One of the most commonly asked questions at a chiropractic clinic is probably the same as the most commonly asked question at an osteopath clinic or even a physiotherapist –
What is the difference between a chiropractor, osteopath and physio?
I thought I’d turn the question round and ask –
Who am I?
- I studied at University for 5 years (you can do it in 4 but as a mature student I needed a foundation year)
- I graduated with a master’s degree.
- People come to see me when they have pain and discomfort in their muscles or joints. Often when they have pain from irritated nerves. Very often because they want to improve their sporting ability and achievements or because they just feel stiff. Many see me because they want to prevent feeling pain, stiff or sore.
- I take a careful medical history related to the presenting complaint and perform a detailed physical examination
- I will refer for further tests if I feel it is necessary.
- I will form a diagnosis and very often differential diagnosis which I will discuss with my patients along with treatment options.
- When deciding on treatment options I take into account the best available evidence, the patient’s individual choices, best practice and my clinical experience.
- Treatment options include; patient education, home exercises, a variety of different myofascial stretch techniques, joint mobilisation, acupuncture, massage, joint manipulation, breathing techniques etc, etc.
- At each treatment appointment, I will ask questions and perform some tests to check on progress and improvements.
- I have to attend a certain number of continuing professional development hours every year – I submit the evidence for this annually when I re-apply for registration.
- I am regulated by a professional body who make sure I behave in a professional manner and I am a member of a professional association who help, support and guide me.
- I regularly receive patient referrals from GP’s and I treat both private and NHS patients.
From this description could you guess what I am – Physio, chiro or osteo?
My point is that we do pretty much the same thing. A good manual therapist is adaptable enough to tailor their treatment plan to the patient in front of them, they are pragmatic in their choices and will use techniques that have been proven to work through clinical trials or experienced best practice. A chiropractor practices manual therapy, an osteopath practices manual therapy and so does a physio. Chiropractic is the name of my profession not my treatment, my treatments are much more diverse and adaptable than simple joint manipulation. If I can see that a physio is using a technique that is better for their patients then I will learn and use that technique. I would expect a good physio to do the same.
In truth, I’m not that attached to the title chiropractor. I wanted to be a chiropractor because I saw how well it worked on my horse – at that point I wasn’t really aware of osteopathy although I had thought about being a physio a few times. What does bother me is the assumption that what I do is ‘chiropractic’ when I actually do so much more. It is this assumption that is limiting my profession when it comes to inter professional relationships with other healthcare providers, receiving patient referrals and also when it comes to what we can advertise that we can treat. Sure, chiropractors are best known for treating back, and neck pain and we are pretty good at it. But our education and training enables us to assess, diagnose and treat most of the human (and sometimes animal) body’s musculoskeletal complaints. Many of these complaints include some very pissed off nerves that we are also very good at calming down.
The sooner we can agree that manual therapy is the same as manual therapy the sooner we can all get on with getting our patients moving using whatever method works.