and torsion in your calf as a result of your flat foot. Treating the knee may make your knee pain go away, but if the foot problem isn’t addressed your knee pain will keep coming back. (still with me?)


A chiropractor would probably look at your knee, X-ray your back and tell you that your knee pain is caused by a joint in your back out-of-place. This is because Chiropractors generally look at spinal joints and the way this would affect the nervous system, and nothing else. (still there?)


A Physiotherapist (now this is a hard one). The best way I can show you the difference is to describe a patient I used to treat and let you work it out for yourself. I used to treat a footballer who suffered from recurrent groin and hamstring strains. The club physio kept getting him pain-free, and back to training. Within a couple of “proper” matches, he’d be out again with the same problem as before.

This had happened 3 times in one season. (nearly the whole season wasted). The player was frustrated. When I saw him for the first time, I looked at his body as a whole and found most of his problems were due to overtight muscles in his hip/buttock area and his low back.

I treated those and I haven’t heard of any problems since (on TV, radio or press. Yes he was that well-known)

Which is the Better for me, Osteopathic treatment, Physiotherapy or chiropractic?

This is a very general reply, and the best way to find out for yourself is to try the 3 therapies. Most offer a free assessment, just make sure they don’t sign you up for life!

The way I practice has changed and while I’m no longer a registered osteopath I still use osteopathic manipulation techniques and other approaches that I used during my 20 years of practicing as an osteopath. These would be familiar to people who have had an osteopath treat them, but I also will use the exercises that Physiotherapists use but in a way that’s tailor made for what you need and can manage.  If you want to find out a little bit more about what I do, I have a free 15-minute assessment to allow you to find out if I can help. You can book an appointment online

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4 Responses

  1. I was talking about this yesterday with a fellow student osteopath. We have gone over the question “What is osteopathy?” a few times but most of us still find it difficult to explain what it is and how it is different from chiropractic or physiotherapy. I think your view is a little derogatory towards the other therapies and some certainly work (especially if the clinician is good) but I too am perhaps a little biased and think that osteopathy is perhaps the best. The question then need to be asked for what? I don’t think an osteopath would have suitable knowledge to rehabilitate a recent amputee to walk again with his prosthetic limb or to treat neurology or cystic fibrosis patients. Is that our field? Should it be incorporated into our knowledge base? Should we as osteopaths also learn proper corrective exercise? (something that I think is lacking in our schools). There is certainly more to the body that “the rule of the nerve” and focusing on spinal alignment alone is myopic. Can you really correct some one with a scoliosis or just help them manage any issues caused by it?

    I could go on but would like to see what others think.

    1. Rob sorry taken so long to reply, but thought this needed due consideration, not some glib of the cuff comment.

      The original post wasn’t supposed to be derogatory, but rather an easy read differentiation in everyday language.

      Secondly what you seem to be getting at are, what are the limitations of osteopathy. I would agree with you that the vast majority of osteopaths don’t have the skills to help a recent amputee learn to walk again, but they do have the skills to help that patient adapt or compensate to changes in posture or gait associated with the prosthesis.

      It would be wrong to think of the patient just in terms of their amputation. We need to, to quote the GOsC Osteopathic practice standards B1.3 “the Ability to consider the patient as a whole”. and to B1.1″ A comprehensive understanding of the principles and concepts of osteopathy to inform and guide rational clinical decision-making.” So if we can justify our treatment plan in terms of osteopathic concepts or principles we should be ok treating to the patients benefit.

      Section B2 also backs this up B2.1 says “knowledge of human structure and function sufficient to recognise and interpret clinical signs of dysfunction and develop appropriate treatment and rehabilitation strategies.”

      We also should not be limited by osteopathic dogma in thinking we are the only answer. Section D1 covers this pretty well. (I’ll leave that for you to read)

      I would like to end with section B3.2.2 which says “….working with other osteopaths and healthcare professionals to secure the most appropriate care for your patient.” because after all the care of the patient is the most important component. Not our ego or belief system.

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