What is the difference between chiropractic, osteopathy and physiotherapy?

This is undoubtedly a question that most complementary healthcare practitioners will be asked throughout their career. In fairness, it is a great question to ask and it appears the general public is still looking for the answer. Not wanting to add to the confusion but there are many differences and similarities between them and we hope that this article can help to provide an overview.

What is chiropractic?

D.D Palmer founded chiropractic in America in the 1890s. Later his son B.J Palmer helped to expand Chiropractic in the early 20th century.

A chiropractor is a primary health care professional, who focuses on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine.

Chiropractors aim to reduce pain and improve the functionality of patients as well as to educate them on how they can account for their own health via exercise, ergonomics and other therapies to treat back pain.

Fundamental beliefs and goals

Chiropractors focus on the intimate relationship between the nervous system and spine, and hold true the following beliefs:

  • Biomechanical and structural derangement of the spine can affect the nervous system
  • Chiropractic treatment can help to restore the structural integrity of the spine, reduce pressure on the sensitive neurological tissue and consequently improve the health of the individual.

Treatment approach

  • A chiropractor may utilise a variety of methods to determine the spinal segments that require chiropractic adjustments to improve spinal health. Depending on the results of the examination, a chiropractor may use additional diagnostic tests, such as:
  • X-ray to locate spinal segment misalignment (the altered position of the vertebra)
  • Some chiropractors use a device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.
  • During the treatment, the chiropractor will use a combination of soft tissue release and spinal adjustment techniques to address any misalignments or dysfunctional areas.

How long does it take to become a chiropractor?

It depends on where you study chiropractic but generally, the course duration is 4 years full-time. https://www.lsbu.ac.uk/study/course-finder/chiropractic-masters.

Are chiropractors medical doctors?

Chiropractors do not hold medical degrees, so they aren’t medical doctors. They do have extensive training in chiropractic care and are licensed practitioners.

Is chiropractic a regulated profession?

Chiropractors are regulated at two different levels:

  • Board certification is conducted by the National Board of Chiropractor Examiners, which creates national standards for chiropractic care.
  • Licensure takes place at the state level under specific state laws. Licensing and the scope of practice may differ from state to state. Most states require that chiropractors complete the National Chiropractic Board examination before they get their license. Some states also require chiropractors to pass a state examination. All states recognize training from chiropractic schools accredited by the Council of Chiropractic Education (CCE).

Chiropractic treatment duration and cost

(Information based on clinics in Singapore and in SGD)


  • The initial consultation can typically range from 15 minutes to 1 hour.
  • Follow up treatments can range from 5 minutes to 15 minutes.


  • Typically range from $50 – $150
  • Promotional rates can offer anywhere from 50% – 95% discounts on initial consultations.

What is osteopathy?

Osteopathic medicine (osteopathy) was founded by Andrew Taylor Still, who was an American surgeon. Still, claimed that illness was rooted in the Musculoskeletal system and that osteopathic treatment could solve these dysfunctions by encouraging the body’s own self-healing mechanisms.

In addition, osteopathy is a form of manual therapy, which recognises the important link between the structure of the body and the way it functions. Osteopaths assist healing by focusing on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function together as a holistic unit.

The four principles of osteopathy

1) The body is a unit
The body is considered as a whole. Each part affects each and every other part and the whole is greater than simply the sum of its parts.

2) Structure governs function
If the structure of the body is compromised (for example through injury or overuse), then it is very likely to have an adverse effect on its function (manifesting as pain, stiffness, instability, etc.).

3) The body is its own ‘Medicine Chest’
Every person has their own built-in healing mechanisms, which can be stimulated and supported by removing restrictive barriers.

4) The ‘Rule of the Artery’ is supreme
For healing to occur there needs to be a good enough blood supply to provide the body with the necessary immune cells and nutrients.

