When and why to see a chiropractor, physiotherapist or osteopath

Breaking down which specialist to go to for which kind of ailment, treatment and after-care

While there is crossover between physiotherapy, osteopathy and chiropractic, each method of treatment uses different approaches and techniques. Photo: Toralf Thomassen / Unsplash

We all know the feeling of having a niggling twist, twinge or sprain, but not quite knowing where to go to get it fixed.

A trio of practices — physiotherapy, chiropractic and osteopathy — are available to treat an array of skeletal and muscular issues, each with different approaches to achieving full movement and mobility.

Of the three areas, physiotherapy is part of traditional medicine, while osteopathy and chiropractic are classified as alternative medicines. While each can be considered alone for treatments, there are areas of crossover, as well as injuries that require a multidisciplinary approach to achieve wellness.

What are the differences between a physiotherapist, chiropractor and osteopath?

Physiotherapists tend to focus on movement issues, working to improve or rehabilitate a person’s movement and function over time.

“A physiotherapist works with patients to develop customised programmes designed to restore as much of their functional ability and movement as possible,” says Farheen Joharbhai Mahetaji, a physiotherapist at Aster Hospital, Qusais. “We work at all stages of healthcare, including prevention, education, intervention, rehabilitation and treatment.”

For chiropractors, the focus is on alignment within the body, using a fast manual technique to manipulate joints, as well as strengthen and soften muscles and connective tissue.

Chiropractor Paul Cheung, president of the National Chiropractic Sports Council UAE, says: “Chiropractic is the profession that examines, diagnoses and, where appropriate, treats musculoskeletal conditions. Chiropractic is well-known for managing back pain, sciatica, neck pain, headaches, shoulder pains and more.”

Osteopaths offer a “bigger picture” diagnosis and treatment plan, which can focus on anything from circulation and joint issues to the functionality of internal organs and overall musculoskeletal health.

“Osteopathy is a holistic therapy in which we assess and treat the body as a whole, looking at the function of the joints, muscles, ligaments, circulation, as well as the nerve supply,” says Aziza Zubeidi, an osteopath at Euromed Clinic, Dubai.

When to see a physiotherapist

“A physiotherapist’s approach is mainly understanding the background behind the injury, postural assessment, movement pattern, nerve function and sensitivity, muscle flexibility, joint mobility, and definitely psychological aspects such as beliefs, attitudes, fears, anxieties, work patterns and lifestyles. In simple words, we re-educate and rehabilitate,” says Abroo Khurshid, senior physiotherapist at Medcare Physio & Rehab Centre. “We aim to make you more knowledgeable about your condition, thus giving you more power to deal with it.”

A physiotherapist can be consulted for various ailments and injuries including orthopaedic (back pain, arthritis, sciatica); neurological (Alzheimer’s disease, multiple sclerosis, cerebral palsy); autoimmune (fibromyalgia, Raynaud’s syndrome, rheumatoid arthritis); and chronic conditions such as asthma, diabetes and obesity.

The practice also takes a holistic, whole-body approach and is an effective treatment for all ages from infants to the elderly. “Physiotherapy is intended to prevent your problems from happening again,” says Mahetaji.

When to see a chiropractor

People most commonly seek the help of chiropractors for lower back pain, headaches, muscle and joint pain and limited motion. Specialists treat these issues with manipulation techniques aimed at altering posture.

“Through manual, hands-on methods of myofascial techniques and joint adjustments, we can make a change to the body in order to make it function,” says Cheung. “Once the patient has been corrected, and it will require a few treatment sessions; they can be referred to a physiotherapist colleague to train the body, to make it stronger and last longer in order to prevent a recurrence.”

Chiropractors see patients from babies to the elderly, with the most common age range being between 25 and 40 years. Children who carry heavy school bags on a daily basis or spend a lot of time on devices may be candidates for regular spinal and postural check-ups, while babies are treated using gentle manipulation techniques to correct issues such as nerve problems, mobility and acid reflux, and to ease tension.

“I usually provide exercises to do at home to help the patient recover. It is an important part of the overall process," Cheung says. "Treatments are largely clinic-based, though patient education, with exercise, stretching and postural awareness, can go a long way to prevent pain and disability returning.”

When to see an osteopath

Osteopathy relates most issues back to the musculoskeletal system, using manipulation and treatment to aid the body's own self-repairing potential. Common reasons to visit the osteopath include for arthritis, joint pain, slipped discs, repetitive strain injuries and jaw pain.

“An osteopath has a clinical focus on the way the body works, in strains or injuries and in human movement,” says Zubeidi. “They provide direct manual therapy interventions including exercise prescription, needling, education and associated lifestyle advice to improve movement, reduce pain and manage and/or treat a range of physical impairments.”

Osteopaths use stretching as well as massage in their treatments and treat patients of all ages from infants to the elderly, including pregnant women.

“During a clinical appointment, I will do a physical examination including an assessment of posture and mobility before feeling the joints and muscles in question to assess for any injury and imbalance," says Zubeidi. "The treatment is usually a combination of hands-on techniques including massage, stretching, joint manipulation, joint articulation, and spinal manipulation.”

She says: “No part of the body can be considered in isolation. A stiff neck may be the root cause of shoulder pain, while tingling in the hand or dropped arches in the feet may be the root cause of an ongoing lower back issue.”