Difference between physiotherapists, osteopaths and chiropractors

If you’re experiencing pain in your muscles, bones or joints, the process of getting the right support can be confusing. It’s not always easy to pinpoint the cause of your symptoms and it can seem like there are multiple courses of treatment to choose from.

Three of the more well-known and popular treatment options are physiotherapy, osteopathy and chiropractic services.

All three of these disciplines deal with musculoskeletal issues, and there is some overlap when it comes to the issues they address and the techniques they use. Each approach uses non-invasive, drug-free, manual techniques to improve physical health and wellbeing.

Who should you visit?

While the three disciplines may seem similar, there are some important distinctions between them. Each has a slightly different focus and no two approaches are the same when it comes to identifying and treating pain.

We’ve put together an overview of each to help you differentiate between the three and pinpoint which method is most likely to work for you.

Chiropractic care – isn’t that the one with all the cracking?

Despite what you might see on social media videos or at the top of Google searches, chiropractors do a lot more than simple ‘back cracking’. Chiropractic care focuses on the relationship between the spine and the nervous system so, while there is a certain amount of focus on the back, chiropractors are also interested in the causes of neck and joint pain.

• A chiropractor will use manual manipulation to adjust your spine and open up certain joints, which is what can cause that ‘cracking’ sound.
• Chiropractors also use a range of other techniques, including mobilisation, massage and muscle release.
• A chiropractor’s main aim is to reduce any pain you’re experiencing by improving the movement and function of your spine and other joints.
• Any manual treatment will usually be coupled with advice on posture and exercises you can do at home.
• Common conditions that chiropractors treat include back pain, neck pain, headaches and sciatica, but they’re trained to diagnose and treat a wide range of musculoskeletal issues.

Osteopathy – it isn’t just for bones and joints?

You might assume that osteopathy is entirely related to issues with the bones. In fact, osteopaths specialise in the diagnosis, management, treatment and prevention of a range of musculoskeletal disorders. They look at the structure of the body and the way that affects how it functions. Osteopathy can involve a number of different treatment options and approaches, based on what issues they identify and which treatments are most suitable for you.

• Osteopaths use a holistic approach to healthcare, looking at how they can improve your overall health and wellbeing.
• An osteopath will focus on your musculoskeletal system, using manual therapy techniques to address any structural and functional imbalances you may have in your body.
• Treatment is hands-on and can involve skilled manipulation of the spine and joints, as well as massaging of soft tissue.
• An osteopath may also provide you with lifestyle advice and nutritional guidance.
• Osteopaths are trained to diagnose and treat a wide range of musculoskeletal problems, including back and neck pain, joint issues and headaches. But their holistic approach means they may also treat issues that are seemingly unrelated to the spine or joints, like respiratory or digestive problems.

Physiotherapy – isn’t that just for sports injuries?

The aim of physiotherapy is to rehabilitate or improve a person’s ability to move and function.

While physiotherapists, or ‘physios’, may be most commonly known for their treatment of sport injuries, they have wide-ranging expertise in anatomy and physiology and use a combination of manual therapy, massage, stretching, exercise and advice to treat a range of musculoskeletal injuries.

• Physiotherapists are trained to diagnose and treat a wide range of musculoskeletal problems through exercise, manual therapy, massage and other techniques.
• Common conditions that physiotherapists may treat include sports injuries, arthritis, back pain and post-surgical rehabilitation.
• A physiotherapist can work with you to improve your range of motion, reduce pain and prevent further injury.
• If your injury is caused or aggravated by lifestyle factors such as frequent heavy lifting or maintaining a bad posture while sitting at your desk, a physio should provide useful tips to improve this and prevent injury re-occurrence.
• They may also provide education and give you exercises and stretches to perform in your own time to help manage your condition at home.

Why is it so important to get the right treatment?

According to the World Health Organization (WHO), around 1.71 billion people have musculoskeletal conditions worldwide, making this the leading contributor to disability throughout the globe.¹

This is a particular issue for both employers and employees. According to Health and Safety Executive (HSE) – a government agency responsible for researching and regulating UK workplace health and safety – around 473,000 people suffered from work-related musculoskeletal disorders (MSDs) in 2022/23, accounting for 6.6 million lost working days.²

What are the most common musculoskeletal conditions?

Back pain is one of the most common musculoskeletal conditions. According to WHO, lower back pain is the leading cause of disability in 160 countries.¹

There are a number of reasons you may experience back pain, from a muscle strain or rib injury to poor posture or an underlying condition. Issues can arise from heavy lifting, repetitive movements or poor posture while sitting at your desk.

That means back issues can affect anyone, from the most active to the most sedentary. And, with more of us working from home for some or all of the week, back issues are likely to become even more prevalent if we don’t stay active or ensure we have an adequate homeworking set up.

Other common musculoskeletal conditions include:

• Neck pain – Like back pain, neck pain is very common and can be caused by poor posture, muscle strains, injury or underlying medical conditions. It can also be brought on by mental health issues like stress or anxiety.
• Joint pain – Our joints are very susceptible to injury or inflammation. Our shoulders, knees, elbows and hips are in almost constant use throughout a normal day. With tendons, cartilage and muscles all working together to keep joints moving, joint pain has a variety of possible sources and causes, including overuse, injury and underlying conditions.
• Arthritis – This is a chronic condition that causes pain, swelling and stiffness in and around the joints. There are different kinds of arthritis, including rheumatoid arthritis, psoriatic arthritis and osteoarthritis, which also means there are many possible causes. Wear and tear and ageing are very common, but arthritis can also be caused by auto-immune disorders or injury. Arthritis symptoms can also be exacerbated by muscle weakness and obesity.
• Sports injuries – sprains, strains, fractures and muscle tears are common, both among athletes as well as those of us that just want to try and keep active. The more we exercise, the more we want to improve our fitness, speed, strength or endurance, and it’s easy to overdo it. These issues are often more short-term if treated correctly and allowed to heal properly with plenty of rest before a careful, staged return to activities.
• Headaches and migraines – you may think headaches are neurological and, therefore, unrelated to the muscles, bones and joints. But very often, headaches and migraines are caused by physical factors, including muscle tension, stress, neck pain and poor posture.
• Sciatica – the sciatic nerve runs from the lower back, through the hip area, down the legs and into the foot. Sciatica, which is usually sharp pain and tingling or numbness, occurs when the nerve becomes compressed or irritated. This can happen in the lower back as a result of inflammation, muscle spasm or structural issues, like stenosis.

These are just a few examples, but musculoskeletal issues can arise for a multitude of reasons anywhere in your body. From carpal tunnel syndrome, which affects the hands when the median nerve is compressed or irritated, to plantar fasciitis, which causes pain and inflammation in the heel and sole of the foot.

If you're experiencing any kind of musculoskeletal pain or discomfort, whether it’s a long-term issue or a recent injury, it's important to seek professional advice.

Chiropractors, osteopaths and physiotherapists are all highly trained in treating musculoskeletal conditions, but if you’re still unsure which course of treatment is right for you, a doctor can help you determine the cause of your symptoms and recommend an appropriate course of treatment.

Please note conditions or treatments detailed within this page may not be covered by your healthcare cover or scheme.

References

1. Musculoskeletal health - World Health Organization
2. Work-related musculoskeletal disorders statistics in Great Britain, 2023 - Health and Safety Executive