Nikki Poges, registered nurse in our Health at Hand team

What’s the difference between physiotherapists, osteopaths and chiropractors?

5 May 2018

Knowing which type of treatment might be best for you and your condition can be confusing, particularly as there are different professions available that treat the same conditions, just in different ways.

The three most common professions available are physiotherapists, osteopaths and chiropractors.

At AXA Health, we speak to thousands of specialists every year and evaluate hundreds of new treatments. We’re using everything we’ve learned over 70 years to bring you the future of private health insurance in the UK today. It’s our calling – protecting and caring for you, today and tomorrow, and leading the way to better health.

So who should you visit?

The distinction between the three professions can be confusing. Without knowing too much, it can seem these practices are similar: non-invasive, drug-free, manual techniques, which aim to improve physical health and wellbeing. But scratch the surface and you’ll find which method is most likely to work for different situations.

Chiropractor – isn’t that the one with all the cracking?

Search analysis shows that there are over 10,000 searches relating to ‘chiropractor crack back’ every month, suggesting that the common misconception surrounding the profession is still rife. In fact, chiropracters need to complete a four-year degree or postgraduate master's course recognised by the General Chiropractic Council, as well as being registered with the General Chiropractic Council, before they can practice. So, if you haven’t been before, the prospect of going might be a bit scary. Most modern chiropractors don’t use ‘cracking’ techniques too often as it is seen as less necessary than getting movement back into the spine. In fact, chiropractors use a range of techniques, from specific manipulation, mobilisation, massage and muscle release to improve the movement and function of the spine and other joints.

Osteopathy – it’s not just for bones and joints

Many people might assume that osteopathy means ‘bones’. However, the practitioners specialise in the diagnosis, management, treatment and prevention of musculoskeletal disorders – looking at the relationship between the structure of the body and the way it functions. Osteopaths are trained to degree level attaining either a Bachelor’s (BSc) or Masters of Science (MSc).

Courses typically last four to five years and are a combination of academic, research and over 1,000 hours of hands-on, patient-facing clinical training. This intensive medical training equips osteopaths with an in-depth knowledge of anatomy, physiology, psychology and pathology combined with robust clinical examination techniques.

An osteopath will give you a clear explanation of what they find and discuss a treatment plan that is suitable for you. Treatment is hands-on and involves skilled manipulation of the spine and joints, and massage of soft tissues. 

Physiotherapy – don’t they just treat sports injuries?

The aim of physiotherapy is to rehabilitate and improve a person’s ability to move and function. Physios use their expertise in anatomy and physiology to assess and treat people. It takes three years to train as a physiotherapist which is undertaken at degree level and is a protected profession, meaning that it is regulated by law and can only be performed by people who have completed an approved training programme and are registered with the health and professions council- HCPC. They are intensively involved in many aspects of illness, injury and disease such as rehabilitating people from illnesses that have affected the patient's ability to move, such as strokes, neurological disorders, recovery from surgery to the joints as well as being able to specialise in sports related injuries. They use a combination of manual therapy, massage, stretches, exercises, ultrasound where needed and advice designed to treat a range of musculoskeletal injuries including back pain.

If your injury is caused or aggravated by lifestyle factors such as frequent heavy lifting or maintaining a bad posture while sitting at your desk, a physio should provide useful tips to improve this and prevent injury re-occurrence.

The most common musculoskeletal condition

Back pain is a particular problem for many people, in fact up to half a billion people suffer globally with the condition.

This is an issue for employers as well as the general public. According to the UK Health and Safety Executive, 30% (480,000 people) of all workplace illnesses in 2019-20 were musculoskeletal disorders, which include back pain. What’s more, they estimate that 8.9 million working days were lost in the same time period due to musculoskeletal problems.[1]

We’ve taken an example of lower back pain, which is the biggest cause of disability. Whether it’s repetitive strain injury, carrying a bag that is too heavy, or simply sitting for a long period of time at your desk, it can be crippling.

This video provides a guide as to how each of the three main professions available approach the condition.

Please note conditions/treatments detailed on the page may not necessarily be covered by the reader’s PMI policy.

Further information

Top 10 exercises for a healthy back - AXA Health

Musculoskeletal hub - AXA Health


[1] HSE ( - Health and safety at work: Summary statistics for Great Britain 2020. (Accessed 28 February 2021).

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