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It is important to initially acknowledge the difficulty in differentiating between professions that borrow philosophy, evidence based medicine, and practice theory from each other. Many years ago there was a distinct difference between these professions but the information age has allowed for an enhancement in all manual therapy professions with the scope of individual practice principals continually branching further into the medical landscape. You may now find physiotherapists practicing like osteopaths and chiropractors and vice versa.

Osteopaths study and practice Osteopathic principals first and foremost but to respect their own principals they must endeavor to understand all forms of medicine to become truly holistic in their approach to their patients. Osteopaths study and in some cases may also practice the elements which are good and effective amongst other medical professions such as chiropractic, physiotherapy, acupuncture, psychology, naturopathy, general practice, and many other health based professions. There is a reason why so many different medical professions continue to exist and there is much to learn and practice the elements which are effective amongst each of them.

With the information above there can only be generalisations about the difference between Osteopathy, Physiotherapy and Chiropractic. So here they are:

Osteopaths generally spend more time with their patients in one consultation which may transfer into less appointments with an adaptation of a self management plan. Osteopaths pride themselves on having a wide range of treatment options for patients and apply appropriate amount of pressure according to patient needs. The primary osteopathic philosophy is treating the person rather than just their symptoms. Osteopaths pride themselves on understanding how the body works as a whole and how structures are related and affected when disease or injury sets in.
Osteopaths in Australia complete 5 years of university training and each year they are required to practice a certain number of hours and study and  to remain registered. They are registered as primary healthcare practitioners and are trained to recognise various conditions in all areas of the body and not just musculo-skeletal injuries (e.g. diseases of the heart, lungs, digestive tract, vascular and nervous system etc.). Your osteopath is trained to screen and examine for conditions that may require referral to other specialists.

Osteopaths are generally capable of dealing with all conditions physiotherapists and chiropractors do.  There is a common misconception that certain manual therapy practitioners are suited to certain conditions and injuries which is mostly untrue - each has their own philosophy on treatment and management. For example, Osteopaths pride themselves on study and knowledge of concepts of rehabilitation (often aligned with physiotherapy), they will apply these principals according to the evidence or text and will also treat the whole body according to the osteopathic principals. Similarly, some people believe that only a chiropractor can deal with conditions of the spine when in actual fact an osteopath is well trained to manage spinal issues but, for example, will also take the time to look at your pelvis, hips, knees, shoulders etc. and your whole system.
A way to distinguish osteopaths from other forms of manual therapy is to list what most osteopaths won't do:
  • Most Osteopaths will not treat more than 1 patient at a time.
  • Most Osteopaths will not use special gadgets such as ultrasound or clicker guns (most Osteopaths will treat with hands on techniques).
  • Most Osteopaths will not just manipulate or crack joints as the only treatment method.
  • Most Osteopaths will not put you on a long term treatment or payment plans.
  • Most Osteopaths will not just treat the painful joint but look at the areas related to the joint and the whole body.
  • Most Osteopaths will not spend less than 5-10 minutes with you

Physiotherapy & Chiropractic
Here are some generalisations about Physiotherapy and Chiropractic:

Physiotherapy is perhaps the most commonly known ‘manual therapy’ in Australia as there is a large volume of practitioners working in the public system as well as the private sector. A Physiotherapist may specialise in rehabilitation and treatment of certain acute and chronic joint injuries and a common generalisation is that they more commonly treat the injured area rather than the holistically. Some physiotherapists use machines such as TENS or ultrasound (and more recently dry needling) as part of their treatment approach and often provide you with a variety of exercises for you to do at home. There is a portion of physiotherapists who also able treat all conditions common to other manual therapists (they may also treat similarly to osteopaths/chiropractors it depends on their education/philosophy).

Like Osteopaths, Chiropractors usually treat the body in a more holistic manner. The person who founded Chiropractic was understood to be a student of the founder of Osteopathy Dr. Andrew Taylor-Still. The discipline is based on the premise that the body is capable of self-regulation and healing itself, which is controlled by the brain, the spinal cord and the nervous system. As with certain physiotherapists, it may be difficult to distinguish between Chiropractors and Osteopaths, however, a certain amount of chiropractors still only treat by using manipulation over multiple sessions. Chiropractors may also refer you for a spinal x-ray to review spinal alignment to aid diagnosis and treatment.

Promotion, Popularity and Public Awareness.
The popularity of physiotherapy and chiropractic may be additionally attributed to their position in the public health system and strong local and national marketing strategies. Generally, osteopaths have tended to be a little more subtle with their promotional strategies. The landscape is changing very rapidly though: Osteopathy is statistically becoming the fastest growing health profession in Australia. The number of people choosing to visit an osteopath has increased by 48% over the last two years (PHIAC June 2012) and even more interestingly osteopathic treatments have increased 270% since 2005 (click here to read more).

How to choose between an Osteopath, Physiotherapist and Chiropractor.
These days you will always have a choice between each of these professions in your area. Here are some ideas to help you choose the right one:
  • Get a recommendation from your respected peers, or other health professionals
  • Contact the therapist for a discussion and find out if he/she can help with your condition/injury. Ask about:
      • experience in dealing with your complaint
      • treatment philosophy, types of techniques used
      • how long they treat for and rational behind the amount of time spent
  • By listening to the therapist you may instinctively be able to recognise if this person is the right practitioner for you.
  • Some therapists are happy to have a face to face discussion with you first. This may also allow you to feel comfortable with your choice.
  • Trial the therapist for a few sessions. You may be able to instinctively tell if this is the right person for you.