Osteopathy vs Physiotherapy

What is the difference between Physiotherapy and Osteopathy? Which one should I see?

Osteopaths and Physiotherapists treat a range of similar conditions, however their approach to treatment and the reason why each would perform a specific treatment technique may differ. When comparing Physiotherapy and Osteopathy there are a lot more similarities compared to differences. Both professions have the knowledge and experience to treat and manage a range of musculoskeletal conditions and presentations. Ultimately deciding whether to see an Osteopath or a Physiotherapist comes down to personal preference and what approach may work best for the individual.

Osteopaths are well versed in the application of spinal and joint manipulation in comparison to Physiotherapists and tend to use a more ‘hands-on’ approach. The difference between osteopaths and physiotherapists is that osteopaths treat the whole body, whereas physiotherapists are usually more area specific in order to target the tissues involved, and tend to use exercise more often as part of their treatment.

This blog aims to highlight the similarities and differences of both professions.

Origins and Philosophy

Physiotherapists help people affected by injury, illness or disability through movement, exercise, manual therapy, education and advice. They maintain health for people of all ages, helping patients to manage pain, rehabilitate injuries and prevent disease.

Osteopathy works with the structure and function of the body. It is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together. Osteopaths use physical manipulation, stretching and massage to:

  • increase joint mobility,
  • relieve muscle tension,
  • enhance the blood and nerve supply,
  • and to help your body’s own healing mechanisms

Assessment Process

During your first session, both a physiotherapist and osteopath will take a detailed clinical history and carry out a comprehensive assessment of your presenting condition.

The assessment will involve the clinician asking you questions and finding out about when and how your symptoms started and how the symptoms behave, i.e. what makes your pain better or worse. You will also be asked questions about your general health and finally a physical assessment is carried out.

Osteopaths take a holistic approach to treatment and doing so may assess areas of your body that aren’t specific to where you are experiencing your symptoms. For example, if you come in with lower back pain your Osteopath may assess and treat your lower back as well as above and below (pelvis, hips, upper back) as dysfunction in these areas may be related to your presenting complaint.

Conversely, physiotherapists assess more locally to the painful/affected area, but will also consider it as part of the overall functional unit. For example, if you have knee pain, a physiotherapist will assess the knee but will also evaluate the knee as part of a functional movement, e.g. a squat.


Most physiotherapists will use some form of ‘hands on’ treatment but will focus on exercise-based rehabilitation and how they can best get you back to what you love doing. It is very uncommon that you will see a physiotherapist that does not give you a home exercise-based program. These exercises are aimed at reinforcing the benefits you have received in your treatment session and are an essential part of most treatment plans.

Osteopaths look at the body as a whole, taking into account the interrelationship of the nervous system, muscular system and psychological aspect to a patient’s presentation. They are known for their excellent hands-on skills and wide variety of treatment techniques including:

  • Soft tissue massage
  • Myofascial release
  • Joint mobilisation and articulation
  • Joint manipulation (AKA cracking)
  • Stretching
  • Muscle energy techniques (MET)
  • Manual lymphatic drainage
  • Cranial and visceral techniques
  • Pain education
  • Lifestyle advice
  • Exercise prescription
  • Taping/strapping for support
  • Dry needling
  • Myofascial cupping

Conclusion: Osteopathy vs Physiotherapy – which is right for you?

To conclude, the decision between osteopathy and physiotherapy hinges on personal preferences and specific health needs. Osteopathy takes a holistic approach, considering the body's interconnectedness, while physiotherapy employs targeted interventions. Ultimately, both professions have the same aim – to treat people in order to reduce musculoskeletal pain, improve mobility and improve the quality of their patients’ lives.