What's the difference between a Chiropractor and an Osteopath?

I once asked this very question to an osteopath and with a wink she replied, “30 minutes.” (This is due to the fact that an appointment with an osteopath is usually 45 minutes and an appointment with a chiropractor is usually only 15 minutes). However, there is a lot of overlap between the two practises so in this blog post I’ll try and explain the difference.

The spine, which transports the central nervous system to the rest of the body, is usually the root of all biomechanics problems.

The spine, which transports the central nervous system to the rest of the body, is usually the root of all biomechanics problems.

Chiropractic Therapy

This is a treatment in which the practitioner (the chiropractor) will manipulate bones, muscles, ligaments and tendons with their hands to provide pain relief. The crucial aspect of this treatment is that it focusses on the spine therefore, back pain the main area of interest. However, it is also useful for related areas connected to the spine such as the neck and shoulders.

It is important to note that this therapy is not considered mainstream medical practice and is described by the NHS as a type of “complementary and alternative medicine” (CAM). However, a chiropractor must be registered with the General Chiropractic Council (GCC) and will be regulated and agree to operate under a code of conduct and ethics. It is not available on the NHS and you should expect to pay anything from £40 to £100 (if not more) to see a private chiropractor.

In my experience (and I’ve seen a few chiropractors in my time) the first session will last 30/45 minutes to assess the problem and recommend a course of care. Some private chiropractors will provide X-rays and MRI scans to aid in the diagnosis of the problem. Then, usually weekly or twice weekly sessions are recommended to provide ongoing pain relief. These ongoing sessions will last for 15 minutes (as mentioned above) and will consist of manual manipulation (cracking) of the spine and massage of the surrounding soft tissues (muscles, tendons and ligaments).


An osteopath will take a more holistic approach to patient care. The general principle of osteopathy is that optimum wellbeing is reliant upon a persons bones, muscles, tendons, ligaments and (to a lesser degree organs) working in perfect balance and alignment. Therefore, it is primarily focussed on biomechanical issues (which will generally be related to spine health) but it may also be used to treat a wide range of other medical conditions such as migraines / headaches and digestive disorders /IBS.

As with Chiropractic Therapy it is termed as a CAM (complementary and alternative medicine) and has its owned regulatory body The General Osteopathy Council to promote and enforce professional standards. Again, it is only available privately and you can pay anything from £30 to £100+ for each session.

Sessions usually last 45 minutes and will consist of the initial consultation / assessment session followed by further follow up sessions. Because of the preventative nature of osteopathy I find that the follow up sessions are less frequent than chiropractor sessions. Depending on the issue they can be bi-weekly, once a month or even longer apart. These sessions will consist of range of motion testing for joints, manipulation (cracking) of the spine, massage and stretching of joints / muscles. Again, all of these are done with the hands. Osteopaths will also recommend exercises and may also offer lifestyle (such as diet) advice. I make a point of seeing my osteopath at least once every six weeks.

Interestingly, I’ve found that many osteopaths are also qualified pilates instructors.


Because the spine is so crucial to overall health most biomechanical problems can be attributed to an issue within some part of the spinal column. This is why there’s so much overlap between the two professions. However, in my humble opinion, you should see a chiropractor if you’re suffering from any type of acute (sudden onset) back pain and you desperately need relief from this pain. An example of this is when you feel fine but you bend down to put on a sock and all of a sudden you feel a sharp excruciating pain in your back and you can’t move. Alternatively, you should see an osteopath when you’re suffering from general aches and pains in your back, neck or shoulders. For example, if you have chronic (ongoing) lower back pain that doesn’t go away for a period of a month or more.

Again, in my humble opinion, chiropractors will treat the symptoms of problem whereas an osteopath is more concerned with the cause of the problem. I always recommend to my trainees that if they get any sharp or sudden pains in their back they should make an appointment with a chiropractor immediately. However, I advise everybody (not just my trainees) that every four to six weeks they should see an osteopath for a back “MOT” and to correct any postural misalignment. This should be even more frequent if you’re very physically active.

I hope this makes things clear.


Neil Symington