Why Chiropractic - and not Physiotherapy or Osteopathy?
- Luke Appleby-Fleet
- Sep 2
- 5 min read
Updated: Sep 9
One of the most common questions I get asked is: “What’s the difference between a chiropractor and an osteopath?” But I think what people are really asking is, “Why am I seeing you and not someone else?” It’s a fair question—especially when there seems to be so much overlap between Chiropractors, Osteopaths, and Physiotherapists these days.
If you’re trying to decide who to see for help with pain, stiffness, or injury, the choice can feel very overwhelming. So in this blog, I want to explain how these professions differ, where they overlap, and why I’ve chosen to practise as a chiropractor. My goal isn’t to say one is better than the other—it’s to help you feel more informed about what to expect, and what might be the best fit for you.
Historical Context
When I’m answering this question, I often start by talking about the history and philosophy behind each profession. These days, chiropractors, osteopaths, and physiotherapists often seem to work in similar ways—and in some cases, they do. At university, chiropractors are trained extensively in the diagnosis and treatment of the musculoskeletal system. And yes, you guessed it—so are osteopaths and physiotherapists.
The difference lies in the approach each profession typically takes—and that’s shaped by their origins:
Chiropractic care began with the belief that many health issues were caused by spinal misalignments interfering with nerve signals. By adjusting the spine to remove this interference, early chiropractors believed they could support the body’s natural healing abilities.
Osteopathy originally focused on the idea that structure governs function—that problems in the musculoskeletal system could disrupt circulation and health. Early osteopaths believed that by improving joint mobility and blood flow through manual techniques, they could enhance the body’s ability to self-heal.
Physiotherapy emerged more through the lens of rehabilitation, especially after war injuries. It focused on restoring movement and function through exercise, physical modalities, and education—emphasising active participation and recovery over time.
What we are taught
Chiropractors are typically taught to make changes to the body through spinal and extremity adjustments—primarily using high-velocity, low-amplitude (HVLA) techniques. It’s what we’re trained in most extensively—it’s our bread and butter.
Osteopaths, on the other hand, are usually taught to work with the body through mobilisation, soft tissue techniques, and stretching.
Physiotherapists are primarily trained to make changes through exercise prescription and rehabilitation.
That said, with further training—and often as part of their university education—all three professions may learn to use elements of each approach. Chiropractors can use exercise. Physios can perform manual therapy. Osteopaths can do HVLA.
So does that mean we’re all the same? Not quite.
Think of a triangle, with HVLA (adjustments), soft tissue work/stretching, and exercise sitting at the three points. Just like character stats in a video game, every practitioner brings their own balance of these skills into the way they work.
In my practice, that triangle leans most heavily on adjustments and rehabilitation exercises—because that’s where I see the best results for the people I work with.
Well if everyone's different, how do I know what's right for me?
This mix of skills means that every practitioner brings their own unique approach—even within the same profession. So how do you decide who might be the right fit for you?
Here are a few thoughts based on what I’ve seen in practice (and yes, others may have different perspectives!):
If you don’t like the popping sound that comes with joint adjustments, you might feel more comfortable with an osteopath or physiotherapist, who may lean more on soft tissue techniques and exercise. (Although, plenty of patients who were unsure about the sound have still found great results with chiropractic care. If you're curious about what that sound actually is, click here to find out.)
If you struggle with doing exercises at home or want more hands-on treatment during your sessions, chiropractic or osteopathy may offer the kind of support you’re after. However, as you saw in my triangle, I believe that without active participation from the patient in their own care, you’ll only reach a certain point toward your goal.
If soft tissue work feels uncomfortable—as it sometimes can for people with conditions like fibromyalgia—you might prefer an approach that focuses more on joint adjustments or structured movement-based rehab.
Of course, the tools we use are only one part of the picture. Who we are as practitioners—and what we focus on—can shape your experience just as much.
Care under any professional goes beyond their physical skill set. Many practitioners have special interests—whether that’s sports injuries, paediatrics, women’s health, or something else entirely.
For me, that special interest is hypermobility. My wife and other family members are hypermobile, which led me to dive deeper into how I could support them better. That curiosity eventually expanded into my practice, and now I work with many patients who are navigating the challenges that can come with hypermobility. I will have a blog coming in the future on this very topic but in the meantime, click here, if you want to understand Hypermobility more. My fellow Chiropractors at Sevenoaks Chiropractic Clinic wrote that blog and it has amazing insights into the topic.
Before you decide whether someone is the right fit for you, here are a few questions to ask yourself after your first visit:
Do I feel heard and understood? Do I understand what they’ve told me about what’s going on? And if I don’t, do I feel comfortable asking for clarification?
It’s also completely normal to feel nervous about seeing someone new—especially if you’re not sure what to expect. I can’t speak for osteopaths or physiotherapists, but if you’re curious about what it’s like to come and see me, click here for a walkthrough of your first visit—from walking through the door to walking out again.
Why Chiropractic?
There’s no one-size-fits-all answer to “Which professional should I see?” Chiropractors, Osteopaths, and Physiotherapists all have unique strengths—and within each profession, every practitioner brings their own experience, interests, and approach.
If you're unsure where to start, think about what matters most to you:
Do you want a more hands-on approach? Do you respond well to structured exercise? Are you looking for someone who really takes the time to explain things clearly?
These are all valid considerations—and the right fit is the one that helps you feel heard, supported, and empowered.
It’s also worth saying that you don’t have to pick just one. In many cases, the best outcomes come from co-management, where professionals work together to support your care. Whether that’s combining chiropractic with physiotherapy, soft tissue work, or input from another specialist—collaboration often leads to better, more lasting results.
📞 If you’re curious about how chiropractic care could support you—or just want to talk through your options—I’d love to help. You can book a consultation here, or take a look at what your first visit with me would be like to see if it feels right for you.
References
Simpson, J. K., & Young, K. J. (2020). Vitalism in contemporary chiropractic: a help or a hinderance?. Chiropractic & manual therapies, 28(1), 35. https://doi.org/10.1186/s12998-020-00307-8
Chartered Society of Physiotherapy. (n.d.). CSP history. The Chartered Society of Physiotherapy. Retrieved September 30, 2025, from https://www.csp.org.uk/about-csp/who-we-are/csp-history
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