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What is the difference between Osteopathy and Physiotherapy?

Blog produced by Jason Dodd Clinic Manager, Sports Therapist and member of the Physiotherapy and Musculo-Skeletal Team at Bodylogics The Sports Therapy Clinic.

As Clinic Manager, I believe my role takes on a broader responsibility than just day to day management and offering bespoke treatments to all our patients.  My role often involves liaising and speaking with patients about which therapy or service is best suited to their presenting symptoms.  Our clinic values are based on trust and honesty, as well as using evidence based research to guide and help our patients become pain free again.  In order to achieve this I decided some time ago that our clinic needed a multi-disciplinary approach which offered a wider range of services in order to provide our patients with the best level of care possible.

With a wider range of services though can come many questions amongst those seeking our services on which route is best for them.  One of those questions relates directly to the difference between Physiotherapy and Osteopathy.

The history of both professions is very interesting. Physiotherapy techniques first originated in Sweden by Per Henrik Ling, he founded the Royal Central Institute of Gymnastics for massage, manipulation and exercise. Physiotherapist is “sjukgymnast” in Swedish which means “sick-gymnast”.  It was then almost 100 years later that during the Crimea War, when more British Soldiers were dying as a result of illness and disease than they were from the Russian soldiers, the British government decided to send someone to Turkey to deal with the crisis. This was none other than Florence Nightingale.  Although not directly acknowledged as the founder of Physiotherapy, her techniques involved medicine and rehabilitation to help the dying and diseased soldiers get back to full, fighting fitness. These techniques then made their way to the UK at the end of the 19th Century and 4 UK nurses first founded the Chartered Society of Massage Therapists before it developed to become what is today known as the Chartered Society of Physiotherapists.

Osteopathy was invented at around the same time as these techniques were making their way to the UK.  Andrew Taylor Still was the son of a surgeon and unfortunately lost his children to spinal meningitis.  He was unhappy with the treatments they were provided with and believed that traditional medicine was insufficient to save them.  Andrew believed that in order to achieve optimal health the treating physician should have to boost the self-healing capabilities of the body using manipulations similar to what we see today in Osteopathy.

What is the difference between Osteopathy and Physiotherapy? Bodylogics

In both Physiotherapy and Osteopathy there are sub-categories or specialities that physicians can specialise in.  The main areas in Physiotherapy are musculo-skeletal conditions, neurology disorders and paediatric respiratory conditions.

In Osteopathy the three main areas are structural osteopathy (which can sometimes be referred to or include Sports Osteopathy), cranial osteopathy and visceral osteopathy.

From these subcategories there are only two that can be really compared as being similar.  They are the musculo-skeletal specialisms and the structural osteopathy.

Let’s start with Musculo-skeletal Physiotherapy; It can be defined as

Musculoskeletal Physiotherapy is a specialised area of physiotherapy treating injuries and conditions which affect the muscles, joints, and soft tissues

It usually involves the diagnosis, treatment and rehabilitation of a particular injury through the use of exercise therapy, manual therapy or self-management strategies. A physiotherapist will be able to use techniques such as: massage, stretching, joint and spinal mobilisations and rehabilitation exercises. A Physiotherapist’s treatment will be focused on improving range of movement, increasing strength and condition of muscular/ligament structures, improving muscle proprioception or improving flexibility if deemed necessary.  In my personal opinion, I would direct someone towards our Physiotherapy department if they presented with tendon issues/pathology, pulled muscles, strained ligaments, recovery after surgery or any swelling of peripheral joints (those that do not make up the spine or neck area).  Any imbalances or issues identified by the Physiotherapist would be highlighted/identified and a specific rehabilitation programme would be given to the patient for them to conduct at home and also within clinic under the supervision of a Physiotherapist to ensure no further damage takes place.  The programme would be modified and altered as the patient progresses and becomes stronger and better equipped to cope with the demands placed upon them.

Structural Osteopathy aims to find the cause of a discomfort or the root of your pain.  I tend to advise people to see our Osteopath team when they are suffering from back pain, neck pain, headaches, migraines, that feeling of ‘being out of place or locked’ (more on this another time!). An Osteopath’s approach focuses not only on treating the site of pain but also the surrounding areas.  Take a sprained ankle for example.  A Physiotherapist would look at the muscles and ligaments surrounding the joint and getting them back to full strength again to allow you to function properly but an Osteopath would start by looking at the mobility of the ankle and the stability of the knee and hip in order to try and work out what was causing the issue in the first place to cause the ankle to roll/sprain. An Osteopath may ask the questions of ‘what is causing this restriction of the ankle’ or ‘why was the message from the brain not able to get to the ankle before the sprain in order to tell it to tighten the muscles to prevent the ankle rolling at the time of injury (in the case of neurology issues)’.  An Osteopath will usually use mobilisations, soft tissue therapy, stretching and spinal manipulations to gain clinical results.

It is evident here that both professions use similar techniques and treatment methods in order to achieve their desired outcomes.  So what is the difference?  The honest answer is, not a lot.  Our societal beliefs may lead us to explore Physiotherapy as our preferred treatment option but the work of Physiotherapists is limited in the sense that it cannot treat everything.  We have a wide range of services on offer here in order to cover as many common presenting conditions as possible but also to provide the very best in clinical care for our patients.  An experienced Osteopath (like those we employ at Bodylogics) and an experienced Physiotherapist should, in my opinion, be able to treat any musculo-skeletal disorder and provide appropriate treatment and rehabilitation programmes in order to get their patient back to their desired level of fitness or function.  Their work, however, is always complimentary and sits at different points on the intervention graph.  A Physiotherapist, it can be argued, is better trained at carrying our rehabilitation and diagnosing injuries but Osteopath’s are often better at carrying out hands on treatment to treat acute and chronic pain.  It is also important to remember the different approaches that define each profession.

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