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Osteopathy vs Physiotherapy: Similarities and Differences

Osteopathy and physiotherapy are both healthcare professions that aim to alleviate pain and improve mobility, but osteopathy focuses more on the whole body and its interconnectivity, while physiotherapy is more targeted towards specific areas of injury or dysfunction.

osteopathy vs physiotherapy

What is Physiotherapy?

Also known as PT or Physio, it is a health profession that promotes, maintains, and restores health and wellness through rehabilitation, disease prevention and health promotion. Physiotherapists provide assessment and treatment for various health conditions of many systems of the body. Physiotherapy can include orthopedic Physio for musculoskeletal injuries and movement dysfunction, Cardiorespiratory Rehabilitation, Neurological Physio, Pediatric Physio and Burn Physio.

Orthopedic Physiotherapists provide assessment and treatment of musculoskeletal pain, injuries, and disorders. Orthopedic Physiotherapists can work in outpatient hospital settings or private clinical practice. They use their assessment results to formulate a treatment plan that typically includes education and manual therapy techniques such as soft tissue massage for muscle tension and joint mobilization for restrictions in joint range of motion. Patients are also given rehabilitative exercise based treatment to help manage pain.

Treatment can include techniques such as joint manipulation or mobilization or soft tissue treatment for muscles to treat neck pain, back pain, or other musculoskeletal health. Treatment can also include exercise therapy. Pain can occur in sports injuries, motor vehicle accidents, pregnant women, diseases or disorders and workplace injuries. Physiotherapists treat the cause of the problem to reduce pain and restore functional movement patterns and allow people to return to their daily lives pain free.

What is Osteopathy?

Osteopathy treatment is a manual therapy practice focused on working with the structure and function of the body to treat one or more problems. It is a holistic approach taking into consideration the whole body in any concern. It is based on anatomy, physiology and biomechanics of the human body and addresses the patient as a whole unit, working with the skeleton, muscle, and connective tissue in the body.

Osteopathy focuses on hands-on or manual therapy techniques to address the components of the body. These components include the musculoskeletal system (including bones, joints, and soft tissues such as ligaments, muscles, and tendons), the cranium and the visceral system (including the internal organs). The goal is to bring balance to the body's systems and positively affect the general health and healing mechanisms of the body systems, including the nervous, lymphatic, and circulatory systems, restoring normal blood and nerve supply.

These areas or systems are assessed to determine if there are any restrictions in alignment, mobility, or vitality. The restrictions found are treated with specific treatment protocols called traditional osteopathic manual practice. Removing restrictions allows for symptoms to resolve and normal function to be restored.

Osteopathy is a distinctive form of health care, founded on the philosophy that all body systems are interrelated and the balance between them is what the body depends on for good health.

manual therapy

What is the difference between Osteopaths and Physiotherapists?


There is a difference in regulation between the two therapies.

Physiotherapy is a Regulated Health Profession in Ontario. They are governed by the College of Physiotherapists of Ontario.

Osteopaths are not regulated in the province of Ontario. It is important as a patient to do your own research and educate yourself on the professional background of the Osteopath you choose to see. Many Osteopaths in Ontario are a part of the Association of Osteopathic Manual Practitioners or the OAO. The OAO promotes the highest standard of osteopathic education and the safest standard of ethical, osteopathic practice in the province. The OAO follows the World Health Organization's minimum criteria for professional education to provide osteopathic treatment effectively and safely.

Education & Training

There is a difference in education between these two therapies.


Physiotherapists must have a Degree in Physiotherapy. In Canada, this degree has become a Master's Degree at all institutions. Applicants to the Master’s Degree in Physiotherapy, must possess an Undergraduate Degree and a related discipline is generally more highly regarded. Physios receive extensive training in a wide scope of therapies, only one of which being Orthopedics.

Once Physiotherapists have graduated from an accredited institution, they must then complete a written and practical exam to be registered as a Physiotherapist by the College of Physiotherapists of Ontario.


