Many people dealing with musculoskeletal pain find themselves choosing between seeing an osteopath, physiotherapist or chiropractor. It can be confusing to decide who to see, as at a glance they appear very similar and seem to treat the same types of problems.
All three professions are government-regulated in Australia and work predominantly with musculoskeletal and movement-related conditions. All three are also likely to use hands-on treatment, exercise and education as core components of patient care.
So how do you go about deciding who to see?
In this article, we’ll provide information about all three professions to help you make informed decisions about your care. We’ll see that the differences between osteopathy, physiotherapy and chiropractic are more often related to philosophy and university-level training than actual clinical methods or outcomes. We’ll cover what these three professions have in common, how they differ and how to decide which one you need.
We’ll also look at what the evidence recommends for musculoskeletal conditions such as low back pain and explore how osteopaths, physiotherapists and chiropractors work together as a team in modern practice.
On this page
- What do osteopathy, physiotherapy and chiropractic have in common?
- Key differences between osteopathy, physiotherapy and chiropractic
- So which should you choose?
- What does the evidence say?
- Can you see more than one?
- Summary
- References
What do osteopathy, physiotherapy and chiropractic have in common?
There is significant overlap between these professions in the way they are regulated, the treatment approaches they use and their scope of practice.
Professional standards and regulation
All three professions are regulated in Australia by the Australian Health Practitioner Regulation Agency (AHPRA), which requires practitioners to complete university-level training before they can become registered.
Practitioners from all three professions must meet ongoing professional development standards and adhere to strict codes of conduct in order to maintain registration. They must also hold professional indemnity insurance that complies with standards set by their respective national boards.
This helps ensure that regardless of your practitioner’s professional background, your care is safe, ethical and aligned with current professional standards.
Clinical methods and treatment approaches
There is also considerable overlap in the clinical methods and treatment approaches used by osteopaths, physiotherapists and chiropractors. Practitioners from all three disciplines carry out clinical assessments including a case history and physical examination, and use clinical reasoning to make important decisions about your care.
They also commonly provide similar interventions such as manual therapy, exercise rehabilitation and education, as well as supportive therapies like dry needling, taping and shockwave therapy.
For many common conditions such as low back pain, clinical guidelines in Australia recommend treatment approaches that are shared across these professions. These include manual therapy where appropriate, exercise-based rehabilitation and patient education.1
Learn more about our Dry needling services >
Explore our Exercise rehabilitation services >
Scope of practice
Osteopaths, physiotherapists and chiropractors also have a very similar scope of practice, dealing primarily with musculoskeletal conditions such as low back pain, neck pain, headaches, joint pain and sports injuries.
As primary care practitioners, they also play an important role in screening for underlying medical conditions and the early detection, prevention and management of chronic disease.
In other words, these professions have quite a lot in common and practitioners from these disciplines often have more similarities than differences in practice.
Key differences between osteopathy, physiotherapy and chiropractic
The differences between these three professions often relate to their philosophy, university-level training and emphasis on certain aspects of care.
| Profession | Osteopathy | Physiotherapy | Chiropractic |
|---|---|---|---|
| Background | Osteopathy was developed in the late nineteenth century with a focus on how the body’s structure and movement influences health. | Physiotherapy developed within hospital and medical settings with a focus on restoring physical function following injury, illness or surgery. | Chiropractic developed with a strong focus on disorders of the spine and the role the spine plays in overall musculoskeletal health. |
| Philosophy | Osteopathic philosophy centres on four core principles: 1. The interconnectedness of the human body 2. Its natural capacity to adapt and recover 3. The relationship between structure and function 4. The importance of improving function, not just symptoms | Core principles of modern physiotherapy include evidence-based practice and patient-centred care. Having been developed primarily within hospital and medical settings, physiotherapy traditionally places particular emphasis on structured rehabilitation and exercise prescription. | A key principle of chiropractic is the relationship between the spine and the functioning of the nervous system. As such, chiropractic has traditionally emphasised spinal assessment and spinal manipulation as important components of care. |
| Training focus | University-level training in osteopathy places particular emphasis on detailed anatomy and physiology, palpation skills and manual osteopathic techniques. Osteopathic clinical reasoning involves clinical screening, standard medical examinations and emphasises palpation-based assessment techniques. Osteopathic treatment focuses primarily on manual approaches that work via the musculoskeletal system, as well as the circulatory, lymphatic and nervous systems. | Undergraduate physiotherapy degrees emphasise the study of biomechanics, exercise physiology and pain science. In addition to manual therapy, physiotherapy training focuses on evidence-based assessment, exercise rehabilitation techniques and injury prevention. Physiotherapists are also trained to manage a broad range of conditions beyond musculoskeletal pain, including neurological and cardiorespiratory disorders. | Much like osteopathic training, chiropractic training emphasises hands-on treatment approaches, particularly spinal manipulation and other manual techniques directed at the spine. Chiropractors are trained to manage a wide range of musculoskeletal conditions, with a particular focus on conditions affecting the skull, spine, ribcage and pelvis. |
| Clinical emphasis | Subsequently, osteopathy in practice is predominantly hands-on and emphasises manual skills for the purposes of diagnosis and treatment. Modern osteopaths commonly integrate these hands-on skills with exercise rehabilitation and other supportive therapies such as dry needling. Learn more in our article What is osteopathy? Principles, treatment and how it works > | In private practice, physiotherapists often focus on rehabilitation programs aimed at improving strength, mobility and functional capacity. In addition to providing hands-on treatment, physiotherapists often place an emphasis on exercise-based treatment, load management and education. | In modern clinical practice, chiropractors combine spinal manipulation with a variety of other treatment approaches such as exercise, dry needling and taping. As with other clinical professions that focus on musculoskeletal conditions, treatment approaches can vary between practitioners based on their postgraduate qualifications, experience and areas of clinical interest. |
So which should you choose?
