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Physio, Osteopath or Chiropractor ?

Updated: Feb 22, 2022

Just what is the difference and does it actually matter ?

" So, I was wondering, what is the difference between you and a Chiropractor ? " ......

If only I had a quid every time someone had asked me this question, after 26 years as a Physio I'd be on a beach in the Maldives. It ranks up there with other great questions such as ' ..which came first, the chicken or the egg ? ' or ' .. jam or cream on the scone first ? Obviously it's jam !

It's unlikely I am alone here and members of all three professions regularly field this question from pleasantly baffled patients phoning to make an appointment, unsure who they should be booking in with for their back, neck or knee pain as they aren't entirely sure what the difference is between each one. A Google search throws up page upon page of articles, blogs and forum questions all attempting to pin down the specific difference between a Chiro and an Osteopath. The conclusion varies wildly according to the training of the particular author and struggle to provide a clear cut answer regarding the ' best ' therapy to engage with as undoubtedly there will be some professional bias. So here's my ham-fisted ( and hopefully unbiased ) attempt with as little jargon as possible

Differences and similarities.

Physiotherapy : Treats a wide range of problems of the joints, muscles and nerves using physical ( manual ) methods like joint stretches, manipulations, muscle and soft tissue stretches, strengthening, balance and co-ordination exercises. They may have additional training to use things such as Acupuncture, taping or specific exercise systems. All Physiotherapists are also trained to treat and rehabilitate neurological problems like multiple sclerosis, stroke or spinal and head injuries and also breathing and cardiac problems too. Physios usually choose which area to specialise in once they have completed their degree and basic training modules.

Osteopathy : A holistic manual therapy which aims to restore natural alignment and function in the body by looking at all of the different systems in the body e.g skeleton, muscles, nerves, circulation. Again it uses physical ( manual ) methods to identify any areas of pain and restriction aiming to relieve them by freeing up connective tissue, restoring circulation and correcting any underlying factors that may contribute to the restrictions.

Chiropractic : Concentrates on diagnosing mechanical disorders of the joints, with a particular emphasis, although not exclusively, on manipulation and treatment of the spinal joints irrespective of the joint that is problematic. It's that classic ' bone cracking ' image that is often portrayed in the media although in recent years Chiropractic model of treatment has broadened it's scope with more corrective exercises being introduced and less of a reliance on pure manipulation. Some Chiropractors may also include taking x-rays as part of their practice.

So as you can where the confusion arises from ..... there is much commonality across the three disciplines such as a reliance on physical techniques rather than any drug therapy, a common goal to relieve pain and get the patient moving properly and functioning again. Yet the approach is different, the length of treatment times and the cost per session most certainly is !

So does the difference matter ?

My own thoughts are that much of this confusion is un-necessary and has been created by bickering amongst the professions themselves, each vying for supremacy over the other. Maybe we re-frame the original question to “ Should there be any difference between a Physio, Osteopath and Chiropractor ? This isn't intended to be disrespectful in any way to any of the professions but I sometimes feel the bickering and the ' my therapy is better than your therapy ' argument misses the point that there is a patient at the centre of this who just wants to get better....... does it really matter how they do that ? The further I go with my job and the more I learn I come to realise that irrespective of the profession we are all looking for the why behind the what for all of our patients. On a daily basis I analyse the movements of my patients and look for changes in soft tissue tensions and asymmetries which would probably traditionally have been the preserve of the Osteopaths and Chiropractors. Doubtless they too look for suitable exercise regimes and movement strategies for their patients to help maintain the improvements gained in a treatment session..


The best therapist is always one that listens to you, puts you at the centre of the plan and ultimately gets you back to living again ! There are many paths to the same goal, you have to choose the one that suits you AND the person that you feel confident and comfortable with.

So I look forward to the day Physio, Chiropractor and an Osteopath walk into a pub and have a quiet drink together. Chiropractor gets the first round in though......seems only fair !

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