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What is the difference between osteopathy, chiropractic and physiotherapy?

Osteopathy, chiropractic and physiotherapy are three health professions that focus on the diagnosis, treatment and prevention of problems and pains in the musculoskeletal system. There is overlap between the various professions, however, each profession has unique techniques and slightly different principles in their therapeutic approach.





Osteopathic treatment focuses on manually locating areas in the body where there is limitation in movement, stiffness, swelling and inflammation. The treatment combines manipulation techniques, massage, focused pressure, stretching and mobilization of joints. These techniques target soft tissues such as muscles, tendons, ligaments and their attachment points in the spine and joints of the body. There are osteopaths who also combine visceral osteopathy (which focuses on improving the function of the internal organs) and cranio-sacral osteopathy (which focuses on gentle treatment of the bones of the skull and the membranes of the brain). The purpose of the treatments is to reduce pain, improve mobility and help the body's natural recovery processes. As part of a comprehensive approach, osteopathy also addresses lifestyle variables such as eating habits, sleep and emotional health.


Osteopathy studies in most regions of the world last between 4 and 5 years. There are countries where you receive a bachelor's degree or a master's degree upon graduation and there are other countries where you receive a Diploma in osteopathy (DO) without an academic degree. In the US, training in osteopathy is integral to medical studies and upon graduation, you receive a Doctor of Osteopathy (DO) degree which is equivalent to a Doctor of Conventional Medicine (MD = Medical Doctor) degree. Osteopaths work in private clinics, Health Maintenance Organizations (HMOs) and pain clinics.


Chiropractic focuses predominantly on the nervous system through treatment of the spine and joints. Chiropractic may also include treatment of the soft tissues of the body such as muscles, ligaments and tendons. In the classic chiropractic approach, a large number of health problems are considered to be related to dysfunction of the nervous system due to structural problems in the spine.


Chiropractors use spinal manipulation techniques in a controlled and specific manner in order to reduce pain, improve mobility and reduce joint stiffness. In addition to manual therapy, chiropractors may advise on nutrition, healthy lifestyle and exercise. Chiropractic studies last between 4 and 5 years and are offered in the USA, Europe, New Zealand, South Africa, Canada and Australia. Upon graduation, students receive a Doctor of Chiropractic degree (D.C). This is a professional academic degree. However, it should be noted that chiropractors are not certified allopathic doctors in the sense of conventional medicine. They cannot perform surgeries and prescribe medications. Within the healthcare settings chiropractors often work in private clinics, HMOs and pain clinics.


In physiotherapy treatment, the main emphasis is on improving function by providing specific exercises to increase range of motion, strengthen the body and improve physical fitness. The treatment is usually done after an injury, accident or following a physical impairment. Physiotherapy includes a wide variety of manual techniques that occasionally combine electrotherapy and ultrasound. Physiotherapists focus on rehabilitation and prevention of injuries and encouragement of physical independence in daily activities. Besides treatment of the musculoskeletal system, physiotherapy deals with the treatment and rehabilitation of a variety of neurological problems and problems with the heart and respiratory system. Physiotherapy treatments also emphasize patient education. This involves provision of information, training and support on issues relevant to health status and the rehabilitation process. Physiotherapists treat in private clinics but also in multidisciplinary teams with other professions including doctors and nurses. Formal education in physiotherapy in most countries is at the level of a bachelor's degree which lasts between 3 and 4 years. Occasionally therapists continue to specialize after qualifying and study for a master's degree or doctorate.


It is important to note that the differences between the professions stated above is a generalization. There can be variations between therapists within each field. In all of the professions, therapists usually work in a way that matches the training they received from their educational institution and their personal philosophy regarding treatment. Furthermore, treatment can differ from patient to patient within the same practice since the intensity of therapy and the techniques used vary according to the clinical diagnosis and the pain threshold of the patient. In addition, therapists in all professions combine additional techniques they may be qualified in via advanced studies (for example, Dry Needling).





Implementation of recommendations in this blog are the sole responsibility of the reader. Your physician should be consulted. Yaron Konigsberg will not be held legally or otherwise responsible for any damages caused or claimed to have been caused to any person following information provided in the blog. The articles should not be seen as recommendation to stop/avoid medical care recommended to you by your physician.

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