What is the Difference Between Chiropractic and Osteopathy?

It is very common to hear the terms chiropractic and osteopathy when dealing with certain pain conditions, especially back pain. Both these disciplines are well-recognised within the medical profession and their manual therapies have been approved by the National Institute for Health and Care Excellence (NICE).

Both therapies may have some commonalities but are also distinct from one another. This can be confusing to patients wanting to find relief for their pain conditions and remain uncertain as to which option offers them the best chances of relief. So, here is a basic rundown of the key differences between the two treatments that may help those considering them better decide which option makes for a better fit. 

Area of Focus

Chiropractic treatments are aimed at correcting dysfunction in the nervous and musculoskeletal system.  There is a keen focus on the manipulation of joints, vertebrae, and spine during these sessions. Chiropractors believe that the adjustments they perform to realign the spine will help the body heal itself. 

Osteopathy takes a more holistic approach. In this field, the belief is that all body systems are interrelated. These systems are co-dependent and need to be balanced for overall health and wellbeing to be achieved. So the focus is not just on the problem area but on the entire body. 

Both treatments are typically non-invasive and apply several hands-on techniques. Chiropractors are however more focused on injury recovery and pain relief related to the spine and joints, while osteopaths are interested in the overall improvement in health and will factor in even other symptoms or conditions that may not seem related.  This can mean spill-over treatment of conditions related to digestion, respiration, and more. 


Chiropractors must earn a chiropractic degree from a recognized university. Currently, there are only 5 universities that offer approved chiropractic degrees in the UK. The degree courses usually require 4-5 years of full-time education to earn degrees. After graduation, chiropractors must register with the General Chiropractic Council (GCC) to practice. They must also undertake Continuing Professional Development (CPD) to maintain their registration with the GCC. 

Osteopaths must be registered with the General Osteopathic Council (GOC). To be registered, they must have completed degree-level training that earned them either a Bachelors or Master in Science. Degree level training typically takes 4-5 years and involves academic work and research. There is also a requirement to undertake over 1,000 hours of patient-facing clinical training. After completing the requisite training, registered osteopaths must undergo at least 30 hours of continuous professional development (CPD) every year to maintain their registration.

Though the duration of training may be similar, there are some differences in the content. For instance, chiropractors are trained in radiography and can read x-rays, while osteopaths do not receive such training.  You will find that course content will vary between the two qualifications. 

It is also worth noting that osteopaths are permitted to prescribe medication to support their treatments. Chiropractors are however not recognised as medical doctors and may not prescribe medications. 


Both chiropractors and osteopaths will conduct their own assessment before proceeding with any treatment. During this initial assessment, chiropractors will heavily rely on imaging like x-rays and MRIs to diagnose the condition and determine what treatment to undertake. Osteopaths are more hands-on during assessments and will mainly use manual techniques to take patients through different movements before making a diagnosis. They may however still use imaging to clarify this diagnosis. 


Chiropractic and osteopathic treatments for the most part involve physical manipulations. Osteopathic techniques however often incorporate more gentle, passive, and repetitive movements than the swifter chiropractic adjustments. Both may however use any variety of gentle or forceful manipulations depending on the condition of the patient. 

A doctor of osteopathic medicine is a qualified physician. They are licensed and permitted to prescribe medication and may perform surgery. Chiropractors however rely exclusively on their adjustments to bring about desired effects. They are not permitted to prescribe drugs. 


Chiropractor sessions tend to be shorter, lasting about 10-15 minutes at a time. They are however more frequent with many patients scheduled for 2-3 sessions a week. Osteopaths provide longer sessions that can last up to half an hour. The sessions are however more spaced and can be weekly during the initial phase. This can be more widely spaced to a session every 3-4 weeks for preventative care. The initial session for both therapies may however be longer, lasting up to an hour or more. 


Chiropractors and osteopaths are more easily found in private clinics where they work independently or may be part of a multidisciplinary team. Chiropractic treatments are not widely available on the NHS but can be availed in special circumstances. Osteopathy is available on the NHS in some areas. Consult with your GP or local clinical commissioning group (CCG) to find out if you can access this service. Otherwise, you may have to opt to pay for treatment privately. 


Overall, both chiropractors and osteopaths provide physical therapies but originate from different schools of thought. The first is focused on the nervous and musculoskeletal systems, while the other is more holistic. The duration of training is similar, but the content can vary. The choice of techniques used can also vary between the two disciplines. 

Both forms of therapy can provide safe and effective pain relief and other benefits to patients. If you are undecided as to which practitioner to seek help from, consult your GP. You may also visit a qualified chiropractor or osteopath without the need for a referral. They can take you through an assessment to determine if their treatment options would be beneficial to your condition. If not, they may refer you back to your GP or another specialist.