What is the difference between an Osteopath and a Physiotherapist?

This is a question that Osteopaths are often asked particularly since physiotherapy is often free on the NHS, while osteopathy is only available through the NHS in some Primary Care Trusts.  In a general sense the difference between an Osteopath and a Physiotherapist can be summarised in the following way:

  • Osteopaths focus on hands on therapy and manipulation, whereas Physiotherapists typically use a mix of exercise and therapeutic devices
  • Osteopaths are trained to independently diagnose and where appropriate treat
  • Physiotherapists are trained to develop treatment protocols based on referrals from doctors
  • Physiotherapists tend to specialise whereas Osteopaths tend to treat a wide range of conditions
  • Physiotherapists are able to take post-graduate courses to learn many of the hands-on techniques that Osteopaths employ

The training for an Osteopath takes a minimum of four years before a candidate is allowed to take the registration exams.  The training includes academic study into bio-medical subjects, hands-on technical instruction in physical therapeutics and at least 1000 hours of supervised clinical treatment of patients.  An Osteopath learns all fundamental aspects of human physiology and pathology.  Osteopaths learn particularly detailed anatomy to enable a very precise biomechanical view of the body.

The training is aimed at providing an Osteopath with the skills and experience required to safely diagnose and treat a huge range of disorders and, very importantly, to recognise red flags that require immediate referral for medical investigation.  An Osteopath is expected to practice autonomously.  It is part of the ethic of the profession that an Osteopath will be a competent generalist and able to formulate a treatment plan for any presenting condition.  Osteopathy is an allied health profession and despite some recent appointments into the NHS, is largely a private health provider.

Physiotherapists are trained for three to four years in bio-medical subjects, physical therapy and the use of medical therapeutic devices. Gaining entry into a physiotherapy degree in the United Kingdom is very competitive and consequently the entry standards are high.  The standard career path is into the NHS where they are referred patients once diagnosis has been made by a Doctor.  Physiotherapists are competent to develop a treatment plan, whilst being overseen by a Doctor, based on physical therapy, exercise and therapeutic devices (such as TENS and ultrasound).  Physiotherapy can be subdivided into a number of specialties including: cardio-pulmonary, geriatric, orthopaedic, sports therapy and intensive care.

Physiotherapists may undertake post-graduate study into spinal and joint manipulation, and some others may choose go on to earn a professional doctorate.  Currently there are plans to make physiotherapists who have undertaken further study able to independently prescribe medicines from a specific formulary.