Treatment approach

  • During your consultation, the osteopath will take a thorough case history, which includes the presenting complaint, your general health and any underlying medical conditions. The information provided will be confidential.
  • Your osteopath will also check for signs of serious conditions they cannot treat and may advise you to see your GP or go to the hospital. They should provide you with a letter explaining what they believe to be the problem.
  • An examination will combine active and passive movements of the body to get a sense of any restrictions or compensations in the body. If there is a specific point of concern, after this the osteopath will do specific movements and provocation tests to assess the area in question.
  • The Examination will determine the health of the joints, tissues and ligaments using their hands and a highly developed sense of touch called palpation.
  • Some of the techniques used by osteopaths will include trigger point and myofascial release, active release and stretching to soft tissues, cranial-sacral therapy and manual adjustment techniques when necessary.

How long does it take to become an osteopath?

To become a registered osteopath it will take 4 years full-time and 6 years part-time. If you want to become an osteopath in America you will need to become a medical doctor before studying the osteopathic medicine course.

If you are wanting to see an osteopath for treatment, it is recommended that you check that the practitioner is fully registered with a legitimate governing body.

Osteopathy is one of the fastest growing healthcare professions in the United States (U.S.).

Is osteopathy a regulated profession?

By law, osteopaths must be registered with the General Osteopathic Council (GOsC).

The GOsC only accepts registration from practitioners who have a qualification in osteopathy that are recognised by the GOsC and who comply with their standards of practice.

Osteopaths are required to renew their registration each year. As part of this process, the GOsC checks they have the correct insurance, are meeting professional development requirements, and remain in good health.

Osteopathic treatment duration and cost

(Information based on clinics in Singapore and in SGD)


  • The initial consultation can typically range from 30 minutes to 1 hour.
  • Follow up treatments can range from 30 minutes to 1 hour.


  • The initial consultation can range from $120 – $250

What is physiotherapy?

It is said that physicians like Hippocrates and later Galen are believed to have been the first practitioners of physical therapy. Who advocated the use of massage, and manual therapy techniques to treat people in 460BC. 

The earliest documentation of actual physical therapy as a professional group date back to Per Henrik Ling, the “Father of Swedish Gymnastics,” who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for rehabilitation and exercise.

The aim of physiotherapy

Physiotherapy is the treatment of injury, disease and disorders through physical methods, such as exercise, massage, manipulation and other treatments. Physiotherapy treatment is usually recommended for patients before and after surgery.

Treatment approach

Physiotherapy can be an effective treatment for a variety of conditions and can help lessen the recovery time after a variety of injuries or surgeries.

Physiotherapists can specialise in a number of different areas including but not limited to sports injuries and rehabilitation, children’s health (paediatrics), and women’s health.

Areas of practice;

  • Musculoskeletal – which is also referred to as orthopaedic physiotherapy is used to treat conditions such as sprains, arthritic pain, postural problems, sport and workplace injuries.
  • Neurological – to treat disorders of the nervous system including strokes, spinal cord injuries, acquired brain injuries, multiple sclerosis and Parkinson’s disease.
  • Cardiothoracic – is the name given to the treatment of asthma, chronic bronchitis, emphysema and other cardio-respiratory disorders.

How long does it take to become a physiotherapist?

To become a physiotherapist you must study for 3-4 years full-time depending on the university. In some countries, you may have to work in a hospital environment before going into private practice.

Is physiotherapy a regulated profession

The World Confederation for Physical Therapy (WCPT) advocates for regulation of the physical therapy profession through recognised and valued systems.

Physiotherapy treatment duration and cost

(Information based on clinics in Singapore and in SGD)


  • The initial consultation can typically range from 30 minutes to 1 hour.
  • Follow up treatments can range from 30 minutes to 1 hour.


  • The initial consultation can range from $100 – $150

Hopefully, the above information helped to provide an overview of the three treatment modalities. Of course, this is just an overview and each of the disciplines has a plethora of concepts, techniques and theories as to how they help to address conditions in the body.



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