So, what’s the difference between a chiropractor, an osteopath and a physiotherapist?
If you have ever experienced pain related to muscles, ligaments or bones – then, hopefully, you were aware that there are various health professionals that are utilised globally to reduce this pain and guide your return to full function. Chiropractors, osteopaths and physiotherapists are such examples. Despite these health professionals being accessible for majority of the Australian population – there remains many individuals who don’t seek help from any of them. Or, they don’t make the most appropriate choice and are therefore susceptible to mixed results. A reluctance to access these services could be due to financial or time constraints – however, quite often it is due to a lack of knowledge surrounding what each profession entails and which would best suit their presenting issue/pain.
Physiotherapy
First, we’ll touch on physiotherapy. Physiotherapists use their knowledge of optimal and suboptimal human movement and function to guide individuals in the rehabilitation of an injury, surgical procedure or physical disability. They also work to prevent various health issues representing or appearing in the first place. While physiotherapists are primarily known for their involvement with sporting injuries, neck and back pain, other examples physiotherapists are adept at helping someone with is post-stroke, those with arthritis, Parkinson’s disease, cystic fibrosis, post-surgery and even those preparing for or recovering from giving birth (1).
The Australian Physiotherapy Association (APA) state that a physiotherapist may help you with the following:
- Muscle and joint stiffness or pain
- Recovery from an injury or operation
- Neurological disorders
- Supporting the aging process
- Occupational safety issues in your workplace
Private practice physiotherapy, such as at POGO, is largely for the general population with injuries or conditions that are usually painful and/or affecting their daily life. Physiotherapy is an evidence-based approached that, through the use of clinical reasoning, diagnose, apply manual or adjunct therapies and prescribe exercises to facilitate the body’s healing process, strengthened weakened areas and return the individual to normal functioning.
Physiotherapy is a free service in public hospitals, however private facilities will cost money – however rebates can be claimed through private health cover. All physiotherapists must complete a minimum of a bachelor’s degree at university and be registered with the Australian Health Practitioner Registration Agency (1).
What to expect from a physiotherapy consult?
- A series of questions aimed at getting all the necessary information regarding from you regarding your issue
- Manual therapy such as massage, or mobilisations (moving the body) to reduce and/or prevent your symptoms
- Developing a treatment plan aimed at achieving your short and long term goals
- Educate and advise you on activities or postures to reduce stress on the body
- Prescribed exercises for you to complete in your own time usually to strengthen muscles that are weak and/or stretch muscles that are tight
Chiropractic
Chiropractors focus on the diagnosis, correction and prevention of the musculoskeletal system, primarily the human spine (1). This type of service has increased dramatically in popularity of late. The professions ability to manipulate the human body to perceived ideal positions is seeked by many individuals in pain (1). The chiropractic profession is based on a belief that spinal adjustment can improve or rectify a range of health conditions (3). They do this by finding and correcting the maligned spinal segment(s) and “unblock” the previously impaired nervous system “flow” that was allegedly causing their issue (1).
Some chiropractors claim that their methods can treat seemingly unrelated disorders such as ADHD, asthma, autism spectrum disorders, high blood pressure and period pains (1). However, this concept does not align with current scientific understanding of disease with no such evidence found to support these claims (1).
Chiropractors use a variety of techniques to reduce pain and improve function of their clients. These techniques include:
- Manipulation
- Ice/heat
- Massage
- Ultrasound
- Acupuncture
- Lifestyle and/or dietary advice (3)
In summary, chiropractic services are considered to be complementary/alternative medicine with critics often pointing to a lack of scientific evidence surrounding their methods (5). However, each individual is different and, for you personally, the chiropractic pathway of treatment may be a successful one. So keep your mind open and discuss your options with your doctor (5).
Osteopathy
In this profession, focus is on the entire body rather than the specific injured area or part (5). Assessment of the whole body unit including your skeleton, joints, nerves, muscles, circulatory system, connective tissue and internal organs is undertaken and considered in the management of the presenting issue (5). Osteopaths also use their hands to apply manual therapy with the aim of reducing symptoms and improving function – however their pressure is often more gentle (5). Other methods utilised are orthopaedic and neurological testing, dietary advice and exercise prescription (1).
Osteopaths are a branch of primary healthcare practitioners that have the skill to recognise conditions that require medical referral. In addition to this, osteopaths are trained to perform standard examinations of the musculoskeletal, cardiovascular, respiratory and nervous systems (4).
Similar to chiropractic services, osteopaths’ techniques have limited evidence and scientific proof – particularly their “holistic”, “whole-body” approach (1). There is some modest research supporting osteopath’s beneficial effect on lower back pain through the use of spinal manipulations and manual techniques (1).
Osteopaths are in private facilities only and do not require a referral from a doctor.
So which option is best for me?
Whether a physiotherapeutic, chiropractic or osteopathic approach is pursued – it is encouraged that the practitioner you are involved with operates under an “evidence-based paradigm” (1). This means that all methods used in the consult and prescribed at home have been proven or concept proven through scientific research. This is to avoid further harm to your issue, or another issue presenting through malpractice. It is also vital to ensure that your therapy benefits you and your money is not being spent in vain.
In summary, whichever option you choose, the therapist should be someone that, above all, empowers you to look after your own body (1). This should be done by teaching you effective strategies in dealing with the pain you are experiencing as well as techniques to avoid future injury (1). Additionally, you should try to avoid those therapists that seem to be holding out a false promise of a cure by doing lots of things to you rather than teaching you along the way how best to improve and manage your health (1).
Alec Lablache
POGO Physiotherapist
Featured in the Top 50 Physical Therapy Blog
References
- ABC Health and Wellbeing. (2017). Physiotherapy, chiropractic and osteopathy: What’s the difference? Retrieved from https://www.abc.net.au/news/health/2017-03-16/physiotherapy-chiropractic-osteopathy-whats-the-difference/8360154
- Australian Physiotherapy Association. (2019). What is physio? Retrieved from https://choose.physio/what-is-physio
- Chiropractic Australia. (2015). About chiropractic. Retrieved from https://chiropracticaustralia.org.au/about-chiropractic/
- Osteopathy Australia. (2018). About osteopathy. Retrieved from https://www2.osteopathy.org.au/pages/about-osteopathy.html
- Medibank livebetter (2018). Physio, chiro or osteo – what’s the difference? Retrieved from https://www.medibank.com.au/livebetter/health-brief/healthy-living/physio-chiro-or-osteo-whats-the-difference/
- Pincus, T., Vogel, S., Breen, A., Foster, N., & Underwood, M. (2006). Persistent back pain – why do physical therapy clinicians continue treatment? A mixed methods study of chiropractors, osteopaths and physiotherapists. European Journal of Pain, 10(1), 67-76. doi:10.1016/j.ejpain.2005.01.008
- Image: https://totalshape.com/
