Osteopath, Chiropractor or Physiotherapist? Whats the deal?

What is an Osteopath? Who should I see between a Chiropractor, Physiotherapist or Osteopath? These are questions I get from people thinking about getting treatment all the time. This is because the scope of practice for these three professions have huge overlap. So lets dive into this topic to help you understand who you can or should be seeing to get treatment for whatever it is you have going on.

First off, what kinds of conditions do they treat? Osteopaths, physiotherapists and chiropractors all specialise in using manual therapy (or hands on techniques) to manage musculoskeletal (this means muscular or joint related) injuries. These injuries can include disc bulges, shoulder or hip impingement, osteoarthritis, tendonitis or tendinosis, ankle and foot injuries, wrist and elbow injuries, headaches, sore and tight muscles and so much more. They also manage lots of patients with non-specific pain. This is the kind of pain that you get in your muscles or joints that is not related to any specific, physical damage to your bodies structures. While physiotherapists are the most common practitioner to see in Australia’s public health system they treat many of the same conditions as osteopaths and chiropractors and sometimes even use the same techniques.

Chiropractors are best known for spinal manipulation which is a treatment technique where a fast movement from the practitioner is used to move a joint through a range that the patient may not be able to do themselves. Its usually accompanied by a crack or popping sound that some find extremely satisfying and others find rather terrifying. While chiropractors are the most well known for this treatment technique they are actually not the only discipline that use spinal adjustments. Spinal manipulation is a huge part of Osteopathic treatment and was being used long before Osteo’s or Chiro’s ever laid claim to it as a treatment method. Physiotherapists can also do special training to use spinal manipulation after they graduate, however, very few physios implement this tactic. Chiropractic can sometimes get a bad wrap from people who have an axe to grind against claims made by some chiropractors and while there are certainly bad chiros out there, this is true of all professions and shouldn’t be used to discredit all chiropractors.

Physiotherapist’s are the dominant practitioners in post-surgical rehabilitation because of their use of therapeutic exercise. Like spinal manipulation for chiropractors, physiotherapists do not have a monopoly on exercise therapy. Both osteopaths and chiropractors receive training in exercise rehabilitation. In my experience studying Osteopathy when I was at university, the focus was much more on the hands on treatment than the exercise. This was great for my skills in giving hands on treatment to my patients, however, the most critical exercise training I received was in my opinion separate to my university studies.

So who should you see? In my opinion I think you should see the practitioner you prefer who has expertise in both manual therapy and exercise therapy. Because manual therapy has very poor scientific evidence supporting its long-term results, it needs to be combined with appropriate exercise to get the best results. If you have a physio who you like and their treatment is working for you, stick with them. If you have a chiro who you have given a red hot crack and its not helping you than don’t be afraid to shop around. Likewise for any of these disciplines.

As an Osteopath I actually utilise treatment methods that are quite different to those used by many of my colleagues, and that is okay. I use just as much exercise as I do manual treatment, and I use a fair bit of spinal manipulation where some practitioners avoid it. The most important thing is that you’re practitioner helps you develop both a short-term and long-term plan to help you get out of pain and stay out of pain. Its also important that your practitioner tailors their approach to your individual needs. If you feel that they do the same thing for every person, this could be a problem. When you go see a manual therapist, be they, osteopath, chiropractor or physiotherapist you should feel that when you go to them you learn more about your body and they help you to improve your health rather than just doing something to you that puts a band-aid over your problem temporarily.

So the verdict… See who you like. Especially if that is me ;)

Until next time,

Nathanael