You may be wondering who should I see for my back pain, a Chiropractor, Osteopath or Physiotherapist, or even what’s the difference?

Chiropractors and Osteopaths in the UK overall are similar.  There is a considerable overlap between the two professions and we treat roughly the same conditions with joint manipulation and muscle techniques, but there are several small differences in the way we work. The training is similar and we often both attend the same Post-Graduate courses.

In reality there is a wide variation in which clinicians from both professions practice, some give more gentle ‘balancing’ treatments whilst others give more intensive joint manipulation with deeper muscle massage or muscle releasing.  There is no one right answer and the proof of the pudding is finding a clinician who helps you, be they a Chiropractor or Osteopath. Many clinicians also add adjunctive treatments, Nutrition, Acupuncture, Rehabilitation and in my case Alexander Technique.

Physiotherapy is often practiced quite differently, more focusing on rehabilitation exercises  after surgery or injury or hospitalization.  Private Physiotherapists can use more joint mobilizations and massage which does have some overlap with Chiropractors and Osteopaths, but they generally do not do full joint manipulations in the same way. NHS Physiotherapist in the UK is often now based more on exercise programs with less hands on treatment.

No trials have been done to effectively compare the Chiropractic and Osteopathic methods of adjustment, so it is unfair to claim one is better than the other.  Trails have compared Chiropractic to Physiotherapy, (here) showing that Chiropractic is highly effective at treating lower back pain and at preventing it from recurring, up to three, or even five years later.

Chiropractors have traditionally used X-rays more that osteopaths to help diagnose conditions. However, it has been shown that x-rays or scans are not always essential in treating lower back pain and Chiropractors are tending to X-ray less now.

Always consult a Registered clinician, either of the General Chiropractic Council (GCC) or the General Osteopathic Council (GOC).

Chiropractic work is recognised worldwide and is overall better known, especially in the United States and Australasia.  Osteopathy has been in practised in England for longer and so it is better known here.

Although both professions treat the same conditions with adjustment techniques, there is a technical difference in the way in which manipulation is done:

Technical differences in joint manipulation between Chiropractors and Osteopaths

Chiropractors use short lever, high velocity thrust, with traction and minimal rotation – a manipulation that is specific to the site of injury or misalignment.  Osteopaths use a  long lever, low velocity thrust, with traction and minimal rotation.  A more general way of manipulating. In reality I suspect there is an overlap and it will probably vary on the individual clinician and how they have developed their own unique way or working.

History of Chiropractic and Osteopathy

Both professions were founded at the same time and in the same town – Iowa, America at at a time when medical services were poor and sparse.  It does seem rather a co-incidence!

Osteopathy was founded in the 1860s by Andrew Taylor Still, who was a medical surgeon who served in the Union Army.  When he lost his three children in 1864 to spinal meningitis he became disillusioned with orthodox medicine and began thinking and developed Osteopathy as a holistic treatment.

Chiropractic was founded in 1895 by Daniel David Palmer. He focused on the biomechanics, function and structure of the spine, musculoskeletal and neurological systems and the role played by the proper function of these systems in the preservation and restoration of health. Chiropractors believe the body will heal itself if the structure and function are corrected.

Comparing Osteopathic and Chiropractic Philosophy

Nervous System vs Blood Vascular System

Osteopaths believe that health occurs when the blood vascular system is working properly

Chiropractor believe that health occurs when the spine and nervous system is working properly.

Both philosophies are equally valid. In some conditions there is more of a nervous irritation or pressure, and some conditions there is more of a circulatory imbalance.

Osteopathy and Chiropractic have similar core principles.

  • The body is capable of self-regulation, self-healing and health maintenance. (Chiropractor call this innate intelligence)
  • Structure and function are reciprocally interrelated.
  • Treatment is based on understanding the principles of body unity, self-regulation, and the interrelationship of structure and function.
  • The body works as a whole – Chiropractors rarely consider one joint in the body without considering the joints above and below – ie with knee pain we examine the function of the ankle and hip or pelvis.

I hope this helps your decision process in whether to choose a Chiropractor or an Osteopath.  It’s best if you don’t  travel too far, if possible.  If a friend recommends a local clinician then be brave and give them a try. Good luck with your treatment!