What’s the difference between Physiotherapy, Chiropractic and Osteopathy?

16 July 2019

Chiropractor helping patient Willow Chiropractic

Who actually knows how to describe what a Chiropractor does? How are they different from Physiotherapists? What about an Osteopath? Have you ever even heard of a Naturopath? There are so many manual and complementary therapies out there that it can be hard at times to wrap your head around the differences between them all. Many of them share similar values, but they each have their own distinct specialisms, techniques and principles. We’re here to break it down for you, with some help from the experts.


Chiropractic is a hands-on, natural therapy which uses various manual techniques to gently manipulate and realign the spine over time. It is focused on maintaining the function and integrity of your nervous system, which is encased within your spine, allowing your body and brain to communicate effectively and efficiently. By manipulating the spine using chiropractic adjustments and some soft tissue manipulation, any blockages or ‘subluxations’ are released by the chiropractor. This, in turn, supports your body’s natural, innate ability to heal itself.

Wrist massage

This is a key point – chiropractors themselves don’t heal your body. They simply prime your body and nervous system to allow it to heal itself.

The chiropractic profession is very well established in countries such as America, but lesser known in the UK. There are approximately 80,000 registered chiropractors worldwide, with less than 4% of them practising in the UK. We’re a rare breed in this country! Doctors of Chiropractic additionally work to educate and promote an overall healthy lifestyle which reduces chemical and environmental stressors, and contributes to a healthy, well-functioning body.


Widely available through referral on the NHS and with notoriously long waiting lists, physiotherapy is likely to be the manual therapy that you are most familiar with. But, do you really understand what it is, what it does, and what it’s for?

The NHS website describes physiotherapy as “a holistic approach that involves the patient directly in their own care. [It] helps to restore movement and function when someone is affected by injury, illness or disability. It can also help to reduce your risk of injury or illness in the future”. Physiotherapy commonly focuses on re-strengthening and mobilising exercises and stretches, and will sometimes use additional techniques such as hydrotherapy or acupuncture to aid recovery. This is usually accompanied by lifestyle advice, such as diet and exercise recommendations.

You can also access physiotherapy privately if you are looking for preventative or maintenance care, and you can expect the techniques and exercises to follow similarly. This is a great therapy for muscular complaints and weaknesses due to the focus on strengthening and mobility.


Bupa’s website describes the work of an osteopath as looking at “the health of your body as a whole and aiming to make sure all your bones, muscles and joints are functioning smoothly together. They focus on manual therapies to get your body back to a state of balance.”

A good starting point, but what does that mean? I asked Marie-Sophie Kiepe, MPH, MSc, an osteopath based in Berlin, to describe Osteopathy for me:

“Osteopathy, also called Osteopathic Medicine, is a medical diagnostic and therapeutic system founded in the late 19th century by the American doctor A.T. Still. One of his students, Little John, brought the osteopathic concept to Europe (London, UK) in 1920. Osteopathy emphasizes the structural and functional integrity of the body and its intrinsic tendency for self-healing, including the musculoskeletal, visceral and so-called craniosacral system. Osteopathy includes a broad variety of manual treatment techniques, applied in a mostly diagnosis-related and individualized way, to treat a range of issues such as specific and non-specific neck, back pain, sport injuries, digestive dysfunction, post-operative and menstrual problems, pregnancy, fatigue or simple (non-pathological) functional impairments in “healthy” persons.”


Maybe you have never heard of this one, or maybe you have – Naturopathy is huge in Australia and the United States, and is growing and flourishing in the UK now too. I spoke to two practising Naturopaths based in London, who both agreed that this type of therapy is extremely specific and bespoke to the individual patient; this means that no two treatments will be alike.

Bridget from Health Optimising gave me the following summary of Naturopathy:

“Naturopathy is a system of complementary medicine which is based on the principle that the body has the inherent ability to heal itself. Combining evidence based research with traditional healing methods, naturopaths utilise a variety of modalities such as herbal medicine, nutrition and lifestyle changes to treat a wide range of conditions. Looking at each person as a whole, naturopaths aim to identify and treat the underlying cause of a condition, and not merely the symptoms. This means that treatment protocols are extremely unique to each different person; it is individualised healthcare. Ailments which respond particularly well to naturopathy include digestive disorders, hormone conditions, skin ailments, stress, anxiety, fatigue and sleep disorders.”

Katie Ruane of Harley Street Naturopath largely agreed:

“Naturopathy is a bit different to lots of other types of Complementary Therapy as a Naturopathy is defined by a set of principles followed; rather than in therapies trained in. This can mean that a Naturopath can use nutrition and/or massage and/or acupuncture etc.  As long as a Naturopath is true to the fundamental principles, they are always being a Naturopath, regardless of what they are doing. Two of the six key principles are ‘do no harm’, which means I rarely give advice on the first session as I need to fully understand a person’s lifestyle and needs before I prescribe or advise anything, and ‘treat the cause, not the symptoms’ – a really good example of this principle is that skin conditions are normally to do with the digestive system and food intolerance/allergy, so the treatment plan would look at that and not just the skin. A third principle is ‘treat the whole’ – this includes emotional, biochemical and structural health. We work with lots of homework so that ultimately the person can look after themselves, so the Naturopath is no longer needed.”


Deep tissue and sports massage works with the deep layers of muscle tissue to relieve and release tension, knots and stiffness.

Glen, massage therapist from our Nailsea clinic said that “Deep Tissue massage works with the deep tissues – basically the muscles. This kind of massage works to relieve, release and soften tension in that muscle. A a massage therapist will generally use Deep Tissue techniques as part of a Sports massage treatment. They’re not two entirely separate things in terms of skills and techniques, but moreso in the nature of what they aim to achieve, and what combination of skills and techniques they apply to get there.”

Lizzie from our Yate and Emersons Green clinics agreed that “essentially that. Deep Tissue massage works with smaller, more focused areas of newer tension, whereas Sports massage works on breaking down older, larger knots that may be a result of injury. Sports massage uses passive stretching techniques alongside the techniques you might find in a Deep Tissue massage, so it’s about tackling the more long-term issues.

You can read a more in depth discussion with our massage therapists here.


Now you know!

This is only the tip of the iceberg. There are a whole range of natural and complementary therapies out there, and it’s up to you to decide which is most appropriate for you.

At the very least, get a consultation and speak directly to a professional, who will be able to advise you on your specific needs. The most important thing is that if you’re reading this, chances are you’re at the stage where you’re ready to really take your health seriously – that’s a big step, so well done. Go forth and live well.

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