Osteopath Vs Physio Vs Chiro – What’s the Difference?

General Medical

Tammy George

 Chiropractor performing manual manipulation on male patient

You hear the terms osteo, physio and chiro used to accompany muscle, ligament and bone pain, but do you know the difference between them? If you’ve used the services of one or two you no doubt have a good idea, but knowing when to see each one can be tricky.

The three professions overlap a little in the services they provide and the areas of the human body they work on but each one has its own specialty. Sometimes patients build a trusting relationship with one provider and see them for all their injuries while others prefer to use a physio, osteopath or chiro depending on their problem.

What is Physiotherapy?

Physiotherapy uses physical techniques to improve movement, reduce pain and stiffness, increase mobility and prevent further injury.

A physiotherapist offers the following services/treatment:

  • Joint manipulation and mobilisation
  • Soft tissue mobilisation/massage
  • Airway clearance and breathing techniques
  • Exercise programs
  • Acupuncture and dry needling
  • Hydrotherapy
  • Help with aids ie crutches & walking sticks to help move around

Female physiotherapist performing physical techniques on female patient to improve movement in her knee.

What is Chiropractic Treatment?

Chiropractic treatment involves using a range of manual therapies to benefit people with a range of musculoskeletal conditions.

A chiropractor offers the following services/treatment:

  • Spinal adjustment
  • Electrotherapies
  • Exercise prescription
  • Rehabilitation
  • Nutritional recommendations
  • Lifestyle advice

Female chiropractor performing spinal adjustment on male patient

What is Osteopathy?

Osteopathy uses hands-on treatment of the neuro-musculaskeletal system which includes the bones, muscles, nerves and other tissue that support movement of the body.

An osteopath offers the following services/treatment:

  • Massage and stretching, repetitive movements
  • Mobilisation and manipulation
  • Exercise prescription
  • Lifestyle advice
  • Dry needling 

Osteopath using hands-on treatment to support the movement of the lower back

Osteopath vs Physio vs Chiro – When to See Each One?

Sometimes there’s confusion around which professional you should see. Many people are unsure of chiropractic vs physiotherapy treatments. Some are adamant they will only see a physio not a chiro and vice versa. Much of it comes down to personal preference.

But some patients gain the best outcome by seeing the professional that specialises in the type of injury they’re suffering from.  

In all three fields, providers begin by assessing a patient to diagnose the problem and explain what’s wrong. They then develop a treatment plan to meet the patient’s needs and provide advice.

A GP may coordinate a patient’s recovery or ongoing management of a condition by referring them to a physiotherapist, chiropractor and osteopath. But a GP referral is not needed to access these services.

Which Specialist for Which Injury?

If you have an injury that needs attention from a physiotherapist, chiropractor or osteopath, read on to find out which one you should see.

Injury type: Bad Back

According to the Australian Chiropractors Association (ACA), the underlying principle of chiropractic is “healthy spine, healthier life” through drug-free spinal healthcare and lifestyle advice.

Chiropractic treatment may be ideal for people suffering a range of back problems. The hands-on treatment uses manual therapy and low force interventions to a spinal joint that is not moving as it should. Restoring the function of the spine can improve mobility, vitality and endurance.  

Injury type: Bad Knees

Directly after a knee injury, most patients use the self-care method of RICE (rest, ice, compression and elevation) and then seek further treatment. A physiotherapist can help a sore or damaged knee by reducing pain, improving weakness, movement and loss of function. A physio may prescribe exercises to do at home to help build strength in the knee and activities to avoid that may place too much stress on the knee.  

After knee surgery, a physio can help patients with exercises and advice to achieve the best outcome possible.

Close up of a injured knee strapped by physiotherapist.

Injury type: Sporting Injuries

Many amateur and professional sports players head straight to their physio after an injury. A physio may recommend several physiotherapy sessions to improve the injury and light exercise before getting back on the sporting field.

A physio also helps prevent injuries by taping ankles or recommending a knee brace before undertaking any sporting activity.  

Injury type: Rolled Ankle 

An ankle sprain occurs when one or more ligaments are stretched or torn, causing pain, swelling, and problems walking. With no treatment, a badly sprained ankle may not heal properly and a range of motion and stability can be lost. A physiotherapist can create a program of exercises to regain movement and strength in the ankle.  

Injury type: Sciatica

Sciatica causes pain in the back and legs as it travels down the sciatic nerve which runs from the lower spine through the hips and buttocks and down the back of the legs to the feet. Most sciatica improves with physiotherapy or chiropractic treatment. You may decide on the specialist you see depending on where the pain is worse, your back or leg.

Injury type: Frozen Shoulder

The symptoms of a frozen shoulder may include swelling, pain and stiffness and are most common between the ages of 40 and 60 years. A frozen shoulder can take weeks or months to improve with the most common treatment being physiotherapy to stretch the shoulder joint and regain lost motion.  

Injury type: Sore Neck

A variety of reasons from poor posture, tension, whiplash injury, prolonged use of a computer, or wear and tear can cause neck pain. All three professions, physiotherapy, chiropractic, and osteopathy provide physical therapies to assist with a sore neck.

A patient may choose a chiro because they also suffer from back pain or decide on an osteopath because they help with ergonomic solutions for the long periods they spend at a desk, or a physio because soft tissue massage provides pain relief.