As we know, there is a great deal of overlap between osteopathy, physiotherapy and chiropractic when it comes to regulation, treatment and scope of practice. Because of this, choosing the right practitioner for you is often less about the profession they belong to and more about the individual practitioner’s experience, expertise and ability to tailor treatment to your individual needs.
Osteopathy, physiotherapy and chiropractic are all professions committed to evidence-informed, patient-centred care. The most important factors in your care are a thorough assessment, a clear explanation of your problem and a structured plan to guide your recovery and return to activity. Your practitioner should also be able to collaborate effectively with other health providers to keep your care connected and well-coordinated. Your long-term outcomes are more likely to be related to these fundamental elements of care than your practitioner’s professional background.
Explore our prevention-led approach >
With that said, a practitioner’s level of experience with certain conditions or population groups may partially determine clinical outcomes for certain patients. If you are seeking care for a specific condition, a practitioner with a clinical interest, experience or postgraduate qualifications in that area may be the most appropriate person for you to see. Most practitioners list their clinical interests, qualifications and experience online to help you make an informed decision about who to see.
An important thing to remember is most people can get good outcomes with a number of different treatment approaches. After all, there are many ways to peel an orange. For many people seeking treatment for musculoskeletal pain, the practitioner they choose will come down to personal preference, experience with a particular treatment approach or a personal recommendation. As long as you can see progress, you can rest assured you’ve made a good decision to move forward and take control of your health.
If you’re considering osteopathic care and unsure where to start, we’re here to help guide you.
Learn more about our Osteopathy services >
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What does the evidence say?
Research into the management of common musculoskeletal conditions such as low back pain consistently supports a small number of key treatment interventions. These include staying active, structured exercise-based rehabilitation, patient education and in many cases, manual therapy.
Importantly, the research does not distinguish between the professions delivering these interventions. Osteopaths, physiotherapists and chiropractors all commonly use these treatment approaches as part of modern, evidence-informed care. Clinical guidelines in Australia therefore focus on the type of treatment that is delivered, rather than the professional background of the practitioner providing it.1
This reflects an important shift in modern allied healthcare, where practitioners from different professions are aligning to ensure the care they provide is safe, effective and up-to-date. This supports the idea that your individual practitioner is the most important factor in your care, rather than the profession they belong to.
Learn more in our article Osteopathy for low back pain: what the evidence says >
Can you see more than one?
Yes, particularly if you are managing complex health issues, chronic pain or belong to a high-risk population group.
Many practitioners develop additional expertise in a particular clinical area to help improve outcomes for specific patient groups. This means that for certain patients, a collaborative approach involving multiple practitioners with different skillsets can improve clinical outcomes and improve safety.
For example, a physiotherapist may provide structured exercise rehabilitation following surgery, while an osteopath or chiropractor provides manual therapy to other regions of the body to support recovery. Other patients may have multiple musculoskeletal issues, for which they see a number of different practitioners.
When multiple practitioners work together as a team, your care becomes safer, more comprehensive and better tailored to your individual needs. For this reason, collaboration between allied health disciplines is becoming increasingly common, with more practitioners and patients realising the benefits of multidisciplinary care.
Summary
Osteopathy, physiotherapy and chiropractic have a lot in common when it comes to managing musculoskeletal pain and movement-related conditions. All three are regulated health professions in Australia, all commonly use manual therapy, exercise and education, and all three play an important role in preventative healthcare.
The differences between them often relate to their philosophy, historical roots and undergraduate training. In practice, these differences inevitably lead to certain aspects of care being emphasised, which may be beneficial for certain conditions or patient groups. These differences can also make collaboration between osteopaths, physiotherapists and chiropractors beneficial for patients with complex care needs or a higher risk of injury.
In terms of treatment approaches, the ones best supported by research evidence are generally shared by practitioners from all three professions. This makes the quality of your care mostly dependent on your individual practitioner, their postgraduate qualifications and experience in a given area of practice, rather than their professional background.
If you’re considering seeing an osteopath, you can learn more about osteopathy at Above Health or book an appointment to discuss your specific concern.
Learn more about our Osteopathy services >
Last reviewed: June 2026
References
- Australian Commission on Safety and Quality in Health Care. Low Back Pain Clinical Care Standard. Sydney: ACSQHC; 2022. View article
