Osteopathy, Physiotherapy and Chiropractic – differences and similarities

This is a common question which practitioners from all three therapeutic modalities are asked. While the differences used to be more defined historically, it's difficult to differentiate each therapy nowadays as there are quite a number of techniques and treatment approaches which we all share. Some of you will be aware of these, having perhaps been to manual therapists from all three, however others may only be aware of physiotherapy through the NHS (which is actually quite different to the treatment protocol offered by private physiotherapists).


Osteopathy is a manual therapy which aims to reduce pain and return patients back to full function by addressing problems we find in the neuro-musculo-skeletal system (nerves, muscles and skeleton). This mostly involves treatment of the muscles and joints using gentle approaches such as soft-tissue massage, stretching, joint articulation and release (manipulation) and, depending on whether the practitioner has had further training, dry needling (similar to acupuncture) and cranial osteopathy.

All UK Osteopaths have completed a 4 year degree with rigorous clinical training after-which they have to be registered with the General Osteopathic Council (GosC). 30 hours of continued professional development is required from us to enable us to remain on the register.




As with Osteopathy, physiotherapy is a degree-based healthcare profession which focuses on reducing pain by restoring movement and function predominantly through exercise rehabilitation. A lot of time is spent on exercise prescription and explanation as a means to empower the patient to participate in and achieve their own recovery. There is usually little soft tissue massage or hands on manual therapy applied by NHS physiotherapists due to time constraints while private physiotherapists often treat in a similar way to Osteopaths and, more recently, a number of them also apply dry needling and have taken short courses to learn manipulation of the spine and other joints.

Physiotherapists practising in the UK must be regulated by the Health and Care Professions Council (HCPC) and complete CPD hours annually.



Again, as with Osteopathy, Chiropractic is a healthcare profession concerned with the diagnosis, treatment and prevention of disorders of the neuro-musculo-skeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques including joint adjustment and/or manipulation with a typical focus on subluxations (misalignments of the spine). Chiropractics also study for 4 years, are regulated (by the General Chiropractic Council) and have to complete CPD hours each year. Chiropractors are working more and more like Osteopaths by including soft-tissue massage and other treatments other than manipulation.


If you're in need of treatment, it's really all about finding a practitioner and therapy which suits you best. There are good and bad practitioners in all three of these professions so it's about having a chat with them, looking online and ensuring that they are part of recognised regulatory body, getting recommendations from friends and family and, otherwise, going for an initial consultation.

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