Osteopathy vs Physiotherapy: What’s the Difference?

Have you ever wondered what the difference between Osteopathy and Physiotherapy is? Or should I see a Physiotherapist or an Osteopath? You are not alone.

These are very common questions asked by our clients in the clinic on a regular basis. We will go into the similarities and differences of both professions in this blog.

Origins and Philosophy

Osteopaths and Physiotherapists treat a range of similar conditions, however their approach to treatment and the reason why each would perform a specific treatment technique may differ.

Osteopathy is a non-invasive form of manual therapy that aims to improve the health of all the body systems. Osteopaths use a range of hands-on Osteopathic techniques to achieve and promote health in the body and take a holistic approach to the treatment and management of your injury and symptoms.

Physiotherapy helps individuals that have an injury, disability or illness through the use of movement. This may include massage, exercise, education and manual therapy.

Osteopaths and Physiotherapists both incorporate manual therapy and exercise prescription into their treatments. However, typically speaking to distinguish between the two professions Osteopaths have more of a manual therapy focus when compared to Physiotherapists who typically use more exercise prescription for the management and treatment of their patients.


Physiotherapy can be dated back to 1813 when Per Henrik Ling; the ‘Father of Swedish Gymnastics’ founded the Royal Central Institute of Gymnastics advocated the use of massage, manipulation and exercise. In 1887 Physiotherapists were given registration officially by the Sweden’s National Board of Health and Welfare. Soon after, other countries started to follow suit and Physiotherapy began to grow in New Zealand and the United States.

In the late 1950s Physiotherapy began to branch out from hospital based practice to; outpatient orthopedic clinic, universities, rehabilitation centres, medical centres and geriatric settings.


Osteopathy was developed in the 19th Century by an American physician, Andrew Taylor Still. Dr Andrew believed in the treatment of a variety of diseases with the manipulation of the musculoskeletal system sparing patients the negative side-effects of drugs, this linking to the a principle of Osteopathy the body has self healing mechanisms; promoting the natural healing capabilities of the human body. The name ‘Osteopathy’ comes from two greek roots osteon – bone and pathos – for suffering.  The name Osteopathy reiterates the theory that disease and physiological dysfunction can be found in the musculoskeletal system.

Osteopathic medicine is based on four principles that encourage a holistic approach to treatment. The four Osteopathic principles are:

The body as a single unit:

The first principle of osteopathy is the human body is a unit and no part functions independently. Abnormality of a structure or function in one part of the body may have a disadvantageous influence on other parts of the body.

The body has self regulating mechanisms: 

The second principle of Osteopathy is the body has the capacity to maintain its own health and to heal itself. Still believed the body has all it needs to either be healthy or that it needs to overcome illness. The role of the Osteopath is to utilize the body’s self healing mechanisms to overcome disease and maintain health.

Structure and function are reciprocally interrelated:

The third principle of Osteopathy is structure and function are interrelated. This means that the musculoskeletal system can mirror changes in other body systems as well as may also produce changes in other body systems.

Rational treatment is based on the first three principles:

The fourth principle of Osteopathy is the rationale to treatment is based on the first three Osteopathic principles.

Training and Education

Both Osteopathy and Physiotherapy are undergraduate degrees at university.

Physiotherapists complete 4 years of university training. Physiotherapists may work in a range of locations including private practice clinics and hospitals. Physiotherapists working out of a hospital may help those with spinal injuries, stroke, post surgery and cardiac issues just to name a few.

Osteopathy is a 4.5 – 5 year undergraduate degree. Osteopaths typically work in private practice clinics however you may also find Osteopaths working in a range of other professional settings. These may include aged care facilities, sports clubs, medical clinics, health clinics or research.

Osteopaths and Physiotherapists are both registered under the Australian Health Practitioner Regulation of Australia (AHPRA) and have to complete a minimum number of hours each year of continuing professional development (CPD).

