Osteopathy vs Chiropractic

Many patients pose the question 'what is the difference between an Osteopath and a Chiropractor?'.  Historically the two professions developed alongside each other.  The founder of the Chiropractic profession was D.D. Palmer who was a student of Andrew Taylor Still (the founder of the Osteopathic profession).  Dr Still spent ten years of study whilst he continued to work as a medical man before he devoted his life to Osteopathy.  History suggests that Dr Palmer was one of Dr Still's first students, but they 'parted company' at some point and Dr Palmer then began teaching with his own emphasis using the skills passed on by Dr Still.  His philosophy and principles varied from that of A.T. Still; hence the Chiropractors approach is subtly different to that of the Osteopathic practitioner.

In simple terms, both osteopaths and chiropractors tend to treat similar conditions with similar techniques. Especially in Britain, where the two evolved along parallel but converging paths, there is some overlap in approach. In general Chiropractors tend to concentrate on the spine for their diagnosis and treatment. Osteopaths always consider the spine but also the muscular and joint systems...


The philosophical and practical differences between Osteopaths and Chiropractors 

The differences between osteopathy and chiropractic stem from a rather subtle variance in philosophy.  Barrie Savory, D.O., in his acclaimed book 'The Good Back Guide', explains that Osteopaths subscribe to two axioms based on the concept of the body as a unique interdependent system.  The first, ‘the rule of the artery is supreme,’ means that a healthy blood supply is likely to support a healthy bodily environment.  Thus, osteopaths take circulation carefully into account when assessing patients.  The second axiom, ‘structure governs function,’ concerns the fact that problems in the structure of the body, for example, too much tension in certain muscles or the misalignment of a bone, can inhibit the natural function of multiple bodily systems.  Though the root of the word ‘osteopath’ means ‘bone,’ osteopaths do not actually treat bones.  Rather, they use the bones as levers to improve the condition of other structures in the body like muscles, ligaments, tendons, fascia, and organs.  By treating these structures, osteopaths can aid the body’s natural healing ability.

Chiropractors, on the other hand, tend to focus on the spine and the alignment of vertebrae as the primary means to relieving pain and tension throughout the body.  The spine consists of the vertebrae, which are bone segments that protect the spinal cord, and the individual nerve branches stemming from it.  These nerve branches exit between the bones, conveying important messages between the brain and the rest of the body.  Because the vertebrae shift and move with everyday activity, they can misalign and interfere with the nerve messages travelling among them. This interference causes problems, and frequently pain, throughout the body. 

The primary objective for both osteopaths and chiropractors is, most frequently, to relieve aches and pain.  However, osteopaths also treat a broader range of functional problems, such as disorders of the respiratory or digestive systems. Both osteopaths and chiropractors treat more than just bones joints and soft tissues. By working with the nervous system and blood supply they are able to influence all of the bodies systems, making them capable of alleviating the symptoms of a number of diagnosed medical conditions, such as; asthma, stress, digestive disorders, period pain, migraine and many more.


How do these differences between Osteopaths and Chiropractors affect patients?

In many cases, patient experiences with osteopaths and chiropractors will be very similar; however, there are some differences.  When diagnosing patients, osteopaths and chiropractors both use visual inspection (observation) and palpation (touch). Chiropractors frequently rely on more diagnostic procedures, such as X-rays, MRI scans, blood tests, and urine tests.  Osteopaths tend to place more emphasis on the physical examination and will generally refer patients on for more diagnostic procedures if required.

The type of treatment a patient will receive at an osteopathic clinic can vary greatly. Osteopaths employ a number of techniques in order to influence the body’s innate healing system. These include; soft tissue, muscle work, joint articulation and mobilisation/manipulation. Some osteopaths work with and thereby influence organ function and movement (‘visceral osteopathy’) and movement of cerebrospinal fluid (‘cranial osteopathy’). The specific treatment will depend upon the patient’s unique circumstances. Osteopathic manipulation consists of positioning a joint into its close packed position and imparting a small but rapid impulse in order to separate the joint surfaces within their normal range of motion. This may produce a pop or a cracking noise; it is not a painful technique. The manipulation has the effect of freeing up any adhesions and encouraging better movement, it has a secondary, but very useful analgesic effect (pain relief).

In contrast, chiropractors tend to concentrate on influencing the nervous system by employing a technique called “adjustment,”. The actual technique is similar to that of osteopathic manipulation. The theory is that adjusting the vertebrae will allow it to return to its proper alignment along the spinal column and permit optimal nerve transmission.  In an adjustment, the chiropractor applies pressure to the bone, unlocking it from its improper position.  The technique is not painful, though patients do sometimes hear “popping” noises. These are thought to be due to small pockets of gas being released from within the joint capsules.  This is completely normal.

The length of treatment also typically varies between osteopaths and chiropractors.  In general, chiropractic appointments tend to be shorter as the practitioner focuses on adjusting the spine (this does not mean to say that chiropractors don’t adjust areas other than the spine).  However, chiropractors tend also to see patients more frequently, as the muscles connected to a misaligned vertebra can pull the bone back out of place, and it may take a few adjustments for the spine to settle into its proper alignment.  Osteopaths tend to spend more time with a patient per visit, as their focus is somewhat broader and their treatment techniques are more varied.  Osteopathic treatments also tend to be spaced out over a longer period of time. 

Having described these differences, it is important to remember that both chiropractors and osteopaths address the same structures and use principally similar manipulative techniques.  There are a huge number of variations between individual practitioners of both disciplines, from what they focus on to how they apply treatment.  Each chiropractor and each osteopath is an individual with his or her own unique style of practice, and it is important for a patient to find a practice that fits his or her unique needs, regardless of the label.

1 Barrie Savory. The Good Back Guide (London: Century), 2006.
2 Letter from James W. Healey, D.C.