I am asked this question all the time and it is a very difficult question to answer. There are a few key points that need to be made that are common to all of us.
Primarily we are all treating musculoskeletal problems…… this means that we are all taught to treat and diagnose issues relating to bones, muscles and soft tissue ( muscles ligaments and fascia). We use many of the same tests to come to a diagnosis, ie to establish what is going on with your body to cause you discomfort or pain. We all are professional and are regulated by professional bodies, in the case of Osteopaths, The General Osteopathic Council. We all need to keep up with current research by completing further training each year. We all have to hold insurance. It is possible to cover the cost any of the treatments with private medical insurance but you should always check with your individual policy to see what they will allow before booking an appointment.
So far we are looking pretty similar. The differences start when it comes to treatment. We all use some of the same, and some different techniques that are specific to each profession. Here is gets more complicated. Due to the nature of our professions we are taught a wide range of techniques. As an individual practitioner we favour certain techniques in our practices. Within osteopathy you will find that two different osteopaths will treat the same injury in different ways. Some techniques are more relevant to certain patients than others. Some osteopaths will have done further training in one form of treatment and so are better at using that specific technique, so use it more frequently. An example might be that I trained as a sports masseur before I became an osteopath so I have specific training in massage techniques that some other osteopaths might not have. I have also done further training in cranial Osteopathy, which some other osteopaths might not have done. As a patient it is important to look at the individual practioners skills set to see what further training they have done.
So, we have established there are many difference within each profession, now to look at the differences between the professions. Here I am going to have to generalise quite a bit.
Physiotherapists work both within the NHS and privately. This is the only profession of the three that is widely available within the NHS. There are a few Health trusts that use Osteopaths and Chiropractors but they are not nearly as available as Physiotherapists. You will generally need to be referred for Physio by your GP and there can be quite long waiting lists, but you won’t have to pay for treatment. Most Chiropractors and Osteopaths you will have to pay for. The costs are generally quite similar between the three professions if you go private. You don’t need a referral from your GP to see anyone out with the NHS ie privately.
Physiotherapists tend to use manual therapy such as massage and moving of joints, therapeutic exercise and ultrasound as their main treatment modalities. Many physiotherapists will specialise in various sectors within the NHS such as stroke rehabilitation, cardiovascular disease or respiratory disease. Others will specialise in Chronic pain management and some will work using a much broader spectrum of illness.
Chiropractors have a special interest in neck and back pain using hands on manipulation of the spine. They also give out advice the same way that Osteopaths and Physio’s do. They don’t only treat the spine they also treat other parts of the body. You may get an individual osteopath who treats very similar to a Chiropractor, using only manipulations, or a chiropractor that uses very few manipulations and more massage and mobilisations. You may get a physio that does mainly ultrasound and exercise, but the other two professions can also use these techniques.
Osteopaths are trained to use a variety of techniques. We are taught to look at the whole body as are Physios and Chiropractors. We are taught to use massage, mobilisations and manipulations at undergraduate level. We are not taught to use ultrasound. We are also trained to give out exercises but perhaps less so that a physio at undergraduate level. An Osteopathic appointment tends to last for between 30-45 minutes but can vary outside that time too. Generally Physio and Chiropractic appointments are for a shorter duration, but not always.
As you can see there are so many similarities between us all it is difficult to see how we are all different. For specific definitions of each profession you should go to the governing bodies websites.
For me it is about trying out different treatments and different practioners. It is so important that you feel safe and comfortable with the person that is giving you treatment. If you don’t feel comfortable then go and see someone else until you find someone who you like and can get on with. Some people love manipulations and other don’t. It is also important to look at the individual practioner to see if they specialise or have further training in the specific area of health that you are interested in. I also think you should ask friends and family if they know anyone that they would recommend. Each professional body will have a “find a practioner” section where you can type in your postcode and they will come up with a list of people who are registered with them that practice nearby. You should never go and see someone that isn’t registered with the respective governing body as they might not have done proper training or hold current insurance.