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Physiotherapy or Osteopathy – How to Choose

physiotherapist or osteopath treating a patient

Osteopaths and physiotherapists are both health professionals who can help patients manage pain and optimise physical wellbeing. If you’re considering whether physiotherapy or osteopathy is right for you, this guide outlines the main differences between them, so you can make an informed decision about your care.

Understanding the difference between  physiotherapy and osteopathy

Osteopaths and physiotherapists both treat musculoskeletal pain and injury. The primary differences between the two professions involve their scope of practice, treatment techniques, and approaches to patient care.


Osteopaths take a holistic approach, looking at the person in their entirety. Osteopathic practice is underpinned by the idea that all parts of the body must work together as a unit for good health. Osteopaths also consider the importance of a person’s social and psychological context on their wellbeing.

Osteopathic treatment is mostly ‘hands-on’, incorporating techniques such as soft tissue massage, joint mobilisation and manipulation to encourage the body’s own healing mechanisms. Osteopaths can draw on an array of techniques, such as cranial osteopathy, visceral techniques, positional release or muscle energy techniques. This means they can adapt treatment to the needs and preferences of the patient.

Some osteopaths enhance their hands-on treatment using interventions such as Clinical Pilates or acupuncture, if they are qualified to do so.


According to the Chartered Society of Physiotherapists, physiotherapy ‘helps people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.’

Physiotherapy sessions may involve hands-on treatment, exercise prescription, modalities such as ultrasound, interferential and electrical stimulation, or a combination of these.

Like osteopaths, physiotherapists may also train in the use of Pilates, acupuncture, or other forms of treatment that they will include in a management plan.

What kinds of people do osteopaths and physiotherapists treat?

Research that has looked at physiotherapy and osteopathy practices has given some insight into the types of people that attend them.


A recent survey of osteopaths revealed some interesting statistics:

  • Patients were aged from one month to 96 years, with 4.8% of patients being under a year old.
  • 81% of patients were seeking treatment for complaints relating to muscles, bones and joints. Other reasons for attendance included nerve pain, digestive disorders, respiratory complaints, allergies and pain related to pregnancy.
  • Osteopaths saw patients for an average of seven sessions.
  • Nearly 70% of patients had chronic pain (that is, for over 12 weeks).


An analysis of physiotherapy practice in 2018 tells us the following:

  • There are around 57,000 physiotherapists in the UK.
  • 65% of these work in musculoskeletal health – that is, diagnosing and treating problems related to the bones, joints, muscles and ligaments.
  • Physiotherapy patients also include those with neurological disorders such as Parkinson’s disease, cardiovascular or respiratory problems such as chronic obstructive pulmonary disorder, people who are recovering from surgery or those who have had a stroke.


So, choosing between osteopathy and physiotherapy may depend on the kind of problem you have. 

Osteopaths can help with pain such as back, neck and joint pain, sciatica, headaches and digestive problems. They are adept at helping with long-term pain, and they specialise in assessing and treating the whole person. 

Physiotherapists deal with a wider range of problems, including medical conditions. They encourage patients to be involved in their own care, through exercise and education. They often use therapies such as ultrasound alongside hands-on care.


Both physiotherapists and osteopaths complete degree-level training to qualify. Some degrees are ‘Bachelor’ and some ‘Master’ – the difference lies in the number of modules in the course, and how much research is involved.

The degrees are usually three, four or five years long, and incorporate anatomy, physiology, pathology, embryology, and clinical skills. All students undertake a minimum of 1000 hours of training with patients in clinic environments. Physiotherapy students have clinical placements in a variety of settings in the NHS, such as neurology and stroke wards.

After qualification, all practitioners must complete a set amount of professional development each year. In addition, some practitioners choose to continue their training with courses or qualifications in areas that interest them.

Find out about your practitioner

As we’ve seen, there’s a lot of overlap in who and what physiotherapists and osteopaths treat. Perhaps the most important thing when making your choice is to find out about your local practitioners. Here are some things to consider:

  • Are they fully qualified and registered with their professional body? Physiotherapists must be registered with the Health and Care Professions Council and osteopaths with the General Osteopathic Council. These regulatory bodies ensure their members have the necessary qualifications, insurance and professional standards.
  • Does your practitioner have any further training that’s relevant to you? For example, they may have a postgraduate qualification in paediatrics or sports medicine.
  • Do they have a lot of experience with a certain type of problem, or have special interests? Some practitioners may specialise in women’s health, for example, or they may work with elite sports teams.
  • If you’ve had treatment before that worked well, does this practitioner use a similar approach? You may have found certain techniques beneficial in the past, such as cranial osteopathy, acupuncture or ultrasound. Check what your practitioner can offer.
  • Think about the practicalities. Is the practice easy to find? Is there parking or nearby public transport? Is the building accessible? Will you need to climb stairs? How much does treatment cost, and what is included? Can you use private medical insurance? Most practices will have this information on their websites, but if in doubt, call and ask.
  • Do you like the practice ethos? Do the practice and the practitioners appeal to you? Do things appear professional? Is there a formal atmosphere, or is it more easy-going? Does the practice have a clinical feel, or is it a relaxed environment? Again, you can often get an idea of these things from a website – take time to find something that feels right for you.


elderly male patient explains his shoulder problem to a physiotherapist

In summary

Physiotherapists and osteopaths both treat pain such as muscle and joint pain, back pain, sciatica and other nerve pain, and sports injuries.

Physiotherapists see a wide range of patients, including those with neurological and other medical conditions. They have a focus on exercise and patient involvement, and often use modalities such as ultrasound and interferential in treatment.

Osteopaths treat people of all ages, and deal with both new and long-term pain. They evaluate and treat the whole body to maximise health. Most of their treatment is hands-on, and they have a wide variety of techniques to draw upon.

Practitioners at The College Practice

Here at The College Practice, we have osteopaths and physiotherapists who, between them, encompass a huge range of skills, experience and interests.

We treat children and great-grandparents, people with sports injuries, those with neuro-developmental problems, pregnant women and dancers.

We use many approaches, including Clinical Pilates and acupuncture. Whatever your age, concerns, background or problems, we can help you.

Our practitioners

To find out more about our osteopaths and physiotherapists, choose from the list below:

Suzanne is an osteopath with over 30 years’ experience. She treats all kinds of people, including sports people, dancers and performing artists, and expectant mums. She is trained in cranial osteopathy and Clinical Pilates, and is experienced in treating jaw conditions (temporomandibular disorders).

Austin is an osteopath who draws on a wide range of techniques, including advanced spinal manipulation and visceral osteopathy. He takes a holistic approach to restore health and vitality to his patients.

Eduardo is a physiotherapist with experience in treating sports people and the older generation, and in neurology and orthopaedics. He adds acupuncture, Clinical Pilates, balance training, rehabilitation and hydrotherapy to his treatment plans.

Patricia is a physiotherapist with more than three decades of experience. She treats all ages and has a special interest in neuro-developmental problems and nutrition. She loves finding answers for people who have struggled after medical issues or surgery.

Jack is an osteopath with a background in sports massage. He adds this and acupuncture to his therapy to restore good function and health to his patients.

If you’re still wondering which practitioner is right for you, why not get in touch and let us know what you’re looking for? We’d be happy to help.