While Osteopathy is unregulated, as mentioned above, the OAO follows the WHO's established criteria for professional osteopathic training requirements to provide Osteopathic services. The minimum requirements are:

• 4200 hours of professional training and education

• This includes 1000 hours of supervised practical experience

Some Osteopathic educational programs provide significantly less training than what is recommended by the WHO. To be recognized by the OAO, an Osteopathic program must include a degree in science, such as Physio, Athletic Therapy, Kinesiology, Massage Therapy or equivalent combined with a professional diploma in Osteopathy. This amount of training and science background results in a stronger focus in pathophysiology and a wider range of treatment techniques and manual therapy skills.

osteopathy vs physiotherapy


There is a difference in how assessments occur between these two therapies.

Your first session with either profession will be an assessment. Practitioners in both Osteopathy and Physiotherapy will take a history and perform an assessment of your presenting condition. The overall assessment process might appear quite similar. However, there may be some key differences depending on your therapist’s training and experience.

Generally, Physiotherapists assess the painful area, but will also assess it as part of a functional unit. If you have knee pain, a Physiotherapist will assess all aspects of your knee, but also assess how the knee operates as part of functional movement, such as in a squat. They will look at how the surrounding joints such as the hip or the ankle may affect movement at the knee.

In contrast, Osteopaths tend to take a whole body or holistic approach. They will focus globally throughout the body to determine any areas where your pain may be originating. If you have a shoulder problem, they may assess your pelvis and lower limbs to see if these are contributing to your area concern. They may even assess your internal organs and how they may be contributing. This is not something most Physiotherapists would do.


Both Osteopaths and Physiotherapists work with all muscle and joint issues. Osteopaths tend to treat spinal problems more predominantly such as low back pain or neck pain or injury. They treat fewer peripheral joints such as the knee or shoulder. They also tend to treat less muscle/tendon injury. Their focus tends to be on bone and joint mobility and balance of all the systems of the body. Osteopaths follow treatment protocols to aid in the recovery process and focus on the hands-on therapy and not exercise based management, making you more reliant on receiving hands on treatment. Osteopathic training does not involve exercise.

Physiotherapists tend to have a more varied caseload, treating a variety of spinal and peripheral injuries related to joints and muscles/tendon. Research in muscle and tendon problems has largely been led by PTs. PTs also tend to work more with athletes through sports clubs. Most PTs will use a combination of manual therapy techniques and exercise based management, allowing you to be an active part of the treatment process, maintaining results between treatments and participating in the recovery process from injury through exercises.

Post-operative rehabilitation

Physiotherapists tend to be highly trained and experienced in post-operative rehabilitation, whereas Osteopaths do not.

Spinal and Joint Manipulation

Spinal Manipulation is a type of hands-on therapy technique. It is a high-speed thrust. Both types of practitioners tend to be trained in spinal manipulation. The origins of spinal manipulation are osteopathic, so you are more likely to receive this specific treatment if you see an osteopath. Some PTs will learn spinal manipulation as part of their postgraduate study.


PTs may choose to specialize in:

  • Pilates or personal trainers
  • Post-operative rehabilitation
  • Pre- and post-natal conditions and women's health
  • Pediatrics
  • Particular joint areas

Many Osteopaths specialize in areas such as:

  • Visceral (internal organs)
  • Craniosacral therapy
  • Pediatrics
  • Spine


If you think that Osteopathy and Physiotherapy sound remarkably similar, you may be right, especially when referring to Manual Orthopedic Physio. It does appear that the two professions are closely aligned. There are more similarities than there are differences between the two professions. In fact, there may even be more similarities between two practitioners of opposite professions than there is between two practitioners in the same profession, depending on background, experience, and treatment style. However, there are some key differences between Osteopathy and Physiotherapy.

Osteopathy works by addressing the body as a whole and balancing all the body's systems and bones to achieve optimal health through hands on therapy. Physiotherapy works by finding and treating the root cause of a problem for patients after assessing function surrounding the affected area. Physio tends to use both manual therapy and exercise therapy to treat your injury.

There is a difference in the origins and underlying philosophies. However, the definitions sound remarkably similar. This is not surprising as both professions work with similar conditions. The difference may lie more in the individual's background and experience. To make an informed decision, we recommend that you thoroughly research your practitioner.

rehabilitative exercise based treatment

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