The Difference Between an Osteopath and Physiotherapist

Many people with physical pain and looking for a solution will have come across references to osteopathy and physiotherapy. Some people will even mistakenly believe they refer to the same treatments, but they do not. While there are some commonalities, particularly when it comes to intended outcomes of reduced pain and improved quality of life, there are certain differences that can influence which choice of treatment you choose to pursue for your particular condition.


Osteopathy has its roots in conventional medicine. It was developed by a physician named Andrew Taylor Still in the US in the late 1800s. Inspired by the loss of his three children during an epidemic, he came to believe that diseases could be treated by correctly adjusting the body through manipulative techniques. The osteopathy treatments he developed have since become more widely used across the world, with specialised courses and licensing in many countries.

Physiotherapy is inspired by physical therapy treatments that have been a part of ancient cultures like the Chinese, Greek and Indians. Rather than osteopathy which takes a more holistic approach, physiotherapy is focused on delivering treatment to the specific part of the body that is in pain. And rather than focus on physical manipulation, there is more emphasis on exercise and massage.

Guiding Philosophy

Osteopaths operate under the view that the body is a whole and that all the systems within are interconnected. With the right application of treatments, the expectation is that the body can be helped to tap into its own self-healing mechanism.

Physiotherapy has a more focused viewpoint that seeks to treat the problem area where symptoms of pain are occurring. Treatments are applied directly to these problem areas to relieve the pain, not often factoring the whole body.


To become an osteopath or physiotherapist, a practitioner is required to undertake training that includes earning an undergraduate degree at a university. However, in the UK, you can earn a degree in physiotherapy within a 3-year program, while osteopathy degrees will require a commitment to at least a 4-year program.

Both degrees cover a diverse range of medical science subjects including physiology and pathology. Students are also required to undertake clinical placements where they spend time practically assessing and treating patients under the supervision of qualified osteopaths and physiotherapists.

However, despite the disparity in the length of the training programs, osteopaths will tend to focus on treating conditions related to musculoskeletal pain and sports injuries. Physiotherapy students will undertake training in a broader range of conditions that include musculoskeletal, neurological and respiratory conditions. They are exposed to handling conditions related to a wider range of body systems than osteopath students.


Osteopathy is essentially a manual therapy that takes a holistic approach to the diagnosis, treatment, and management of various acute and chronic conditions. Attention is paid not just to the part of the body where the pain is being experienced, but also to connected body parts, tissues, bones, and body systems, with a goal of restoring balance. The majority of the treatments used are hands-on.

The range of treatments applied by osteopaths to accomplish this include:

  • Soft tissue massages
  • Stretching
  • Mobilisation and articulation of tissues and joints
  • Gentle and indirect release techniques
  • Positional release techniques
  • Muscle energy techniques

Physiotherapy treatments accommodate injuries and pain conditions from a wider range of body systems. Practitioners develop treatment plans that not only seek to relieve and manage the pain condition, but also take into consideration patients’ lifestyles, normal activities and health conditions.

About half of physiotherapy treatment time is spent undertaking hands-on approaches, with the rest of the time devoted to other aspects such as teaching patients what exercises they can do on their own and electrotherapy.

The range of treatments that can be incorporated into these treatment plans can include:

  • Soft tissue massages
  • Joint manipulation and mobilisation
  • Muscle training
  • Dry needling
  • Electrotherapy
  • Hydrotherapy
  • Strengthening exercises

Also, note that osteopaths rely on physical techniques for treatments and prefer to avoid the use of medications or surgery. Physiotherapists in the UK do have prescribing powers that allow them to prescribe medication to their NHS patients.


You may be referred to a physiotherapist or osteopath by your physician. Physiotherapy treatment is covered by the NHS. However, the sessions are typically limited. This means within the sessions you are provided you would be trained on what exercises to undertake on your own, after which you may become responsible for your own care and recovery.

Osteopathy treatment is not as widely available on the NHS, meaning you will likely need to be covered privately or pay out of pocket. Because the treatments are primarily hands-on, there is no limit as to how many sessions you can have.

So, how do osteopaths and physiotherapists differ?

Both osteopaths and physiotherapists are highly trained medical professionals. Both professions are focused on relieving pain conditions and helping patients enjoy a better quality of life. However, the range of treatments they offer can vary, as does the amount of time dedicated to the application of hands-on techniques.

Osteopaths do spend more time applying hands-on techniques, with treatments often involving massage, spinal, and joint manipulation. They do not just focus on the problem area but give more consideration to related body systems and the body as a whole when diagnosing and applying treatments.

Physiotherapists tend to focus on the specific body part experiencing pain and target their treatments here. These treatments can involve some level of hands-on techniques, though there is less emphasis on this here when compared to osteopathy. Physiotherapists will try to give as much consideration to exercise-based management in treating pain conditions and injuries.