As a Physiotherapist who runs a joint physiotherapy and osteopathy clinic I get these questions all the time, For more info on back pain check out my previous article ‘what is causing my back pain and what can I do to treat it.‘ or the back pain pages of the OC website.
So, in celebration of the arrival of two exceptional Osteopaths to the OC team – Andrew Hudson and Anna Aydinc (see below to find out their specialisms) I thought I would spread light on this commonly asked question.
The quick answer is that an experienced Chartered Physiotherapist and an experienced Registered Osteopath who are clinically excellent will provide very similar assessment and treatment and BOTH treat back pain as part of their core expertise. The differences if any at this stage come down to personal experience – what the individual clinician has chosen to specialise in over the years. It is therefore worth reading the individual bio of a clinician to make a decision on who you want to see, or, in the case of Octopus Clinic, to ask our admin team who they would advise you see,
The other important note is that if you are not recovering at the speed you thought you would then it is ALWAYS worth getting a second opinion and any decent Physiotherapist or Osteopath experienced enough to have confidence in their own ability will not be offended or concerned that you are doing so. At Octopus Clinic, we seek second opinions from other members of the team all the time, that is one of the joys of working with a twelve-strong bunch of experienced clinicians. Check out my article on ‘Second opinions – scary or sacred?’
However, there are a few differences that are worth noting and they come from training background. Both Physiotherapists and Osteopaths assess, diagnose and treat pain or dysfunction of the neuromusculoskeletal system including muscles, joints, bones, nerves, ligaments and tendons. Both are trained in the anatomy, physiology, pathology and biomechanics of the whole body, not just of the musculoskeletal system.
As part of their 3-4 year degree or masters, Physiotherapists train in all the areas of physiotherapy (orthopaedics, respiratory, neurological, elderly care, cardio, medical, intensive care, paediatrics and sometimes other specialisms like hands, burns and mental health) before specialising in ‘musculoskeletal’ which goes hand in hand with ‘sports’ physiotherapy. Historically, Physiotherapists would spend at least a couple of years on the NHS after graduation before moving into private practice but with the cut backs on the NHS this is not necessarily the case now. The undergraduate training for Physiotherapists focuses on exercise based medicine and movement facilitation with a strong bias on the patient becoming independent. Basic manual techniques are taught at university but most are learnt post-graduate level in the form of courses and in house training.
In the 3-4 year osteopathy degree or masters there is far more training in manual techniques with a strong focus on joint manipulation, visceral treatments and the spine and pelvis. Basic lower limb biomechanics is taught but most lower limb and upper limb movement patterning, exercise based medicine and post-operative rehab is learned at post graduate level.
If this is confusing you even more well let me give you a personal example. As an experienced Physiotherapist, if I think a patient needs a joint manipulating (which is a fast sudden movement involving a crack) and/or I need a second opinion on a pelvis and/or I suspect something visceral going on, I will often refer to my osteopath colleagues. I also know that Hazel, an experienced Osteopath, will refer to me if she wants a second opinion on biomechanics, movement patterning and high level rehab. However, I also refer to my fellow physio colleagues for second opinions and I know that she does the same with her fellow osteos.
So here are our new Osteopaths, please do not hesitate to get in touch if you would like further information and don’t forget our 10% refer a friend promotion!
FAQ
What is the difference between a physiotherapist and an osteopath?
Both diagnose and treat musculoskeletal problems and there is considerable overlap in practice. Physiotherapy training emphasises exercise-based rehabilitation, graded return to activity and objective testing. Osteopathy emphasises hands-on technique and whole-body structural assessment. The individual practitioner’s experience often matters more than the professional title.
Should I see a physiotherapist, an osteopath or a chiropractor for back pain?
All three treat back pain and outcomes across them are broadly comparable for common mechanical back pain. The practical difference is emphasis: exercise-led rehabilitation, whole-body hands-on treatment, or joint adjustment. Octopus Clinic in Blackfriars offers physiotherapy and chiropractic, and the team will say if one suits your problem better.
Should I see an osteopath or a physio for sciatica?
Either can help, and the more important factor is whether the practitioner assesses the nerve properly — testing sensation, reflexes and strength to identify which level is involved and to rule out anything serious. Sciatica needs a graded movement and strengthening programme alongside hands-on treatment, not hands-on treatment alone.
Are physiotherapists and osteopaths regulated differently in the UK?
Yes. Physiotherapists must register with the Health and Care Professions Council, osteopaths with the General Osteopathic Council, and chiropractors with the General Chiropractic Council. All three are protected titles requiring registration to practise, and all three registers are publicly searchable.
Which is better for a sports injury?
Physiotherapy is generally the better fit for a sports injury, because returning to sport safely needs objective strength and movement testing and a staged reloading programme, which is central to physiotherapy training. Hands-on treatment helps with symptoms along the way but does not by itself determine when you are ready to compete.
Can I see both a physiotherapist and a chiropractor?
Yes, and at Octopus Clinic patients frequently do, since both work from the same Blackfriars clinic and can share notes. The usual pattern is chiropractic adjustment for joint restriction alongside physiotherapy-led strengthening, so that the improvement in movement is held by a change in capacity.