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Who should I see? Osteopath? Chiropractor? Physio? What's the difference?

This must be the most commonly asked question in clinic.

What's the difference? Who should I see for back pain? What will they do? Who should I see for a knee injury or shoulder problem?

To be fair these days there can be a great deal of cross over between them all which doesn't help in making your decision. I'm going to try and make it as simple and as straightforward as I can (#osteopathview #lovemyjob).


..........look at the body as a whole.

Our main principles include: the body is a unit and structure governs function. Therefore Osteopaths use a range of techniques including:

  • Soft tissue massage/ myofascial release

  • Stretching

  • Muscle activation

  • Clicking/popping (when required)

These techniques vary depending on the person and their injury, different techniques work for different people.

Osteopathy was created by Andrew Taylor Still in 1874, he quoted,"to find health should be the object of the doctor, anyone can find disease".

Still soon discovered that in order to achieve the highest possible form of health, all parts of the body should work together harmoniously, he established the American School of Osteopathy in 1892.

It takes four years to train to be an Osteopath. Many Osteopaths choose to specialise or take up further training in a particular area after qualifying. This may be sports related or something completely different such as pregnancy and pre/post partum.

For me personally I have enjoyed further education in Clinical Anatomy, Rehabilitation, and more recently Biomechanics (see more: Emma).

However, I will add, I do enjoy treating any pain or ache that presents in clinic. Further study is an ongoing process and is part of why I love being an Osteopath.

*Interesting fact: Osteopathy literally stands for "bone suffering" or "bone pathology" as we would now call it. The word was not formed to describe treatment but a principle upon treatment is based in the search for health.


  • 'Hands on' manual therapy (various massage techniques)

  • Clicking/popping technique (If consented)

  • To remove part/ some clothing (to see the area of dysfunction)

  • Usually 2-4 treatments (depending on individual and injury)

  • Advice for long-term recovery (Postural/ Exercise)

  • 30-45 minute appointments


.......are traditionally recognised for their focus on spine alignment.

Canadian-born American called Daniel David Palmer (1845–1913) concluded that restoring the spine to it's proper alignment would restore health. His believed misaligned spinal vertebrae had an effect on the nerve flow and this caused disease (1896).

People who are suffering back pain and neck pain often chose to see a Chiropractor due to this focus on the spine, and the 'clicking' adjustment technique that is readily used. Some practitioners will have a much wider repertoire in technique or an additional massage therapist in clinic to help various aches and pain.

It takes four years to train to be a Chiropractor and the focus is on this speciality of spine alignment from start to finish.

*Interesting fact: Palmer was originally a student of Andrew Taylor Still (founder of Osteopathy) and was jailed for practicing Osteopathy without a license before inventing his own license and approach.


  • Clicking/ Popping techniques

  • Focus on spine alignment

  • Can be a 10- 20 minute appointments (these techniques don't take long to do!)

  • Occasional massage (dependant on the practitioner)

  • Often weekly visits for 6-8 weeks.

Physiotherapists... are often better known for their exercise prescription, particularly within the NHS.

Private physios often offer more, 'hands on' work or the use of ultrasound/ shockwave, however, in my experience the focus is still on the exercises. Unlike Chiropractors, people often see a Physio for an injury anywhere on the body, not just back pain. Sometimes seeing a Physio can coincide well with having 'hands on' treatment, particularly if you want to get back to a sport or level of fitness quickly.

In 1913/14 Schools of Physiotherapy were established in New Zealand and America. In 1921 the first research paper was published and since then physiotherapy has been an evidence-based therapy.

It takes five years to train to be a Physio. The training is longer as Physios train and rotate in many areas, for example: cardiovascular/ stroke, respiratory, intensive care, as well as musculoskeletal (MSK). For a Physio to treat in MSK you then have to commit to further training in that area to learn and specialise. Some Physios learn the 'clicking' technique and therefore it may be used.

*Interesting fact: The positive effects of exercise have been proven over and over again. This is why it is used so strongly in Physiotherapy. It's very difficult to prove (in evidence-based research) the specific result from 'hands on' techniques as each person and their pain is individual and therefore the response is very variable.


  • Exercise Prescription

  • Possible ultrasound/ shockwave

  • Occasional massage (dependant on practitioner)

  • 1-3 weekly visits (dependant on injury)

  • Possible lead to further referral (NHS)


The main primary goal of all the professions is to relieve aches and pains in the body and to improve your health.

If your not sure ask the practitioner themselves, any good practitioner will be more than happy to explain and ensure you are secure and comfortable.

For more interesting facts:

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Bye for now!

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