What’s the Difference Between a Physiotherapist, Osteopath, and Chiropractor?
If you’re suffering from musculoskeletal discomfort or pain, it can be challenging to decide which pathway of care is best for you. Especially when there are multiple distinct professions that, on paper, are equally qualified and capable of treating the same conditions despite having different techniques and philosophies. This is a confusing aspect of the healthcare system.
Similarities
All three professions:
- Treat the musculoskeletal system for injury and/or pain.
- Are recognized in Australia and supported by some insurers and other funding schemes.
- Are able to assess, diagnose, and advise.
- Provide conservative (non-operative) management.
Physiotherapy
Physiotherapy, especially in Australia, is often the default and assumed musculoskeletal care provider. Uniquely, physiotherapy focuses significantly on returning individuals to function, such as returning to work or sports. Treatment options are diverse, including but not limited to hands-on therapies, electrical devices, exercise, advice, education, and workspace modifications. Although rarely, physiotherapists can refer for a limited number of scans. Physiotherapists tend to have moderate success at being evidence-based clinicians.
Osteopathy
Osteopathy provides a comprehensive whole-body assessment, with treatment primarily centered around manual therapy. Their services are typically sought for complaints of the spine or neck. Many people report feeling better following osteopathic care, which may be influenced by the practitioner-patient relationship and the process of assessment, treatment, and reassurance (1). While there are evidence-based elements in their training, research indicates that Australian osteopaths, despite being supportive of evidence-based practice, engage in such activities less frequently (2).
Chiropractic
Chiropractic care involves a thorough assessment similar to osteopathy, but the treatment is heavily focused on spinal manipulations. The practice began in 1895 when David Palmer performed an adjustment that allegedly restored a deaf janitor’s hearing. In modern times, chiropractic care has a significant presence, and while some claims about resolving non-musculoskeletal issues exist, many people report feeling better after a chiropractic session, similar to osteopathy (1). However, they tend to engage in evidence-based practice less frequently (3) and receive more complaints to regulatory bodies compared to osteopaths and physiotherapists in Australia (4).
Conclusion
Ultimately, excellent and less effective practitioners exist in all three professions, and it is up to the practitioners themselves to commit to lifelong learning and delivering the best care possible. On average, physiotherapy is more likely to provide scientifically-backed and effective care. However, the best choice for a patient is to select a care provider with whom they have good rapport and trust.
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