The differences between Physiotherapists, Chiropractors and Osteopaths go right to the heart of many fundamental well-being questions including the causes of injury and disease, ancient wisdom vs modern research-based evidence and even hysteria-inducing “fake news” vs well-funded “real news”. All three practices appear to have their strengths and limitations, and individuals will swear their undying support for each. Their objectives however are much the same, so it would appear that is difficult to go too far wrong.
All are highly educated in their practice: Physiotherapy is a minimum 4 year degree and both Osteopathy and Chiropractic are 5 year degrees
In Australia, all are regulated by Australian Health Practitioner Registration Agency
All utilize spinal manipulation and manual therapy
All charge similar fees
None require a doctor’s referral
All support a basic premise of movement being the foundation of health and well-being
All will give you homework and expect you to comply for results
PHYSIOS – Considered Mainstream
Physiotherapists specialise in the diagnosis, management and prevention of movement disorders and their practice is evidence based. They are the soft tissue and joint mobility experts and their general philosophy is to loosen then strengthen.
Physios use a combination of manual therapy, movement training and physical and electro-physical agents as well as dry needling.
Physios are the most frequented therapists for sports teams and are the first port-of -call for doctors’ referrals. Like all Western medicine however, the limitation of their practice is the availability of good research based evidence.
CHIROS – Considered Complementary or Alternative
A Chiropractors' focus is the diagnosis, correction and prevention of disorders of the musculoskeletal system (spine, pelvis, muscles, ligaments and joints).
Their practice is nearly always associated with spinal and neck manipulations, but it involves a combination of hands-on care, physical therapy modalities (ultrasounds) and exercise.
They claim they can cure a host of health issues by locating and "correcting" spinal misalignments, so as to unblock so-called nerve flow and eliminate disease, infection and childhood illness. Their anti-vaccination stance has put them at odds with traditional views on the causes and prevention of diseases.
Although evidence based results are more difficult to find, there is strong, often-cited evidence for the relief of lower back pain — and a review of spinal manipulation found that it could alleviate back pain. The question is whether this is more effective than other therapies.
OSTEOS- Considered Complementary or Alternative
Osteopaths focus on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a holistic unit. They see pain as a sign the body’s compensation mechanisms are not coping well.
Osteopaths work on the premise that posture, injury, or negative lifestyle patterns compromise anatomical structure and lead to poor health. As practitioners, they look at the relationship between the structure of the body and the way it functions.
Osteopaths adopt gentle and effective treatment techniques aimed at addressing any bio-mechanical dysfunction, including stretching, joint mobilisation, massage and sometimes manipulation.
Similar to chiropractors, there is underwhelming research based evidence of results. However their holistic approach which includes nutrition and lifestyle analysis, can be a goldmine of good advice in itself.
When choosing a practitioner, it seems that the individual may be more important than the practice. Their aim should be to educate, find strategies to maximize well-being and day-to-day management of pain. Ideally the practitioner should provide a holistic approach, basing their treatment on as much evidence as possible, taking into consideration an individual’s own physical goals and lifestyle. At the end of the day however, you are your own treatment and results depend largely on your own compliance.
Adding my 2 cents worth, it would be great if the practitioner is also willing to work with trainers – I can be their wing man, incorporating prescribed stretches and strength work into workouts.