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Hands up if you know the difference between Physiotherapy and Osteopathy?

Updated: Jan 23

It’s a question we hear very often at Hempstead Therapy Centre. Here is a joint response from our Senior Consultant Physiotherapist Stuart & Experienced Specialist Osteopath Clarissa…


Fact is there are arguably more similarities than differences! Here is some information to hopefully guide you & dispel some myths. But firstly, lets just outline these professions general backgrounds.


Physiotherapists complete a degree at University then traditionally complete ‘Junior rotations’ for 2 years on the `NHS under the mentorship of a senior. Experience is accrued within various speciality areas, such as Musculoskeletal (MSK), Orthopaedics, Neurology, Paediatrics, Respiratory etc. Thereafter, as a senior they can develop their expertise within one of the listed specific area's, sometimes up to Doctorate or Professor level.. Core principles of Physiotherapy include:

  • A science-based profession with a whole person approach to therapy healthcare & well-being

  • Clinical reasoning as a basis to clinical decision making

  • A Patients involvement in their treatment is essential via education, awareness, interaction & involvement promotion

There are two main types of Osteopath. European School & American School. American Osteopaths carry a doctorate in Osteopathic medicine, whereas, their European counterparts attain a diploma / degree. Thereafter they move mainly into primary care roles, usually within private practice. Here they may also adopt specialities such as treatment of infants & pregnancy care or musculoskeletal. The core principles of Osteopathy are:


  • The body is a whole

  • The body has its own ‘medicine chest’

  • Structure governs function

  • The rule of the artery is supreme

Comparing ‘a Physiotherapist’ to an Osteopath is dependent upon which type of Physiotherapist is exampled. A Respiratory or neuro-Physiotherapists’ clinical practice is generally speaking very different to that of a typical Osteopath. However, MSK Physiotherapy & Osteopathy display much more similarities than differences. This fact is often not recognised by other healthcare professionals, the public or often the involved professionals themselves!


The term ‘musculoskeletal’ refers to bones, muscles, fascia, tendons and ligaments and within modern practice also the nervous system plus the skeletal systems interaction & relationship to the internal organs. The key common philosophy for both professions is that the body functions as a unit / a whole. Both professions believe that physical imbalances & strains to the skeletal structure impair your body’s ability to maintain itself in a state of health.

Let’s dispel some myths…


Physio’s just rehabilitate after surgery.. Osteopaths specialise in treating spines..

Both Osteopathic & MSK Physiotherapy treatments are universally applied across the ‘whole body’, for a wide range of conditions. Osteopathy can certainly aide post-operative recovery and Spinal specialist Physiotherapists are very widespread.


Osteopaths are ‘bone crackers’… Physiotherapists give exercises & do little hands-on treatment….

Contra to popular belief both professionals employ a wide range of hands on treatment techniques. They may include; soft tissue massage, joint manipulation, stretching, muscle energy techniques, nerve or joint mobilisations.

MSK Physiotherapists specialise in manual therapy (including manipulations) and quite a few Osteopaths opt to employ soft tissue techniques frequently. Although a Physiotherapist may specialise in Physical exercise therapy this does not mean that your Osteopath will be unversed in advising on this type of therapy.


Physio’s treat mainly using equipment …Osteopaths are not medically trained…

Osteopaths have a sound para-medical education & carry out comprehensive medical questioning during assessments. Physiotherapists do use equipment (e.g. shockwave / Ultra-sound) … so, also, do a number of Osteopaths. Stuart was recently involved with a shockwave therapy course where half the attendees were Osteopaths. MSK Physiotherapists employ manual therapy skills & do treat ‘hands-on’ much more frequently than with ‘equipment’.


Physiotherapy is based on Western Medicine ethos’, Whereas, Osteopathy is alternative & holistic.

Fact is that both professions utilise both traditional western medical values, principles & knowledge… as also holistic or ‘non-western’ therapy types that have proven evidenced based results. Examples of this would be Physiotherapists teaching yoga techniques or utilising acupuncture & Osteopaths teaching clinical Pilates or utilising therapeutic ultra-sound equipment.


So… Which therapist should you choose?

Despite some differences in philosophy, the aim of both Osteopathy and Physiotherapy is to relieve pain, restore function, promote well-being and help your body to work well. It’s also important to remember, too, that no two practitioners in either profession may provide the exact same treatment.


It’s worth discussing briefly with the team at the therapy site you wish to attend to see what the general opinion may be…. As either type of practitioner may specialise in exactly what you need. After all; we are all different!


And then … You never know… Maybe seeing both the Physiotherapist and Osteopath in tandem will produce exactly the result you… The Patient… are looking for.

Because, after all that’s what counts. Irrelevant of therapeutic ‘Ethos’.


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