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Osteopaths and Chiropractors: Similarities and Differences


A question often asked is: What is the difference between an osteopath and a chiropractor? Or, what is the difference between osteopathy and chiropractic?

This is not an easy question to answer.

Firstly, it is not easy to answer the lay person, as it involves some technical issues.

Secondly, any discussion about the differences between two professions has the potential to stir up heated and emotional debates.

It is not my intention to start any arguments here. But since the question is often asked, I ought to try my best to answer. Bear in mind that I am answering as an osteopath. If you ask a chiropractor, you may get different answers.

The Origin

Osteopathy was “discovered” in 1872 by Dr Andrew Taylor Still, an American doctor who grew disillusioned with orthodox medicine after his wife and three children died from spinal meningitis. Many accounts of the history of osteopathy mention that one of Dr Still’s early students was Daniel David Palmer (D D Palmer), who founded chiropractic in 1895. Palmer reportedly studied with Dr Still for only about six weeks. However, the association between Dr Still and Palmer is usually not mentioned in accounts of the history of chiropractic.

The Public Awareness

More people seem to know about chiropractors than about osteopaths. This is because historically, chiropractors have been more active in promoting and publicizing their work. Osteopaths tend to be more conservative with regards to marketing and promotions.

The Philosophy

Osteopathy and chiropractic share a common philosophy about the importance of the integrity of the spine in ensuring good health. In fact, this philosophy is shared by almost all traditional healing arts as well as martial arts, including yoga, taiqi (tai chi), aikido and many others. It is also found in many treatment modalities in modern complementary and alternative medicine, including Structural Integration or Rolfing®, and Alexander Technique.

The Treatment Objective

The primary treatment objective of both osteopathy and chiropractic is to remove bodily aches and pain. Osteopaths often seek also to treat functional disorders such as disorders of the respiratory or digestive systems. Some chiropractors, called “therapeutic chiropractors” might do that as well while others, called “straight chiropractors” concern themselves solely with aches and pain.

The Medical Recognition

In many countries, osteopaths are trained and recognized as primary care physicians and they see and treat patients just as ordinary doctors do. In the US, osteopaths are also trained in surgery and there are about 20 osteopathy hospitals offering the full range of health care.

The Diagnosis

Osteopaths and chiropractors are both able to perform diagnosis by visual inspection and palpation (feeling by hand). However, chiropractors usually also rely on x-rays for diagnosis. Osteopaths do not order to have x-rays unless they are clinically indicated. This minimizes a person’s exposure to radiation.

The Treatment Techniques

Chiropractors employ a wider range of techniques for manipulating the spine, whereas osteopaths employ a wider range of techniques overall. Apart from manipulation, osteopaths use other techniques such as stretching, pressure and mobilization. Osteopaths are also trained in cranial osteopathy or cranio sacral therapy, which involve very subtle and gentle adjustments without any “clicking” of the joints. These techniques are seldom used by chiropractors. Another difference is that osteopaths do not “click back” a joint the way chiropractors do.

The Treatment Duration / Frequency

This is the one factor that depends the most on the practitioner. However, it is generally the case that osteopaths spend longer time with each patient. In addition, osteopathic patients generally require less frequent treatments, and their treatments are spaced out over a longer period of time, rather than once or twice weekly.

At osteopathic school, there is a joke that the difference between an osteopath and a chiropractor is “$96,000 after five years” because the chiropractor would have seen a lot more patients by then. On a more serious note, some chiropractors are known to require or encourage their patients to sign on for a course of 12 or 24 or more treatments, even for minor complaints like lower back ache. Osteopaths do not impose such requirements. Depending on a person’s condition, some complaints may require just one or two treatments. It is only in very serious cases, such as scoliosis or abnormal curvature of the spine, that the patient is advised to undergo regular treatment over a prolonged period.

The Attire

This last difference may sound like a joke, but there is definitely some truth in it. When I was a student of osteopathy in the UK, I used to attend meetings of complementary and alternative health practitioners. And it was easy to tell who was who. The naturopaths would be wearing flowers and beads, while chiropractors would come with their suits and ties. Osteopaths were somewhere in between.

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