An osteopath, a physiotherapist and a chiropractor walked into a bar…

by Rosi Sexton

A lot of people ask me what the difference is between an osteopath, a physiotherapist and a chiropractor. There’s a few different answers to that question. Some people might talk about the theoretical differences between the underlying models and philosophies on which each therapy is based. That’s an interesting discussion, but not immediately relevant to someone who’s in pain, and just wants to know how to make it stop.

I have a simpler answer. In practical terms, it mostly depends on the practitioner.

We’re all in the business of providing conservative care for musculoskeletal pain, using some combination of hands-on manual therapy, exercise rehabilitation, and general advice. In my experience, the best therapists tend to work in a remarkably similar way, regardless of the title they use on their business cards; and just as there are physiotherapists with whom I have plenty in common, there are also osteopaths who treat totally differently. While there are some broad trends within each profession, hard and fast generalisations are tricky.

That’s not helpful when you’re trying to decide who to see about your bad back, or your recent sports injury, though. Unfortunately, there’s no sure-fire way to tell whether someone’s any good, but here’s a few tips on what to look for if you’re in that situation.

  • Be prepared to talk to, and perhaps visit, a number of different therapists before you find the right one for you.
  • A personal recommendation from a friend or family member is often a good place to start.
  • Make sure that the person you see is registered with their appropriate professional regulatory body. Physiotherapists must be registered with the Health & Care Professions Council, Osteopaths with the General Osteopathic Council, and Chiropractors with the General Chiropractic Council. While this doesn’t necessarily mean that they’re any good, it does at least indicate a minimum level of training and standard of conduct.
  • Any good therapist will be happy to explain what they think is going on, what their recommended treatment is, and answer any questions you may have. If you’re not sure how something’s supposed to work, then don’t be afraid to ask.
  • Look for signs that your therapist stays up to date with the latest research in their field. This may be hard if you’re not scientifically inclined yourself (and spotting pseudoscience is a whole other blog post, for another day) but, for example, someone who tells you that they’re about to “realign your spine” probably doesn’t.
  • Be very wary of anyone who’s dismissive of the medical profession as a whole, or who tells you to stop taking a medicine that you’ve been prescribed.
  • If you’re a keen sports person, it’s helpful to find a therapist who has experience of working with people involved in similar sports. You’ll want someone who understands the demands you place on your body, and how to get you back to doing that.
  • If you’ve been seeing one practitioner for a while, and haven’t noticed an improvement, don’t be afraid to get a second opinion.
  • Look for a therapist who makes you feel like an active partner in your recovery, who will give you exercises and advice to take away, and who will help give you the tools to manage your injury, rather than merely making you dependent on her treatment.

So, what happened to the osteopath, physiotherapist and the chiropractor in the bar? I’d rather not say. But I’ll offer a small prize for the best punchline I get sent via my contact form.

Disagree? More to add? I’d love to hear from you.