Osteopathy, Chiropractic and Physiotherapy – What is the difference?

 A question we hear time and time again, but it's a very valid one and can be a little complicated too, so please bear with us, and we'll try and demystify it for you. Osteopathy, Chiropractic and Physiotherapy all fall under the umbrella term of Manual Therapies. This means we all use hands-on, or manual, techniques to help treat and prevent pain, along with exercise rehabilitation. The way in how we apply those techniques differ slightly which is often where the confusion lies.

Osteopaths use hands-on manipulation techniques that include a combination of muscle work (such as massage, stretching and exercise rehab) alongside joint mobilisations (taking the joint through its natural range of movement and encouraging stiff joints to work better) and spinal manipulations that can involve clicking and cracking. The intention is to improve joint mobility, release muscle tension, improve circulation and to promote healing. Osteopaths also seek to improve the patient's posture which can help to release restrictions of movement; they also aim to change external influences such as stress and nutrition, that may affect the body by either hindering or promoting the healing of body tissues. Working this way they help the body to maintain optimum health and therefore prevent injuries from occurring.Osteopaths use a variety of techniques to fine tune their treatments to the individual needs of the patient, and all treatment modalities are viewed as being of equal importance. It is very much a combined approach to full health.

The Chiropractor approaches treatment by focusing more on the spine itself. They will often use the phrase "out of place" which is misleading as joints do not go out of place without severe injury. They can treat other areas of the body, but by using manipulations on the spine, they attempt to improve joint or muscle problems elsewhere in the body. They often use more short, sharp, thrusting movements to achieve these spinal manipulations which make clicking noises. Their theory is based around releasing spinal joint restrictions to improve the neural supply to nerves that exit at different spinal levels from the spinal cord, to improve joint and muscle function in related areas of the body.

Physiotherapists, (Physio), often focus their treatments on education on how we should move and offer advice on the best exercises to help strengthen the area of the body that has a problem. Their manual therapy is often more massage-based. They commonly work within the NHS where a more patient-directed rehabilitation approach is encouraged which can include lots of prescribed exercise and pain management techniques. If the physiotherapist is working in private practice, they will often apply a more hands-on approach to their treatments, tending to use massage and joint mobilising techniques alongside extensive home rehabilitation plans. Some Physios take an additional qualification to enable them to use joint manipulation, i.e. clicking and cracking, but this is less common, and often courses are only of short duration.

So to summarise, all three of these professions have an amount of crossover within their approach however they all originate from slightly different perspectives be it focusing more on spinal manipulation or patient-led exercise and rehabilitation. Osteopaths work towards a combined approach, using both of these treatment types with the focus on the manual work using joint mobilisations and spinal manipulations together with massage, muscle release, myofascial techniques and some additional exercise advice too.

We often tell people that the main difference often lies in the specific practitioner. It is vital to find someone that is right for you regardless of their discipline. Sometimes, a different practitioner of the same discipline will suit your body better.