By Laurie Melrose-Doering, Osteopath & Applied Kinesiologist
What is the difference between an osteopath and a physiotherapist? This is perhaps one of the questions osteopaths should be most prepared to answer. After all, a large chunk of our patients want to know.
Read on to explore some similarities and differences.
An osteopath studies for four years to use their hands, with over 2,000 hours of touch-training, including manipulations. At some institutions, training also includes visceral osteopathy, cranial osteopathy, women’s health and paediatrics (this is especially so at the European School of Osteopathy).
After four years of full-on study, osteopaths obtain an integrated master’s degree (MOst). This is one of the prerequisites for registration with the General Osteopathic Council (GOsC), the UK’s osteopathic regulator.
In the UK, only practitioners who are members of the GOsC are allowed to call themselves osteopaths. The GOsC requires every osteopath to undertake a minimum of 30 hours further study per year.
The three most prestigious osteopathic institutions are the University College of Osteopathy (UCO), the British College of Osteopathic Medicine, and the European School of Osteopathy.
The UCO has a slightly more orthopaedic approach and takes pride in being the oldest school for osteopaths in the UK. The ESO has the broadest curriculum, teaching more visceral osteopathy and cranial osteopathy.
Physiotherapists generally train through the NHS for three years to acquire a BSc in Physiotherapy. Their rotations include musculoskeletal, neuromuscular, cardiovascular and respiratory training.
As such, physios treat a wide range of patients, but their training is often less ‘hands-on’ than an osteopath’s.
Training in the NHS, physios are taught to follow treatment protocols (a condition-centred approach) and provide rehabilitative exercise-based treatment. Physios have to be registered by the Health and Care Professions Council. The professional organisation for physios is the Chartered Society of Physiotherapy.
While there are over 90 institutions offering physiotherapy degrees in the UK, there are less than a dozen osteopathic colleges in the UK.
The number of osteopaths compared with physios is reflected by the number of institutions – there are, as of 2020, around 5,000 osteopaths in the UK, compared to around 74,000 physiotherapists.
Physiotherapists are not only more abundant overall, but also far likelier to work in the NHS. This is why GPs tend to refer patients to physios, not osteopaths.
The large majority of osteopaths work in private practice.
Osteopathy & physiotherapy have many similarities – both focus on the diagnosis, treatment, prevention, and rehabilitation of musculoskeletal problems and use hands-on techniques. And both osteopaths and physiotherapists study anatomy, physiology and pathology. But there are notable distinctions in their philosophies:
The founder of osteopathy, Andrew Taylor Still, developed the four principles of osteopathy which inspire the treatment approach. These are:
In other words, the body functions as a unit and has an innate ability to self-regulate and heal itself. But sometimes the self-healing mechanism needs to be triggered.
This is where the osteopath comes in. In order to get a holistic picture, the osteopath will consider lifestyle, medical history, past traumas, general health, and family history.
In addition to the principles, osteopathy considers five different, but overlapping, models through which the patient can be seen. The models are:
The biomechanical, the circulatory-respiratory, the neurological, the energetic-metabolic, and the psychosocial (this blog post goes into more depth).
Physiotherapy is more aligned with conventional medicine, looking more at the symptomatic area, rather than the whole body.
Physios have a more condition-centred approach, relying more on exercises, and less on hands-on treatment than osteopaths. Physiotherapy can be considered an exercise therapy.
I believe the reason osteopaths are more hands-on goes back to the principles: An osteopath may argue that the self-healing mechanism needs to be triggered, and this may be by resolving a patient-specific restriction somewhere in the body (patient-centred approach).
In the case of such a ‘restriction’, ‘blockage’, or ‘somatic dysfunction’, an exercise would not be sufficiently tailored to the patient to resolve the issue.
| Osteopathy | Physiotherapy |
| -more hands-on, less exercises | -less hands-on, more exercises |
| -looks at the body as a whole (may consider areas not immediately apparent to be connected) | -focusses more on site of injury |
| -structural, functional, visceral (internal organs), cranial techniques -spinal manipulation, joint manipulation, soft tissue techniques | -structural techniques, may use shockwave therapy |
| -note: some osteopaths may work more like physios | -some physios may be more hands-on |
Ultimately, you have to decide. Despite some obvious differences, both osteopathy and physiotherapy are both manual therapies and have the same goal – to treat pain and improve function.
It is important to remember that every practitioner has a slightly different approach. And that sometimes an osteopath may work a bit like a physio. You have to find the best osteopath or physio for you.
I have helped many patients who reported not getting the desired results from seeing a physio. But I have also referred patients to physios when I felt they needed someone to gently nudge them towards being more proactive about their health, or when I thought they needed a rigorous rehabilitation plan.
I find it important that – osteopath or physio – the practitioner has done some further study, is open-minded and pushes the boundary of what is possible, and is passionate about helping patients.
I believe one does not necessarily replace the other, and that both professions complement each other nicely.
Osteopaths are excellent for pain relief (e.g. acute low back pain or neck pain) and chronic problems, physios for rehabilitation after injury or surgery. If you are in post-op recovery, suffering from chronic pain or an injury, seeking help from both is highly recommended.
For further reading check out my article osteopath vs chiropractor.
To book a session with one of our herbalists, click here. Alternatively, you can contact us at 020 8942 3148 to learn how our treatments can benefit you.
Aston Clinic London is a third-generation complementary health clinic located in New Malden, serving Kingston, Norbiton, Wimbledon, Raynes Park, Surbiton, Chessington, Worcester Park, Sutton, Richmond, and other areas of southwest London and Surrey.
By Laurie Melrose-Doering, Osteopath & Applied Kinesiologist
