If you are recovering from an injury, experiencing aches and pains or having trouble with pain-free movement and mobility there are several types of practitioners that can help you.
Many of your friends and family may have an opinion on whether a Physiotherapist, Osteopath or Chiropractor is best. Often when you tell these people about an injury or niggle they will insist on you seeing someone they swear by, someone that has helped them in the past.
So who do you listen to?
How do you know which one is best for you?
The distinction between the three health professions can sometimes be confusing. Each of them has unique origins and backgrounds, However, over the years the lines between them have become quite blurred. Although some parts of their practice will overlap they all have their own areas of expertise and will take a different approach to treatment and use different techniques. Despite this, their ultimate aim of improving physical health and wellbeing through non-invasive, drug-free, manual techniques is essentially the same. Ultimately, it depends on the practitioner’s expertise and what you are seeking treatment for as to whether they are suitable for you.
So what is the difference between the three health professions?
Physiotherapy is an evidence-based health science focused on movement and function, often following injury, surgery, or when dealing with physical disability.
Physiotherapists use a variety of techniques to help the body move to its full potential. Their treatment approach involves not only correcting abnormalities but also preventing the recurrence of those abnormalities through tailored exercise programs.
Along with manual techniques such as soft tissue work, joint mobilisation, and manipulation, Physiotherapists also use things like electrotherapy, laser therapy, and ultrasound to treat their patients. Patients may also get homework in the form of stretching or light exercise when seeing a physiotherapist to help them take control of their own rehabilitation.
Physiotherapy developed within the established medical system and tends to use a more evidence-based approach to treatment compared to that of Osteopathy and Chiropractic. Practitioners are generally required to use treatments only if their effectiveness has been demonstrated in scientific research. They are also more commonplace, as they are found not only in private practice but also within the public and private hospital system.
In Australia, Physiotherapists require completion of a minimum four-year degree, but many have additional post-graduate qualifications in specific areas of interest. While Physiotherapists are mostly known for their treatment of sporting injuries as well as neck and back pain, they can be consulted for a wide range of health conditions and doctors refer to them more than any other health practitioner. Physiotherapists must be registered with the Physiotherapy Board of Australia, part of the Australian Health Practitioner Registration Agency, to practice in Australia.
Chiropractic is a form of complementary health care based on the diagnosis of joint misalignments, particularly those of the spinal column and pelvis. Chiropractors believe that any vertebral misalignment causes compression on nerves and can refer symptoms and problems to surrounding tissues and other parts of the body.
Chiropractic treatment is focused on treating and preventing musculoskeletal problems throughout the body and is nearly always associated with spinal and neck manipulations. It can also involve soft tissue work, strengthening and rehab techniques, and other physical therapy modalities such as ultrasound.
The primary reason Australians seek Chiropractic care is for spine-related musculoskeletal disorders, especially back pain, neck pain, and headaches. Chiropractors often use spinal x-rays to help with any diagnosis and some chiropractors have on-site facilities to conduct these x-rays.
Despite Chiropractic’s surging popularity, its proven benefit is fairly limited. The only strong evidence is related to lower back pain. Reviews of spinal manipulation found that it could alleviate back pain, but that it was no more effective than other common therapies, such as exercise therapy.
In recent times, the Chiropractic profession has attracted criticism for the promotion of anti-vaccination views and promoting treatment of a wide range of diseases, infections and childhood illnesses through spinal manipulation. These issues recently lead The Royal Australian College of General Practitioners to discourage its fellows from referring to Chiropractors. It is important to note, however, that many Chiropractors reject this approach and follow a more evidence-based approach, specialising in musculoskeletal issues and conditions relating to the spine.
Chiropractors work in private practice and do not require a referral. They complete a double degree that takes five years, and practitioners are regulated by the Chiropractic Board of Australia which is part of the Australian Health Practitioner Registration Agency.
Osteopathy is also a form of complementary healthcare that recognises the important link between the structure of the body and the way it functions. Osteopaths focus on the health of the entire body, rather than just an injured or affected part.
The core belief of Osteopathy is that if one part of the body is restricted then the rest of the body must adapt and compensate. They look at how the skeleton, joints, muscles, nerves, circulatory system, connective tissue, and internal organs function as a holistic unit, believing that the body as a unit is capable of self-regulation and health maintenance when functioning properly. Using skilled evaluation, diagnosis and a wide range of hands-on techniques, Osteopaths can identify important types of dysfunction in the body.
Osteopaths use techniques such as stretching, massage, myofascial release, articulation, joint mobilisation and spinal adjustments to release areas of restriction within the body. They may also recommend exercises and dietary modifications.
If you see an Osteopath for a sore knee, they may also take a look at your ankle, pelvis, and back. The practitioner might also ask about your medical history, as well as factors that don’t appear to be directly related to your current injury.
Similar to Chiropractic, Osteopathy’s proven benefit is fairly limited with little high-quality research investigating the effectiveness of its holistic approach. There is some evidence for its treatment of lower back pain, typically through spinal manipulation and manual techniques, but the benefits appear to be modest.
In Australia, Osteopaths work in private practice and do not require a referral. Osteopaths complete a minimum 5-year double degree or masters degree and must be registered with the Osteopathy Board of Australia, part of the Australian Health Practitioner Registration Agency, to legally practice.
Choosing the Right Practitioner
Each of these health disciplines will overlap in some way, shape or form. Many of the modalities used in treating patients are similar and the practitioner will be working towards a similar end goal. Your choice of practitioner will depend on your expectations, what you would like to achieve and what type of issues or symptoms you are dealing with. Is it muscular? Skeletal? Back pain? Headache?
Whether you see a Physiotherapist, Chiropractor or Osteopath, the most important thing is that you find a practitioner you are comfortable with. All of these practitioners will treat with manual techniques and they will be quite hands on. They may require you to wear minimal clothing and may need to know more personal information such as detailed medical history, diet, digestive function, and reproductive function.
You also want to find a practitioner that helps you look after yourself, gives you exercises you can do to help your progress and teaches you strategies for dealing with ongoing pain. It is important that they understand what you do on a day to day basis, for work, leisure and exercise. A practitioner will not be able to effectively help you get back to doing your activities of daily living if they don’t know or don’t understand what you do. If you have a particular area of concern, you may need to seek out a practitioner who specialises in that area.
It’s important to remember that neither Physiotherapists, Chiropractors or Osteopaths are doctors and medical advice should always be sought from a qualified medical practitioner. Keep in mind that Chiropractic and Osteopathy are considered complementary or alternative medicine, and some critics point to a lack of scientific evidence. However, they may still be beneficial to you when seeking treatment for any musculo-skeletal injuries or conditions.