Injury type: Poor Posture

A poor posture can lead to a variety of injuries and complications including pain, joint degeneration, round shoulders and spinal dysfunction.

Young woman suffering from neck pain while working from the couch.

An osteopath or physiotherapist can assist with suggestions for improving and maintaining good posture when sitting, standing, driving and sleeping. An osteopath may suggest ergonomic furniture and changes to everyday activities to assist with better posture.

Injury type: Carpal Tunnel

Carpal tunnel syndrome is a painful wrist injury often caused by repetitive hand and wrist movements such as cutting hair, typing or using vibrating hand tools, but can also have no known cause. A physiotherapist can treat the inflammation and pain and may recommend wearing a wrist brace.  

An osteopath also diagnoses and treats carpal tunnel. Osteopaths are ideal for conducting an ergonomic investigation of the cause and provide suggestions for making changes to your daily activities that may contribute to the problem.

Injury Type: Workplace Injury

The injury sustained at work will depend on who they see for their recovery. Multiple professionals may assist with improving or fixing the injury and to help facilitate a return to work.

For example, falling from a height and sustaining a back injury and a broken ankle at work may require a chiropractor to assist with the spinal injury, a physio to work on the ankle rehabilitation and mobility aids.

Some injured workers see osteopaths to assist with their return to work. Occupation health treatment from an osteopath may include:

  • Help in the recovery of a workplace injury
  • Prevent long-term absence
  • Instruction to manage activities safely
  • Advice on gradually resuming work tasks
  • Exercises to improve a patient’s condition for work tasks
  • Return to work plans and workplace assessments

Condition Type: Cystic Fibrosis

People living with cystic fibrosis often use ongoing physio treatment for airway clearance therapy, exercise and inhalation therapy. Physio treatment and advice on musculoskeletal complications can provide a better long-term outcome for patients.  

Condition Type: Headaches & Migraines

Many people treat headaches with pain relief and chiropractic treatment. The most common causes of headaches are muscle tension and trauma to the neck. Chiropractors may find the cause of headaches to be knotted muscles in the neck or upper back and relax them through manual therapy.

Chiropractor assessing a female patients neck pain.

FAQs About Chiropractic vs Physiotherapy vs Osteo

Here are the answers to your questions surrounding these three services. 

Multidisciplinary Care

Do I Need a Doctor’s Referral to See an Osteopath, Physiotherapist or Chiropractor?

No, you don’t need to see your GP first for a referral to any of these services. Some patients will start with their GP to diagnose the injury and gain their advice on which provider (chiro, physio or osteo) will be best suited to help with the recovery.  

Does an Osteopath and Chiropractor or Physio Work Together?

Yes, a GP may recommend a patient sees multiple professionals whose complimentary care will benefit the patient.

If a patient isn’t being managed by their GP, one professional may recommend them to another for treatment in an area they don’t specialise. Sometimes a combined approach of chiro and osteopathic treatment or a physiotherapist and osteopath working together can provide a faster, better long-term outcome for a patient depending on their injury or condition.

Cost of Osteo, Physio or Chiro Appointments

Does Medicare cover Physiotherapy, Osteopathy or Chiropractic Services?

Medicare may cover the cost of these services for some patients.

People with chronic conditions and complex care needs may be eligible for a Medicare rebate on a maximum of five services each calendar year.

A chronic medical condition is one that is likely to be present for six months or longer such as asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions or stroke.

GPs can plan and coordinate the care of patients by referring them to a multidisciplinary team of specialists that may include a physio, chiro or osteopath to assist with a patient’s ongoing care. 

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If you’re being treated in a public hospital you may see a service provider such as a physiotherapist whose services are covered under Medicare. For example, as part of your recovery after an operation, a physiotherapist may help with movement and mobility.

How Much do Osteo, Physio or Chiro Appointments Cost?

The majority of these services are provided by private practitioners so the cost varies. Before booking an appointment, you can ask for details of the costs. Sometimes the first appointment is more expensive than subsequent ones because they need more time to analyse, diagnose the problem and prepare a plan.

Can I Claim for Appointments with a Chiropractor, Physiotherapist or Osteopath with my Private Health Insurance?

Yes, if you have any level of Extras cover with HIF, you can claim on the cost of appointments with a chiropractor, physiotherapist or osteopath.

Seeing Qualified Professionals

How do I Know if the Person I’m Seeing is Qualified? 

Whether you see a chiropractor, osteopath or physiotherapist, all three professions in Australia must hold a recognised university-level qualification and be government registered with the Australian Health Practitioner Regulation Agency (AHPRA).

Physio Qualifications

All physiotherapists are required to be registered with the Physiotherapy Board of Australia (PhysioBA) and abide by their code of conduct. You can use the Find a Physio website for details of all members of the Australian Physiotherapy Association (APA).

Osteopath Qualifications

All Australian osteopathic graduates must register with the Osteopathy Board of Australia. You can Find an Osteo via the Osteopathy Australia website.

Chiro Qualifications

All chiropractors must be registered with the Chiropractic Board of Australia ( National Board) to practise in Australia. You can Find a Chiropractor via the Australia Chiropractors Association website.  

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

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