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What is the difference between physiotherapy, chiropractic and osteopathy? 

Deciding on who to see for your pain or injury can be a tough decision. With so many different options, it can be challenging to know which one is the right choice for you. This blog post will look at the differences between three very different professions: physiotherapy, chiropractic, and osteopathy. This way, you’ll have all of the information necessary to make an informed choice about what’s best for your situation!

To begin with, each of these professions has a unique and very successful background. However, over the years, the lines between them have become quite blurred. Some Osteopaths will treat similarly to Chiropractors and Chiropractors like Physiotherapists and vice versa. With increased co-operation between the professions and sharing of information through the internet, the differences are sure to get smaller and smaller.

However, some fundamental differences in philosophies still exist across the delivery of care.

Let’s examine each profession’s fundamental philosophies.


Osteopathy is a form of manual healthcare that recognizes the important link between the body’s structure and the way it functions. Osteopathy treatment revolves around a core belief that if one part of the body is restricted, the rest must adapt and compensate. Osteopaths use stretching, myofascial release, articulation, manipulation, and joint mobilization to release areas of restriction within the body. Osteopathy is very hands-on, which can be incredibly beneficial to reduce pain and stiffness, whether muscles or joints. Many people think it is all about bones due to the name osteopathy ( osteo meaning bone); however, osteopaths treat the entire body, including muscles, joints and ligaments.  

Osteopathy is one of the fastest-growing health care professions due to its popularity and success.

Osteopathic treatment can help with a wide range of conditions, including chronic pain disorders, digestive health problems and musculoskeletal issues. They are best known for the fast, effective treatment of neck and back pain and “stubborn conditions” that have not responded to other methods.

Osteopaths also work in conjunction with other healthcare professionals to provide the best possible care for their patients. It is important to remember that osteopathy works alongside conventional medicine rather than instead of it. More and more, allied health and medicine are working together to benefit patients who are suffering from pain, injury, or medical condition.


Physiotherapists use a variety of techniques to help your body move to its full potential. They help people affected by injury through movement, exercise, manual therapy, etc. Their treatment can include physiotherapeutic massage, joint mobilization and hydrotherapy. They treat patients with injuries or chronic pain such as back pain caused by physical strain on the upper body’s muscles like sprained joints. Physiotherapy is extremely successful for many individuals, including those suffering from osteoarthritis. Physiotherapists in Australia undergo a minimum of 4 years of study at university, similar to chiropractic and osteopathic training ( both 5 years).

Physiotherapy and osteopathy are similar in that both disciplines focus on the musculoskeletal system. However, each field using different techniques to treat problems such as pain relief or muscle injuries. The differences between physiotherapy and osteopathy can be seen when examining their educational backgrounds.


Chiropractic is a form of complementary health care based on the diagnosis of misalignments of the joints, particularly those in the spine. These misalignments are believed to cause disorders by affecting nerves, muscles and organs. The most common forms of treatment involve making “adjustments” or adjustments using spinal manipulation. Chiro is effective for acute back pain.

Often chiropractors will have massage therapists or myotherapists working alongside them to work on the muscular components of your condition. Stretching exercises, massage and electrotherapy are often used in combination with chiropractic.

Training and Education

Both physiotherapy, chiropractic and osteopathy are undergraduate degrees (BSc Hons) studied at a university.

Physiotherapy is a 4-year degree. Chiropractors and osteopaths both do degrees of 4 or 5 years, respectively. In their studies, they cover the basics: anatomy, biomechanics, physiology and pathology. As part of the degree, students complete mandatory clinical placements to learn from and help real clients by assessing, diagnosing, and treating them.

Physiotherapists gain experience in hospitals and local clinics on placements and osteopaths in a private teaching clinic affiliated with the university.

The most significant difference between the two degrees is the breadth of conditions that they will be expected to treat regularly. Physiotherapists have the opportunity to improve their skills by completing a work placement that allows them to gain experience working with patients and treating different conditions, such as cardiovascular, respiratory and neurological conditions. They often take these placements at local hospitals.

As part of their university course, physiotherapists have the chance to complete a work placement to put their skills into place and treat actual patients. These placements allow them to learn how best to address physical problems and disorders that affect “systems” of the body (e.g., movement or musculoskeletal).

