What’s the difference between an osteopath, a physiotherapist and a chiropractor?

This is another common question. The answer, I think, is touch. Osteopaths train for a minimum of 4 years and in that time practice for at least 1000 hours in a clinic getting hands on people. This hones the sense of touch or ‘palpation’ to be able to assess tissue quality, the range of movement, symmetry and even the tenderness of an injuried or strained area. Osteopath assessments and treatments involve palpation so your session will always be ‘hands on’.

A physiotherapist or chiropractor has different principles to an osteopath. Although trying to achieve the same outcome i.e. getting the patient better, the patient will experience treatment differently visiting each professional.

Let’s use low back pain as an example. Where a physio might see glutes not firing and prescribe exercises, an osteopath or chiropractor might see sacroiliac joint dysfunction and perform spinal manipulation and/or articulation. Both aim to help the low back problem and both have advantages and disadvantages (of course). The physio might argue that the spinal manipulation is short lived and won’t help if the glutes don’t fire to stabilise the changes made. The osteopath/chiropractor might argue that the glutes won’t fire properly while there is imbalance and limited movement in the spine. The nerves that fire the glutes leave the spine between L4-S1 so they are unlikely to be the only problem. It’s a bit like a chicken/egg argument where no one answer is ‘right’.

Osteopaths, like physios, are Allied Health Professionals (AHPs) and have been recognised as such since 2017. Chiropractors aren’t.

There are more physios in the NHS than osteopaths who remain a small profession in comparison. There are no chiropractors working in the NHS (to the best of my knowledge.)

What remains important in answering this question is that a good osteo/chiro/physio should get you right with a mixture of hands on, exercise prescription, and lifestyle advice. They’ll go about it in different ways, but a good healthcare professional is worth their weight in gold to their patients.