Assessment Process

During your first consultation both an Osteopath and Physiotherapist will take a thorough case history including questions about; your current symptoms or injury, medical history, any medications you are taking or other factors related to your health and wellbeing that may be related to your concerns. This allows your practitioner to get a full picture of what may be causing your symptoms and other factors that may be influencing them, beginning the process of coming up with a treatment plan specific to you and your condition. Following this your clinician will take a physical assessment of your presenting complaint.

Your physical examination may include some of the following; active/passive ranges of movement, strength testing, Orthopedic testing, neurological testing, movement/functional testing and postural assessments.

Osteopaths take a holistic approach to treatment and doing so may assess areas of your body that aren’t specific to where you are experiencing your symptoms. For example if you come in with lower back pain your Osteopath may assess and treat your lower back as well as your pelvis, hips, knee and ankle as dysfunction in these areas may be related to you presenting a complaint.

Physiotherapists take an overall examination and will assess areas that are specific to your presenting complaint as well as other areas that may be influencing your concerns.

Some of the reasons why people may go to see their local Osteopath are for:

  • Foot pain, ankle pain, hip pain and knee pain
  • Back pain, neck pain and sciatica
  • Shoulder pain, hand pain, elbow pain, wrist pain
  • Headaches
  • Tennis elbow and golfer’s elbow
  • Sporting injuries
  • Postural issues
  • Jaw pain
  • Muscular sprains and strains
  • Scoliosis and Low back pain
  • Arthritis
  • Osteoporosis
  • Arthritis
  • Workplace injuries
  • Repetitive strain injuries (RSI)


Reasons you may see a Physiotherapist are:

  • Rehabilitation (pre/post-surgical)
  • Neck pain
  • Back pain
  • Sciatica
  • Postural issues
  • Sports injuries
  • Headaches
  • Tendon problems
  • Hip, knee and ankle pain
  • Shoulder, elbow and wrist pain
  • Arthritis


After a thorough assessment your Physiotherapist will provide you with a treatment plan specific to the individual and their concerns. Your Physiotherapist may use the following treatment techniques during your consultation:

  • Joint mobilisation and manipulation
  • Dry needling
  • Taping
  • Soft tissue treatment
  • Pain education
  • Exercise prescription

Osteopaths will take a holistic approach towards your assessment and treatment. During your Osteopathic treatment your Osteopath may use a combination of the follow techniques:

  • Soft tissue massage
  • Joint mobilisation and articulation
  • Joint manipulation
  • Stretching
  • Muscle energy techniques (MET)
  • Pain education
  • Exercise prescription

Both Physiotherapists and Osteopaths may give you at home exercises and stretches, Ergonomic advice or movement advice for further management of your condition and symptoms.

Post-operative rehabilitation

Who should you see for post-operative or even pre-operative rehabilitation? Physiotherapists work with a lot of pre and post surgery rehabilitation and have a vast knowledge in this area. Your physiotherapists can help manage clients to pain free return to full/optimal function whether it be walking, playing sports or reaching goals of activities of daily living.

Spinal manipulation

Spinal manipulation or high velocity thrust techniques is aimed at improving the range of motion available at a joint. The noise made when your therapist manipulates or as some call it ‘crack’ your joints is actually the sound of air bubbles releasing within the joint.

Both your Osteopath and Physiotherapist can perform spinal manipulation techniques, for a variety of complaints. Your Osteopath is more likely to use spinal manipulation compared to a Physiotherapist as it is one of the main techniques used by Osteopaths. Osteopaths use manipulation as a treatment option for the spine as well as for your upper and lower limbs.

Conclusion: Osteopathy vs Physiotherapy – which is right for you?

Osteopaths and Physiotherapists treat a range of similar conditions, however their approach to treatment and the reason why each would perform a specific treatment technique may differ. When comparing Physiotherapy and Osteopathy there are a lot more similarities compared to differences. Both professions have the knowledge and experience to treat and manage a range of musculoskeletal conditions and presentations. Ultimately deciding whether to see an Osteopath or a Physiotherapist comes down to personal preference and what approach may work best for the individual.