May 16, 2023

Chiro, Osteo, Physio – What’s the Difference?

Jay Glover

I am so often asked the questions:

“Should I see a Chiropractor, Osteopath or a Physio?”

“What’s the difference?”

There is a tendency to define each of these respective professions via an assumed “weapon of choice” approach i.e.

“Chiro = the ones who crack your back = I need to see a Chiro to realign my spine”

“Physio = the ones who give exercises = I need to see a Physio to strengthen my back/core”

We like to try and simplify things and people into neat boxes but this is a reductionist approach to a topic that’s much more nuanced than you might think.

This blog post is a summary of key take away points from the podcast episode I recorded with Sonia Fierro (Osteopath) and Kathryn Deverson (Chiropractor) which you can listen to HERE

Chiropractic

Chiropractors are regulated by the General Chiropractic Council (GCC)

“Chiropractors are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints, and muscles), as well as the effects these disorders can have on the nervous system and general health. They have a specialist interest in neck and back pain, but when they assess patients, they take their entire physical, emotional and social wellbeing into account.”

– BCA (British Chiropractic Association)

Osteopathy

Osteopaths are regulated by the General Osteopathic Council (GOsC) in the UK

.”Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms. They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.”

– GOC (General Osteopathic Council)

Physiotherapy

Physiotherapists are regulated by the Health & Care Professions Council (HCPC)

“Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice. They maintain health for people of all ages, helping patients to manage pain and prevent disease. The profession helps to encourage development and facilitate recovery, enabling people to stay in work while helping them remain independent for as long as possible.”

– CSP (Chartered Society of Physiotherapy)

Are there any instances when you should see a particular profession?

The more important question is what is the specialism of that professional rather than what profession they qualified as.

As Kathyrn mentions, if you were to just go off what each profession learns at University you would only ever see Physiotherapists typically for post-surgical rehab e.g. ACL reconstruction and any spinal injury you would see an Osteo or a Chiro for. Chiros and Osteos are provided with comprehensive training in manipulation but not much in the way of exercise prescription during their initial training. This is instead acquired post-grad depending on which route the individual goes. This was the exact opposite for myself as a Physio. I received lots of training in exercise prescription during my degree course and didn’t learn manipulative techniques until my Masters + additional courses that attended. Therapists post-graduate qualifications, experience and training are going to vary widely so it’s more important to…

ACTION POINT:

Research to find a therapist based primarily on the criteria of:
Practitioner’s specialism and post-graduate experience vs filtering via profession first
Professional who is as aligned as possible with your specific goals and your specific sport/activity

More about the PRACTITIONER and less about the PROFESSION

Biggest Misconceptions:

“My Pelvis is Out of Alignment” = “Manipulation will put it back in place = See a Chiropractor or Osteopath”

There is a common notion that your bones and joints or discs can simply “pop out” or be twisted out of alignment and the only way to solve this is by “pushing them back in.” I can’t tell you how many times I’ve heard patients telling me some version of “my tail bone popped out so the osteopath popped it in again.” Let me assure you that this does not happen as much as you may have been led to believe. This use of this terminology is either used to inaccurately explain your symptoms, or deliberately as a narrative to convince you that manipulation and regular “adjustments” are required to resolve your pain. You don’t even need to take my word for it, Kathryn debunks this herself during the podcast. Manipulations are an effective treatment technique, but the mechanism via which they improve your pain is NOT by pushing a joint back into position.

A Practical Guide to Finding a Therapist

To wrap up I thought it might be useful to give you guys some actionable points to help you navigate the sea of therapists out there, to steer clear from the dodgy ones and head towards reputable, reliable and well suited ones for your specific problem.

Therapist Red Flags to watch out for:

THINK “F.E.A.R.S”

Fearmongering tactics to convince you
Endless appointments with no clear discharge outcome
Absolutes “I always do this and I never do this”
Rest – Prescribing indefinite rest or telling you to quit an activity all together
Short appointment times < 30mins