What Is the Difference between Osteopathy and Physiotherapy?

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  • Written By: Marlene de Wilde
  • Edited By: O. Wallace
  • Last Modified Date: 20 May 2019
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Osteopathy and physiotherapy have evolved to treat many of the same conditions but use different approaches according to different ideologies. Physiotherapy is a symptom-specific approach while osteopathy views the body as interconnected and so is concerned with the system rather than just the symptom. Both approaches are hands-on and massage oriented with slight differences.

Osteopathy is more of a hands-on approach with techniques such as gentle touch and pressure, massage and manipulation. Osteopaths may also incorporate acupuncture as well as give lifestyle advice. While massage is an important part of the physiotherapy approach, it is more oriented towards the correction of incorrect movements and rehabilitative exercise programs. The use of ultrasound is common to both osteopathy and physiotherapy.

A further difference between osteopathy and physiotherapy is that osteopaths are primary health care givers while physiotherapists are supplementary to medical practitioners. Osteopaths are diagnosticians first and then are able to treat musculoskeletal dysfunctions taking into account any psychological or social factors they feel may play a part in the condition they are diagnosing. The most common role of the physiotherapist is to evaluate and manage conditions that have already been diagnosed by a doctor, and patients are more likely to see a physiotherapist after referral by their doctor. Osteopaths are trained to understand and diagnose the pathology of the disease, whereas pathologists may not fully understand the pathology but are trained to treat it.


Both osteopaths and physiotherapists take a thorough medical history and perform a physical examination to determine the right treatment path. A well known technique applied by osteopaths is manipulation, in which a characteristic clicking can be heard and visceral and cranial osteopathy are two other applications used to relieve imbalances and dysfunctions throughout the body. Osteopaths believe the cause of pain and discomfort in one area may be located in another area of the body and so treat the individual rather than the symptom.

Physiotherapists use manipulation only after taking a post-graduate course, whereas osteopaths undergo two years of training in this technique. Physiotherapy is more likely to incorporate therapeutic and training exercises, electro-therapeutic and mechanical intervention as well as education and counseling. The aim is to treat the symptom but there is also an emphasis on fitness and quality of life. The end results of courses of osteopathy and physiotherapy treatment are most likely the same, despite the different approaches to the dysfunction that inspired them.


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