So What’s the difference?

We commonly get asked what’s the difference between chiropractors, osteopaths and physiotherapists. Its a difficult question to answer!

Chiropractic and Osteopathy have much in common and the two originated in the Midwest of the United States at a similar time. Whilst possessing common principles, they differ from their original philosophies. Today the two can be difficult to separate. There may be more similarities between a chiropractor and a osteopath or physiotherapist than there is between two chiropractors. More often than not it comes down to the skill and enthusiasm of the practitioner. Not much help when trying to choose.

Having said that, there are educational differences that often facilitate different approaches.

Chiropractors & Osteopaths

Generally qualify with a 5 year MChiro and a 4 year MSc(Ost) Masters degree. Both are recognised primary healthcare professionals, which means they are qualified to diagnose in a similar way to a GP, and then treat or refer based upon that diagnosis. You don’t need a referral to see one. Chiropractors are qualified to take x-rays, and both Osteopaths and Chiropractors are qualified to read them, along with MRI scans and CT scans, which Physiotherapists and GP’s are not.

Both are qualified to manipulate joints, and spend at least 4 years of their full time education practicing and learning this skill. For Chiropractors the last two years of college is in supervised clinical practice, and then there is a post graduate 5th or 6th year ‘on the job’ learning to gain their DC (Doctor of Chiropractic) qualification. Sometimes Physiotherapists and GPs attend courses in manipulation which sometimes do not produce the same levels of manual skill that you would expect to find in either a Chiropractor or an Osteopath.

Both professions are fully qualified in soft tissue therapies, injury rehabilitation, and are best placed to diagnose and treat most neuromusculoskeletal (nerve, muscle, and joint) problems.

Physiotherapist

Generally qualify with a 3 year BSc(Hons) degree course, which includes around 1000 hours of clinical ‘hands on’ learning before qualification, and then a further 1 year on the job before they are eligible to apply for ‘charted’ status.

Physiotherpy is enormously diverse, encapsulating such a wide arena of skills and specialisms. Those that specialise in the musculoskeletal area tend to focus around the rehabilitation and functional exercise program aspects.

GP (General Practitioner)

It takes a long time to become a General Practitioner, initially a 5 or 6 year degree, followed by 5 years ‘on the job’ learning before they are allowed to practice independently. We all tend to go there first with whatever problems we have, and indeed a GP is qualified to provide a general diagnosis on an immense diversity of health issues. In terms of nerve, muscle and joint problems, we expect far too much from them. Once they have broadly defined the problem, the only treatment tools open to them are the prescription of anti-inflammatory tablets, painkillers, and an array of generic muscle stretches. If these don’t solve the problem they are able to refer you through to a more specialised professional. More often than not that will tend to be a Physiotherapist.

Consultant

The title given to a senior doctor after they have completed a designated amount of specialist training in their chosen field. Consultants must first complete the same 5 or 6 year medical degree that a GP would, and then instead of going into a private GP practice, the doctor must remain within the hospital environment for a further 8 years on the job learning before becoming a consultant. Consultant’s diagnostic skills are correspondingly more in depth than a GP for their chosen speciality.

In the UK however, Orthopaedic Consultants tend to be surgeons, and as a result, their remit will usually be to assess your problem with a view of whether to operate or not. They do not generally get involved with any non-surgical treatment, or rehabilitation either before or after surgery. Surgery is not by any means without risk, particularly when the spine is involved. It is therefore a last resort after exhausting the more conservative alternatives. For this reason Consultants do not treat or operate, but simply refer the vast majority of patients they see to Chiropractors, Osteopaths, Physiotherapists or for Pain management (anaesthetists).