If you’re experiencing pain in your muscles, bones or joints, the process of getting the right support can be confusing. It’s not always easy to pinpoint the cause of your symptoms and it can seem like there are multiple courses of treatment to choose from.

Three of the more well-known and popular treatment options are physiotherapy, osteopathy and chiropractic services.

All three professions commonly work with musculoskeletal symptoms, but their approaches, training pathways and the evidence for individual treatments differ.1-3 A safe plan should include assessment, clear explanation, shared decision-making and referral where needed.

Who should you visit?

While the three disciplines may seem similar, there are some important distinctions between them. Each has a slightly different focus and no profession can guarantee that a particular approach will work for every cause of pain.

We’ve put together an overview of each to help you differentiate between the three and pinpoint which method is most likely to work for you.

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Chiropractic care – isn’t that the one with all the cracking?

Despite what you might see on social media or at the top of Google searches, chiropractors do a lot more than simple ‘back cracking’. Chiropractic care focuses on the relationship between the spine and the nervous system so, while there is a certain amount of focus on the back, chiropractors are also interested in the causes of neck and joint pain.

  • A chiropractor will sometimes use manual manipulation to adjust your spine and open up certain joints, which is what can cause that ‘cracking’ sound. This approach should be discussed beforehand, including possible benefits, risks and alternatives.
  • Chiropractors also use a range of other techniques, including mobilisation, massage and muscle release.
  • A chiropractor’s main aim should be to help manage symptoms and function. The most appropriate treatment depends on the diagnosis and the person’s preferences; manual therapy is usually one part of a wider plan rather than a stand-alone answer.
  • Any manual treatment will usually be coupled with advice on posture and exercises you can do at home.
  • People may seek chiropractic care for back or neck pain and some other musculoskeletal symptoms. Headaches, sciatica and other symptoms need appropriate assessment because they can have different causes.

Osteopathy – it isn’t just for bones and joints?

Osteopaths also assess and manage musculoskeletal symptoms. They may use hands-on techniques, exercise and lifestyle advice as part of a plan tailored to the individual.

  • Osteopaths may take account of wider lifestyle factors that affect symptoms and wellbeing. Claims about treatment for non-musculoskeletal conditions should be discussed carefully with an appropriate medical professional, as the evidence and scope of care differ by condition.
  • Osteopathic treatment may include hands-on techniques such as mobilisation, manipulation or soft-tissue work, alongside advice and exercise.2
  • Treatment is hands-on and can involve skilled manipulation of the spine and joints, as well as massaging of soft tissue.
  • They may provide general lifestyle advice within their competence. For dietary advice for a medical condition, seek a registered dietitian or doctor.
  • Osteopaths commonly see people with musculoskeletal symptoms such as back or neck pain. This article does not recommend osteopathy for respiratory or digestive conditions; seek medical assessment for these symptoms.

Physiotherapy – isn’t that just for sports injuries?

The aim of physiotherapy is to rehabilitate or improve a person’s ability to move and function.

Physiotherapists work across a range of settings, including musculoskeletal, neurological, respiratory, rehabilitation and sports. They assess movement and function and use education, exercise and, where appropriate, manual therapy and other evidence-based approaches.3

  • Physiotherapists are trained to assess and treat a wide range of musculoskeletal presentations through exercise, manual therapy, massage and other techniques.
  • Common conditions that physiotherapists may treat include sports injuries, arthritis, back pain and post-surgical rehabilitation.
  • A physiotherapist can help you set goals, improve movement and confidence, manage symptoms and plan a gradual return to activity.
  • A physiotherapist can help you set goals, improve movement and confidence, manage symptoms and plan a gradual return to activity. Outcomes vary and no treatment can guarantee prevention of future injury.

Why is it so important to get the right treatment?

According to the World Health Organisation (WHO), around 1.71 billion people have musculoskeletal conditions worldwide, making this the leading contributor to disability throughout the globe.4

This is a particular issue for both employers and employees. According to Health and Safety Executive (HSE) – around 511,000 people suffered from work-related musculoskeletal disorders (MSDs) in 2024/26, accounting for 7.1 million lost working days.5

How do I choose between a physiotherapist, osteopath or chiropractor?

While physiotherapists, osteopaths and chiropractors have different professional backgrounds and training, there is considerable overlap in how they assess and manage musculoskeletal conditions.

All three professions may use a combination of exercise, education, advice and hands-on treatments, depending on the clinician and your individual needs.

It’s also worth remembering that approaches can vary significantly between individual practitioners, even within the same profession. For example, two physiotherapists may have quite different approaches to managing the same condition.

Rather than focusing solely on the professional title, consider the clinician’s experience in treating your particular problem, their approach to treatment and whether you feel comfortable working with them.

Ultimately, choosing the right clinician may be just as important as choosing the right profession.

If you have ongoing musculoskeletal pain or a recent injury, seek assessment from a suitably qualified clinician. For urgent warning signs, contact NHS 111, your GP or emergency services as appropriate.

Chiropractors, osteopaths and physiotherapists are all highly trained in treating musculoskeletal conditions, but if you’re still unsure which course of treatment is right for you, a doctor can help you determine the cause of your symptoms and recommend an appropriate course of treatment.

Please note, conditions or treatments detailed within this page may not be covered by your healthcare cover or scheme.

References 

  1. The Code of Professional Practice – General Chiropractic Council
  2. Osteopathic Practice Standards – General Osteopathic Council
  3. Standards of proficiency: physiotherapists – Health and Care Professions Council
  4. Musculoskeletal health – World Health Organisation
  5. Health and safety statistics 2025: work-related musculoskeletal disorders – Health and Safety Executive