Which way to turn when you have a bad back

What’s the difference between a chiro, an osteo and a physio? This isn’t the start of a joke, and you’re probably not in the mood to laugh when you need one.

But who do you turn to when you’ve got a stiff neck or a bad back?

There are more similarities between chiropractors, osteopaths and physiotherapists than there are differences.

You don’t generally need a referral from your doctor to see a chiro, osteo or physio, and they’re all trained in helping with aches and pains.

“They all treat musculoskeletal injuries, be that sprained ankles, headaches, hamstring strain or sciatica,” says chiropractor Dr Cassie Atkinson-Quinton, co-founder of Melbourne’s Body & Brain Centre.

She says that while osteopaths tend to do the most cranial therapy, chiropractors are also trained in cranial techniques.

Traditionally physios use ultrasounds, TENS and other machines more frequently, but chiros and osteos use them as well.

The main differences come down to postgraduate training (a physiotherapist has to study for a minimum of four years, while it’s five for chiropractors and osteopaths) and the practitioner’s own experiences.

“There are lots of similarities between the professions, so it’s really about finding the right practitioner,” says Dr Atkinson-Quinton.



Dr Atkinson-Quinton says chiros have the most training in joint manipulations or adjustments to the spine, arms and legs.

“We all learn about joint mobilisations (gently wiggling joints), massage and stretches, home rehab exercises and technologies such as laser and ultrasound therapy,” she says.

“Chiropractors and osteopaths tend to have a more holistic view by looking at physical, chemical and emotional influences on health rather than just the pain itself.

“For example, migraines can have lots of contributing factors including neck, shoulder and cranial biomechanics, as well as food and stress triggers.”

Refer to the Chiropractic Board of Australia for a list of registered chiropractors.


“An osteopath would primarily treat with manual therapy,” says osteopath and physiotherapist Stephen King.

“For a musculoskeletal consultation, people can expect a similar approach to an appointment whether they see an osteopath or physiotherapist.”

“Both professionals will perform a thorough clinical history to help understand the individual and their current complaint, and a thorough assessment to identify the cause of the problem.”

Both will use a combination of manual therapy and exercise as well.

So why opt for an osteo instead of a physio?

“It comes down to personal bias, past experience of themselves, family and friends, and lack of success elsewhere,” says Stephen.

Registered osteos can be found at the Osteopathy Board of Australia.



“Traditionally one may have seen a physiotherapist for some manual therapy and a movement based approach,” explains Stephen.

While physios may use techniques such as manipulation, mobilisation or massage, usually the focus of physiotherapy treatment is on therapeutic exercise and self-management.

You’ll be given exercises to do between appointments to assist recovery and improve your condition.

Physiotherapists need a bachelor’s degree, but Stephen says these days a Masters degree or Doctor of Physiotherapy qualification is expected.

Further study to qualify for fields such as sports and paediatric work requires an additional two years.

Check if your physio is registered with the Physiotherapy Board of Australia.

Written by Samantha Allemann.