How to choose between visiting a Chiropractor, Physiotherapist and an Osteopath
There is much confusion about the roles of Chiropractic, Physiotherapy and Osteopathic professions. This is not helped by the way practitioners often present themselves as being able to do “all things for all men”. It is true that all three can be helpful in a range of debilitating conditions, but there are important differences in their levels of knowledge, training and the core ideas informing their diagnosis and treatment. This article seeks to clarify the differences so that a considered decision can be made about which therapy to choose.
Mostly known for their success in treating back problems, and also trained to treat issues with joints. Many Chiropractors treat children. They almost always employ spinal manipulations as part of treatment. Chiropractors will usually have their own X-Ray equipment and often suggest an X-Ray as part of the initial consultation.
They aim to improve the function of the peripheral nervous system (the part that allows you to move and to feel sensation), to bring balance back into the musculo-skeletal system.
Primarily spinal manipulations with a less direct work on muscles. There may be some exercise and lifestyle advice. Electrotherapy (like ultrasound) is seldom offered.
A Bachelor or Masters of science that takes 4 years of study including 1000 hours of clinical experience. The degree is academically demanding and involves extensive anatomy, physiology and pathology.
Areas of Expertise:
Chiropractors are probably the best trained in spinal manipulation of the three professions. In comparison an Osteopath will also have had very extensive training in spinal adjustments, but with a gentler emphasis and will have also been exposed to a wider range of alternative techniques. A physiotherapist is very unlikely to have had any training in spinal adjustments when they graduate. If they have it will be a tiny fraction of that received by the other two.
If you have a back or neck problem that responds well to “being clicked” then a chiropractor is a good choice.
Physiotherapy is rooted in that part of the medical profession concerned with restoration of movement and recovery from trauma following surgery. They have a thorough training in musculoskeletal issues and consultations tend to emphasise advice on exercise and lifestyle, with less hands on therapy. Physiotherapists have traditionally been hospital based, but private practices are becoming more common.
Physiotherapists concentrate on movement by trying to restore mechanical function. The prime purpose of physiotherapy is to restore and maintain function, activity and independence and prevent injury or illness through information and advice on healthy lifestyles.
Physiotherapists make use of manual therapy in the form of traction and massage and joint movements, although depending on the complaint, this is not always offered. Therapeutic exercise is an important part of the therapy. Patients can expect a lot of exercise and lifestyle advice. The appliance of electro-physical modalities like ultrasound and tens used to be popular, but these are going out of fashion due to of lack of evidence on effectiveness.
A Bachelor of science that takes three years and includes 1000 hours clinical experience. This is usually supplemented with additional post graduate professional development courses.
Areas of expertise:
With it's pedigree in hospital based rehabilitation, physiotherapy is ideal for the management of neurological conditions like multiple sclerosis or Parkinson's disease, geriatric care and for rehabilitation following injuries.
Physiotherapy works well following injury or operation, especially in the area of exercise and lifestyle advice. If you prefer a more “hands off” style then physiotherapy is a good choice.
Osteopathy, along with Chiropractic care, has a well deserved reputation for success in treating back neck and shoulder pain. It is reasonably perceived as the gentler approach, even though it does often involve spinal adjustments. Osteopaths frequently treat without manipulations and are well versed in comfortable interventions that involve careful precise movements of joints to encourage healing.
Osteopaths believe that the body has it's own healing resources and that a healthy supply of blood to all parts of the body is vital to health. This belief informs much of their approach to treatment, along with an emphasis on joint function and structure.
Balanced use of spinal and joint manipulations, along with joint articulation, traction and soft tissue massage form the majority of Osteopathic treatment. Cranio-sacral therapy is also practised by many, along with variants like balance ligamentous tension. There is less exercise and lifestyle advice than is given by physiotherapists, but this is still regarded as an important part of the treatment approach. They make far less use of X Rays than Chiropractors and prefer to leave radiological investigations to the specialists.
Like Chiropractors, Osteopaths complete a 4 year degree resulting in a Bachelors or Master of Science which includes 1000 hours of clinical experience. Again the degree is academically demanding, involving extensive anatomy, physiology and pathology. Spinal adjustments are studied and practised for a full 3 years, whilst gentler techniques including cranial Osteopathy and the treatment of children are also taught.
Areas of expertise:
Along with excellent spinal adjustment skills, the Osteopaths concentrate on the gentler side of treatment, ensuring that sensitivity is incorporated with effectiveness. Cranial technique is very much the territory of the Osteopath, and the restoration of balance in addressing the underlying causes of problems.
Osteopathy is the ideal way to have back, neck and shoulder pain treated for the patient who prefers and gentler approach. Osteopathy is also very well suited to the treatment of sports injuries, as it assists in the full life-cycle of healing and can address important underlying issues.