The difference between an osteo, chiro and a physio

By Jo Hartley

5 minutes

10 December 2018

The difference between an osteo, chiro and a physio

When it comes to physios, osteos and chiros, many of us are confused. Who should we visit with a bad back, sporting injury or neck pain? And, who will provide us with the best outcome?

The truth is all of them can.

These practitioners overlap in the conditions they treat, the most common being musculoskeletal problems, sports and work injuries, back pain and headaches.

The main difference between them is in how they assess and treat the complaint.

Osteopaths focus on pinpointing what’s stopped working well within the body to cause mechanical overloading and pain in the area that’s sore.

Chiropractors focus on diagnosing, treating and preventing musculoskeletal problems throughout the body.

Physiotherapists focus on physical movement and function for patients, most commonly after injury or surgery.  

Here we explore in more detail how each practitioner works.


Chiropractors are experts in caring for the spine and neuro-musculoskeletal system.

“There’s a common misconception that chiropractic care involves only spinal adjustment,” says Matthew Fisher, CEO of Chiropractic Association Australia. “But chiropractors use a patient centred, multi-modal model of care.”

Manual therapies used may include spinal adjustment, but also mobilisation, muscle and soft tissue techniques, electrotherapies, exercise prescription, rehabilitation, nutritional recommendations and lifestyle advice.

The primary reasons that Australians seek chiropractic care is for spine-related musculoskeletal disorders, back pain, headaches.

Other conditions include postural problems, sciatica, mid back and chest pain, various muscle and joint problems, tendonitis or bursitis, and sports injuries.

Chiropractic education involves undergraduate and/or masters-level university training over five years.

“Study includes units in basic and clinical sciences,” says Fisher. “Chiropractic pre-professional training requires a significant proportion of the curricula to be clinical subjects related to evaluating and caring for patients.”

Other units studied include physical therapy, physical rehabilitation, radiology, nutrition, paediatrics, geriatrics, public health and evidence-based practice.

In Australia chiropractors are registered to practice with the Chiropractic Board of Australia and the Australian Health Practitioner Regulation Agency (AHPRA).

Registered chiropractors must complete mandatory continuing education each year to maintain registration.

They must also meet other registration standards including those related to English language proficiency, recency of practice and professional indemnity insurance.

Top 10 reasons for visiting a chiropractor

  1. Musculoskeletal disorders
  2. Back pain
  3. Headaches
  4. Postural problems
  5. Sciatica
  6. Neck pain
  7. Chest pain
  8. Muscle and joint problems
  9. Tendonitis
  10. Sports injuries


Physiotherapists are experts in exercise prescription and aim to maximise a person’s physical capacity through movement and pain management.

“Physiotherapists uniquely use ‘hands on’ techniques with exercise and lifestyle modification to assist people to function better,” says Darren Beales, a member of the Australian Physiotherapy Association (APA) and the APA Musculoskeletal Physiotherapy Group.

Manual techniques include joint mobilisation and soft tissue techniques like massage and sometimes manipulation. Some practitioners use machines, such as a TENS unit, to help with healing or pain reduction.

The most common pain problems relate to back, neck and headaches. However, physios are also involved in other areas of practice.

“We’re involved in cardiac rehabilitation for heart problems and work with people with lung problems as well,” says Beales. “We’re involved in elderly and terminally ill care, and work in occupational areas to prevent and manage work related injuries.”

Physiotherapists also work with children across a multitude of childhood disorders, rehabilitate people after surgery and assist women during pregnancy and post birth.

Physiotherapists study for four years at university.

Topics encompass advance anatomy (the body), physiology (how the body works) and pathology (what goes wrong with the body) for the entire life span across all health conditions.

Physiotherapists need to continue learning to maintain their license to practice and must be registered with the AHPRA. Many go on to do formal training beyond their initial university degree.

Top 10 reasons for visiting a physiotherapist

  1. Back pain
  2. Neck pain
  3. Shoulder pain
  4. Knee arthritis
  5. Headaches
  6. Ankle injuries from sport
  7. Chronic pain
  8. Hip osteoarthritis
  9. Dizziness
  10. Pelvic floor dysfunction (eg incontinence)


Osteopathy is a hands on manual therapy. It focuses on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a whole.

“We’re interested in the global view of the body, regardless of the location of discomfort,” says Georgia Ellis, Osteopathy Australia board member. “We try to have a ‘big picture’ approach to diagnosis and management.”

Osteopaths treat conditions using techniques such as massage, myofascial release, stretching, joint manipulation and visceral manipulation. Some practitioners use dry needling.

“We’re all registered health professionals and mostly manual therapists,” says Ellis. “We can also suggest exercise and lifestyle modifications that will help benefit a patient.”

To qualify as an osteopath, you need to complete at least a four-year program of study in osteopathy. This is delivered as a double bachelor degree or a bachelor and masters degree format. 

Topics studied include anatomy, physiology, toxicology, pathology as well as osteopathic history, philosophy, osteopathic techniques, exercise prescription and clinical diagnosis and management.

In addition to university training, osteopaths must have current CPR and first aid training, have personal professional indemnity insurance and be registered with the Australian Health Practitioner Regulation Agency (AHPRA).

Victoria, New South Wales, and Queensland are the only states that offer osteopathic programs.

Top 10 reasons for visiting an osteopath

  1. Lower back pain including sciatic pain, sacroiliac joint pain, coccyx pain
  2. Neck pain
  3. Cervicogenic headaches 
  4. Stiffness related to osteoarthritis
  5. Mobility issues at shoulders, knees, hips
  6. Inflammatory conditions
  7. Tendinitis and bursitis
  8. Musculoskeletal complaints related to pregnancy
  9. Work related injuries
  10. Sports related injuries

You know best

As a patient, the techniques used by these practitioners can feel similar. However, there will be differences in the philosophy in how they apply these techniques to treat patients specifically on that day.

“As a patient, it may be beneficial to expose yourself to each type of practitioner,” advises Ellis. “Only you will know which one suits you and your body best.”

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