Osteopaths rarely have placements in the hospital setting and have clinical placements as part of their university courses. However, this is often a ‘private practice’ teaching clinic. Most patients will attend due to musculoskeletal pain and sports injuries, e.g. neck and back pain. This exposes the osteopathy students to a narrower breadth of injuries and complaints during their training. After their study, an osteopath is better equipped for private practice as a new graduate. In contrast, a physiotherapist would need considerable training from an experienced clinician to be able t provide great care in a private practice setting for acute musculoskeletal injuries.


Your choice of therapist for a particular condition will depend on the individual’s experience and training. Most physiotherapists use a combination of ‘hands-on’ treatment and more rehabilitation-based treatment (exercises).

Manual therapy involves applying gentle pressure, compression or joint mobilization to increase your range of motion.

It is very uncommon that a physiotherapist will not provide a home exercise-based program (or at the very least provide suggestions for exercises) after your treatment sessions. These exercises are aimed to reinforce the benefits received from your treatment plan and are an essential part of most treatments.

Osteopaths also use ‘hands on’ treatments, but there may be less emphasis on home exercise for you to carry out between your treatment sessions. This varies among practitioners, but most physiotherapists will use exercise more often than osteopaths, and osteopaths will use their hands more than physios as a generalization.  

Physiotherapists spend more time during their undergraduate training focusing on the use of exercise therapy and rehabilitation. During my osteopathic education, there was less emphasis on how to do these techniques, which I feel is a serious limitation of osteopathic training. Some osteopaths learn them later in their training through postgraduate education. Physiotherapists learn much less manual therapy/hands-on treatment, which is very effective for many acutely painful conditions, so often they have to learn this on the job or through additional courses.

A significant body of research has now been established to show exercise therapy is a very important part of a treatment program for any back condition. Certainly, all of the physiotherapists at Premier Sports & Spinal Medicine have extensive postgraduate training in both manual therapy techniques combined with rehabilitation and exercise.

Is an osteopath better than a physiotherapist?

It depends on the conditions being treated, the preferences of the individual and what their body may respond to. Each profession does, in my opinion, have certain advantages over the other. These are general statements and do not apply to every professional from that discipline as it depends on their skills, interests and commitment to professional development.  

They do have different approaches that would benefit certain conditions and patients.

Particular conditions are suited to specific professions.

Post-operative rehabilitation

I would recommend a physiotherapist for post-operative rehabilitation. They will work with orthopaedic surgeons to ensure patients are pain-free and can return to regular function as soon as possible. Physio has much more experience in treating this type of condition due to their time in hospital on placements that osteopaths do not undertake.

Back pain

For both acute and chronic back pain, seeing an osteopath who has experience treating this condition is optimal. They have a holistic approach to treating back pain and will use spinal manipulation, massage, cold therapy and exercise to reduce inflammation.

Osteopaths also consider other factors that may contribute to your symptoms, including your lifestyle choices (such as sitting at work or spending long periods on the computer), which can all contribute to low-grade chronic tension in muscles around the spine.

Osteopaths look at the entire body and recognize that your back pain may be stemming from another region, even though you feel the pain in your back. A common example is when your hip flexors (muscles at the front of your thighs) are tight and pull on the lumbar spine, or when your upper back is too hunched and causes neck pain or headaches.

Sports injury

Traditionally sports injuries would be the domain of a physio; however more and more osteopaths and chiropractors are developing an interest in this area. As such, it makes it harder to recommend an entire profession. Sports injuries, especially to the peripheral joints ( arms and legs), are prevalent conditions for physiotherapists’ to see. It would account for 30 % or more of their caseload in a private setting. Osteopaths and chiropractors would see much less of these sorts of injuries – perhaps around 10-20%. A sports physiotherapist has additional training and qualifications in sports injuries and would be the best place to start if you had a severe injury or one that was not progressing, or if you were playing sports at a high level.  

Now osteopaths can receive their postgraduate title as sports osteopaths to recognize their achievement in managing sports injuries. This is a recent addition and something that the physio profession has had for years. 

Hopefully, this has helped clear up any confusion about who you should see. If not, call our friendly receptionist who can advise you as to the best person to see. We have experienced professionals from all disciplines who can help you whatever your injury and preference for treatment.

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