What’s the Difference Between an Osteopath, Chiropractor, and Physiotherapist?

Back pain

Everything and nothing.

When you’re in pain, what matters most is finding a practitioner who listens to your story, understands your goals, and works with you to create a personalised treatment plan. While osteopathy, chiropractic, and physiotherapy may look similar from the outside, their roots, philosophies, and approaches have unique differences—yet today they often overlap in practice.

Let’s take a closer look at how these three professions came to be, what makes them distinct, and how to decide which might be right for you.

A Brief History of Manual Therapy

Hands-on techniques to ease pain, improve mobility, and restore function have been around for thousands of years. Ancient records from Greece, China, and Egypt describe forms of manual healing dating back as far as 360 BC.

Over time, these practices evolved into structured professions, each with its own philosophy and clinical focus. Today, manual therapy is an important part of modern healthcare, commonly used for back and neck pain, headaches, joint issues, sports injuries, and more.

In New Zealand, the three most common regulated choices are osteopathy, chiropractic, and physiotherapy. So, what sets them apart?

Osteopathy: A Whole-Body Approach

Osteopathy was founded in the late 1800s by Dr. Andrew Taylor Still, who believed that if the body’s structure was working well, its natural ability to heal would be more effective. He observed that restrictions in the body’s tissues could interfere with circulation and healing, and developed techniques to restore balance.

Osteopathy is guided by four principles that still hold true today:

• The body is a unit—mind, body, and spirit are interconnected.

• The body has self-healing and self-regulating abilities.

• Structure and function influence each other.

• Treatment should work with these principles to restore health.

Modern osteopaths use mobilisation, stretching, soft tissue massage, and gentle manipulation to relieve pain, improve mobility, and restore function. Appointments typically last 30–45 minutes, allowing time to look at the whole picture.

Chiropractic: Focus on the Spine and Nervous System

Around the same time, D.D. Palmer developed chiropractic care, based on the idea that spinal misalignments—called “subluxations”—could disrupt the nervous system and impair health.

Chiropractors traditionally focus on the spine, using spinal adjustments (high-velocity thrust techniques) to improve alignment and relieve pressure on the nervous system. Many now also incorporate exercise advice, ergonomic support, and soft tissue techniques. Appointments are usually shorter, around 10–20 minutes.

Physiotherapy: Rehabilitation and Movement Science

Physiotherapy grew from 19th-century “medical gymnastics” and gained prominence during the rise of orthopaedic surgery, where rehabilitation was essential.

Physiotherapists are experts in restoring movement and function after injury, surgery, or illness. They use exercise therapy, manual techniques, education, electrotherapy, and functional rehabilitation. With a strong foundation in movement science, physiotherapists often work with athletes, post-surgical patients, and anyone aiming to regain strength and mobility. Sessions are typically 20–40 minutes.

What Do They Have in Common?

Despite their differences, osteopaths, chiropractors, and physiotherapists share important similarities:

• Protected titles: In New Zealand, you must be fully qualified and registered to legally use these professional titles.

• Rigorous education: All require a 4–5 year degree, combining theory with extensive hands-on clinical training.

• Regulation and accountability: Each is governed by a professional body, ensuring safe, ethical, evidence-informed care.

• ACC registered: Patients can access subsidised care for covered injuries through ACC.

This regulation distinguishes these professions from other bodywork or manual therapies, giving patients reassurance of training, safety, and standards.

So, What’s the Best Option?

The truth is, there’s no single “best” profession. The lines between osteopathy, chiropractic, and physiotherapy often blur, with many practitioners integrating techniques from each field.

Ultimately, the right choice isn’t just about the title on the door—it’s about the practitioner themselves. Do they listen to you? Do you feel comfortable with their approach? Does their treatment style suit your body and your goals?

At Osteopathy Nelson

At Osteopathy Nelson, we believe healing starts with feeling heard. Our osteopaths work holistically, blending traditional principles with modern, evidence-informed care. We take the time to listen, understand your unique story, and support your recovery through hands-on treatment, education, and movement.

Because when it comes to your health, it’s not only about choosing a profession—it’s about finding the right practitioner for you.