Chiropractor, Osteopath or Physiotherapist: who should I see?

There’s a nagging pain in your back or a twinge in your neck and you feel you need some treatment but it’s difficult to know which type of treatment to choose.

There seem to be similarities between chiropractors, osteopaths and physiotherapists so how would you know which treatment is best for you?

Here we try and clear up the confusion between the different professions.

What is the difference between the three treatments?

Chiropractors are more ‘joint specific’ than the other two professions. The approach being that if a joint, particularly in the spine, is locked then it needs to be freed. They use manipulation to help move the joint, restoring mobility, and so improving flexibility and reduce pain.
Manipulation is also utilised by osteopaths and physiotherapists, but the approach is slightly different.

An osteopath will look more at the muscles and how that affects joint mobility. Restoring muscle function will improve joint mobility and so improve flexibility and reduce pain.

Osteopaths are more likely to manipulate your neck or back by ‘cracking’ it. This is where synovial fluid sits within the joint capsule and its role is to lubricate the joint so that the facet joints can move smoothly without getting stuck on each other. During an osteopathic manipulation, it is the movement of these facet joints that causes the audible ‘pop’ or ‘crack’.

Osteopathic manipulation is much more gentle than chiropractic manipulation.

Physiotherapists tend to help patients manage pain and prevent reoccurrence through movement, exercise and advice. They are generally more area specific and will target the tissues involved. Physiotherapists may also use ultrasound, electrotherapy and hydrotherapy and are more likely to include exercise as part of their treatment.

In comparison to osteopaths and chiropractors, one of the primary distinctions of physiotherapy is its use of an all-encompassing approach that looks beyond the purely physical elements of an issue, also taking both psychological and social factors into account when treating patients.

Which conditions are best suited to which treatment?

Soft tissue injuries such as sprains, strains, ligaments and muscles do really well with physiotherapy. A physiotherapist is very experienced with these types of injuries and will know how to relieve your discomfort and the exercises you will need to get you back to fitness.

If you are suffering from a recurring problem, a more complex injury and/or back pain then it may be worth seeing a chiropractor or osteopath.

Chiropractors and osteopaths work extensively with back and neck pain but increasingly both professions are treating more muscle and joint injuries. They can also help with whiplash and neck related headaches or vertigo.

According to the NHS some patients with the following conditions choose the following treatments:

Chiropractic can mainly help with pain in muscles and joints, such as:
• Back pain
• Neck pain
• Shoulder pain
• Elbow pain
• Pain from osteoarthritis

Most people see an osteopath do so for conditions that affect the muscles, bones and joints such as:
• Lower back pain
• Uncomplicated neck pain
• Shoulder and elbow pain
• Arthritis
• Problems with pelvis, hips and legs
• Sports injuries
• Muscle and joint pain associated with driving, work or pregnancy

Physiotherapy can be helpful for people of all ages with a wide range of health conditions including problems affecting the:
• Bones, joints and soft tissue (such as back pain, neck pain, shoulder pain and sports injuries)
• Brain or nervous system (such as movement problems resulting from a stroke, multiple sclerosis or Parkinson’s disease)
• Heart and circulation (such as rehabilitation after a heart attack)
• Lungs and breathing (such as chronic obstructive pulmonary disease and cystic fibrosis)

Physiotherapy can improve your physical activity while helping you to prevent further injuries.

Still confused?

It is difficult to know who to choose if you are in pain but in reality, the three professions are more similar than they are different.

A good therapist will try to establish which treatment and exercise programme will work best for your particular problem although each will have a different way of delivering treatment.

When choosing a chiropractor, osteopath or physiotherapist in the UK make sure they are registered:

  • Chiropractors should be registered with the General Chiropractic Council (GCC)
  • Osteopaths should be registered with the General Osteopathic Council (GOsC)
  • Physiotherapists should be Chartered (they will have MCSP after their name) and registered with the Health and Care Professions Council (HCPC).
All content on is provided for general information only and should not be treated at all as a substitute for the medical advice of your own doctor or any other health care professional. Silversurfers will not be responsible or liable for any diagnosis made by a user based on the content on and we are also not liable for the content of any external websites or links from or to Silversurfers to any other websites. Please always consult your own doctor if you are in any way concerned about any aspect of your health.
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Melina - Assistant Editor

Hi I'm Melina, a mother of 3 teenage children and with a particular interest in all things health related. I run a busy household and smallholding alongside my work with Silversurfers, which currently includes dogs, fish, hens, ducks and pigs!

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