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What is the difference between a Chiropractor and an Osteopath?

One of the most common questions I get as a Chiropractor is “what is the difference between a Chiropractor and an Osteopath?”

As you might expect there tends to be bias from each profession when answering this question. You find that whichever profession the author belongs to they tend to sneakily make out theirs is slightly better than the other. It is also surprising at how much one does not know about the other. I'll try to give you a balanced opinion with as little bias as possible. Though, remember that I am a Chiropractor so I tend to know a lot more about Chiropractic and will therefore be able to provide more information on this profession.

Chiropractor manipulating a patient's lower back in side posture
Chiropractor manipulating a patient's lower back in side posture

Many have the opinion that Chiropractors and Osteopaths are in direct competition, when they actually get on really well and are known occasionally to work together in the same practice. Physiotherapists are also known to not like Chiropractors and Osteopaths, however it is usually the minority that feel this way as it is rightly considered to be unprofessional to bad mouth another profession.

An easy place to start is by pointing out the obvious, both professions are different in name, award given and place of study. The problem however lies in giving a straight concise one line answer to the question of how treatment differs. The reason this problem occurs is because no matter which you visit, whether Chiropractor, Osteopath (or even a Physio), you will find that individually they will treat differently from practitioner to practitioner, let alone from profession to profession.

The same differences in treatment choices between practitioners can occur between MDs and private Physio treatments, so it is not uncommon.

However, I myself find the difference in treatments and plan of managements used in Complementary Alternative Medicine (the umbrella term under which Chiropractic and Osteopathy come) to be somewhat larger in comparison.

This can be a good and a bad thing as not all patients respond in the same way to each treatment so it is good to have a wide selection of options to choose from. On the other hand however, the scope of treatment diversity can be so large that treatment options lacking in evidence can work their way into some peoples practice which give the public different views on what to expect from each profession.

Chiropractic manipulation of a female in supine
Chiropractor manipulating a patient in the supine position

It can also make research hard as for example saying: “Chiropractic or Osteopathy can treat X,Y,Z” is not very specific as Chiropractic and Osteopathic treatments can cover such a wide spectrum of techniques and treatment options. It is often therefore better to state specific techniques rather than the name of the profession using it when promoting research.

Each practitioner has a large choice of treatment options, what is expected is that using experience and evidence they must decide the correct path to treat the patient on an individual basis.

Individuals aside there are some overall differences that can be mentioned.

1. Chiropractic’s original philosophy was that disease within the body originates from the nervous system whereas Osteopathy’s original philosophy was that it originated from the cardiovascular system.

These philosophies are now considered very old and as time has progressed, so have the professions and both professions now appreciate every bodily system in the manifestation of disease, poor movement and pain. 2. Chiropractors are known for using ‘Manipulation’ (many Chiropractors may choose to call this a ‘Chiropractic adjustment’) as their main method of treatment (a short thrust given at a joints maximum range of movement essentially used to increase a joints ability to move that is commonly associated with a click or popping noise).

3. All Chiropractors have a deep understanding of how to take and read X-rays. This is a big difference from the other professions as they can learn this but usually only after graduation. chiropractors have 4 years of training in this discipline alongside all the other theory and practical techniques.

Chiropractor looking at X-ray
All Chiropractors can take and read x-rays

4. Technique differences

Just to show you the variety in techniques from practitioner to practitioner that make the answer to the titled question so hard. Of the 300+ techniques out there, here are some techniques that both professions tend to use: Ultrasound, Interferential, shock wave therapy, Dry Needling (a western form of Acupuncture), Acupuncture, Diagnostic Ultrasound and Low Level Laser Therapy as well as all kinds of systematic soft tissue techniques and therapies. They may also use devices such as an “Activator” or a “Thumper”. An Activator is a Chiropractic tool used by both Chiropractors and Osteopaths normally used to manipulate the spine in ‘fragile’ individuals and a Thumper is a machine used to provide deep massage to a patient’s back. There are a vast list of different individual systematic manipulation, mobilisation and Sacro-occipital techniques that are beyond the scope of this post which can be mentioned also. Each with their own reasons for working and varying level of evidence. Also be aware that there is a big difference in treatment received between a "Chiropractor" and a similar profession called a “McTimoney Chiropractor”.

Check that the Chiropractor or Osteopath you visit is properly qualified. It is illegal to call yourself a Chiropractor if you are not registered with the General Chiropractic Council (GCC).

As a patient it is understandably daunting that there are so many options and treatments that may be given. Though remember, that in the grand scheme of things, the goal is to get the patient better. If you know of a practitioner that is good at getting people better, then no matter the technique or profession, it would be wise to choose them.

“There are hundreds of paths up the mountain, all leading to the same place, so it doesn’t matter which path you take. The only person wasting time is the one who runs around the mountain, telling everyone that his or her path is wrong.”


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