What is the difference between an Osteopath, a Chiropractor and a Physiotherapist?

The differences between osteopaths, chiropractors and physiotherapists can be difficult to differentiate between as they all seem to treat similar areas of the body and are drug free manual therapies. In this article we will attempt to make the professions a little clearer, citing their similarities and differences to help make the right choice.

When investigating the claims of the three professions it can be difficult to choose between the three as they claim to have similar systems of care. Below is a table comparing their philosophies.

Osteopathy Chiropractors Physiotherapy

The body has the natural ability to maintain itself and, by helping this process, an osteopath can promote restoration of normal function. The principle of osteopathy is that the well-being of an individual relies on the way that bones, muscles, ligaments, connective tissue and internal structures work with each other.An osteopath will take the time to understand their patient, and their unique combination of symptoms, medical history and lifestyle. This helps to make an accurate diagnosis of the causes of the pain or lack of function (rather than just addressing the site of the condition), and from that, to formulate a treatment plan that will achieve the best outcome.

They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.

Osteopaths frequently work alongside other health professionals, such as GPs, nurses and midwives as well as alternative medical practitioners. Osteopathy works well to complement other medical interventions including surgery and prescribed medication.

(Institute of Osteopathy, GOsC)


Chiropractors are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints, and muscles), as well as the effects these disorders can have on the nervous system and general health. They have a specialist interest in neck and back pain, but when they assess patients, they take their entire physical, emotional and social well-being into account.Chiropractors use a range of techniques to reduce pain, improve function and increase mobility, including hands-on manipulation of the spine. As well as manual treatment, chiropractors are able to offer a package of care which includes advice on self-help, therapeutic exercises and lifestyle changes.

Chiropractic treatment mainly involves safe, often gentle, specific spinal manipulation to free joints in the spine or other areas of the body that are not moving properly. Apart from manipulation, chiropractors may use a variety of techniques including ice, heat, ultrasound, exercise and acupuncture as well as advice about posture and lifestyle.

(British Chiropractic Association)


Physiotherapy helps restore movement and function when someone is affected by injury, illness or disability. Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.

They maintain health for people of all ages, helping patients to manage pain and prevent disease.

The profession helps to encourage development and facilitate recovery, enabling people to stay in work while helping them to remain independent for as long as possible.

Physiotherapy is a science-based profession and takes a ‘whole person’ approach to health and well-being, which includes the patient’s general lifestyle.

At the core is the patient’s involvement in their own care, through education, awareness, empowerment and participation in their treatment.

(The Chartered Society of Osteopathy)

Essentially, they are all non-invasive, drug-free, manual techniques, which aim to improve physical health and well-being.

In the UK, physiotherapy is most integrated within the NHS and consequently better known. There is no charge to visit physiotherapists on the NHS with referral via the GP but waiting lists can be long. Physiotherapists work both on the NHS and in private practice. Osteopathy is not as widely available on the NHS and the majority of osteopaths and chiropractors work in private practice, where no referral is needed.

What we believe to be essential here, regardless of profession is that your healthcare professional of choice operates of the best available evidence to treat your condition. A recent article on comparison between the three professions had Dr Andrew Leaver, Senior Lecturer in Physiotherapy at the University of Sydney pointing out that evidence-based practice is “not a black and white proposition”. It is important to understand that there is not enough robust evidence available for every condition.

Whether you see a physiotherapist, chiropractor or osteopath, Dr Leaver says the most important thing is that you find a practitioner who “operates under an evidence-based paradigm”.

“So physiotherapy is not a treatment — it’s the person who provides the treatment. And similarly, chiropractic is not a treatment — it’s the person who provides the treatment.”

What you want to avoid, he says, is somebody who makes false promises of a cure and takes too much credit for natural recovery. Correcting “misaligments” for example do not fit with the later scientific understanding of pain.

“You don’t want to be seeing somebody who is holding out a false promise of a cure with lots of interventional treatment — so somebody who does lots of things to you, rather than teaches you to do things for yourself.”

“You want to see someone who empowers you look after your own body, and to look after yourself, who teaches you good strategies for dealing with day-to-day pain,” Dr Leaver said.

The article featuring Dr. Leaver’s views can be found below: