Should I see a Physiotherapist, Osteopath or Chiropractor?
What is the difference between a physiotherapist, osteopath and chiropractor? And how do you know which is best to see? This is one of the most common questions that we get asked as therapists, and a hugely difficult one to answer. Here we will outline each profession and explain what to look out for when choosing a therapist.
What are the similarities between physiotherapists, osteopaths and chiropractors?
All treat musculoskeletal pain conditions - pain that arises from either the soft tissue (muscles, ligaments, tendons), bones, or the nervous system.
All have protected titles - this means you cannot call yourself an osteopath, chiropractor or physiotherapist unless you have completed the relevant course
All have a university based education
All have to be regulated and registered with the relevant governing body, either the General Osteopathic Council (GosC), General Chiropractic Council (GCC) or the Health and Care Professions Council (HCPC) for physiotherapists.
All have to complete a process known as Continuing Professional Development (CPD) to ensure they stay up to date with skills and training
What does a Chiropractor do?
Chiropractors generally treat pain related problems using manipulation of the joints, called adjustments. These are quick, high force movements that take the joint to the end of the available range of motion to improve pain and stiffness. They are often associated with a “cracking” noise - this is from air bubbles in the joint fluid popping as the joint is stretched.
Chiropractors also use other techniques such as shockwave therapy, exercise therapy and acupuncture, and may offer lifestyle advice to help recovery.
Physiotherapist and osteopaths are also trained in manipulation, but it is rarely seen as a first choice treatment like it is with a chiropractor. Chiropractors are able to take x-rays, whereas physiotherapists and osteopaths would need to refer you to your GP or a private scanning service.
What does an Osteopath do?
Osteopathy is also a predominately manual based (“hands on”) treatment of the musculoskeletal system. They believe that for the body to be healthy all tissues should be able to move as they are built to, and so will identify issues for treatment.
They use techniques to restore structural alignment in a similar way to chiropractors, but they tend to be more gentle with their treatments. They also use soft tissue massage, stretching and exercise prescription to improve pain and restore function.
Some therapists may have had additional training in Cransiosacral therapy (CST) which is a gentle way of working with the body using a light touch. This is suitable for babies and children as well as adults.
What does a Physiotherapist do?
Most physiotherapists will have had experience in other areas of healthcare as part of their degree, including cardio-respiratory, neurological, intensive care, elderly care, and orthopaedics. They tend to specialise in their area of choice after qualifying.
Physiotherapists can look at alignment but they also test joint mobility, muscle strength, muscle flexibility, nerve function, posture, and movement patterns. They restore movement and improve pain predominantly through exercise rehabilitation, postural re-training and lifestyle advice, but also use hands on techniques.
Although physiotherapists in the NHS tend to use limited hands on therapy due to time constraints and long waiting lists, physiotherapy in the private sector can be quite different.
Private physiotherapists are able to use techniques similar to osteopaths such as soft tissue massage or manipulation alongside a tailored exercise programme to compliment your recovery. Some may have additional training in acupuncture to improve pain and function.
So who is best to see?
The answer to this question is that it depends… there isn’t a single best profession! All can improve pain, rehab injuries and restore function. There just may be a slightly different approach with each profession, but even within the professions people tend to work differently. Sometimes one physiotherapist may work in a more similar way to an osteopath than to another physiotherapist, and vice versa.
However… one thing to think about is that in every profession there will be “good therapists” and “bad therapists”. Generally speaking, the good therapists will all share similar traits, as will the bad ones. It’s important that no matter which profession you look to, you ensure that you are getting one of the good guys.
A good therapist will…
Build a rapport with you easily, it won’t feel forced or unnatural
Use treatment that is predominately active - giving the ownership to you
Put you at the centre of your care. They give you time to speak, really listen to you and take on board what you have to say
See you as often as you need, and will not “over treat”. They will not prolong care longer than is necessary
Aim to let you go as early as possible if you feel comfortable, and empower you to take control of your condition
Explain all treatment to you fully, ensuring that you understand what the treatment does, or doesn’t do
Make it feel like a partnership - they are facilitating your recovery, rather than “fixing” you
Seek to help you to understand WHY you have the problem rather than just treating the symptoms
A bad therapist will…
Feel a bit like a generic sales process when they are speaking to you, and they may not listen to what you have to say
Use words like “fix”, “realign”, and “cure” with emphasis on what they can do for you, rather than help you to understand your pain
Use treatment that is predominately passive - mainly you lying or sitting down to have things done to you
Feed you bad narratives - having to do things to you, needing to fix you, straighten you out, or that you will need to keep coming indefinitely to keep you in “alignment”
Possibly mention exercises and self management, but likely as an afterthought, with no emphasis on its importance
Make it feel like it is not a partnership - they are in control of your pain and only they can fix it
Not ask questions about your lifestyle, activity levels, stress or other factors, or dig further into why you have the problem
At First Line Physio we are passionate about only working with physiotherapists that have the traits of the “good” therapist. We firmly believe that knowledge is power - we aim to help you to understand your condition, giving you the power to manage it and prevent it from happening again.
We do use hands on techniques such as massage, manipulation and acupuncture, but we emphasise the importance of following this up with an exercise programme which we will tailor to you.
We also feel it is very important to talk to you about your beliefs and attitudes toward your pain, as these factors have been shown to be more predictive of a good outcome than an X-ray or MRI scan.
If you are still unsure about which therapist to see, we would be more than happy to have a chat with you about your particular situation and answer any questions you have. Please get in touch via our contact page.