Resolving body aches and pains: how to choose between a physio, osteo or chiro

A bad back plagues many Australians at some stage of their lives. Pain is the most common symptom and it can be hard to manage without the help of an allied health professional - but which professional should you choose? Citro partner nib explains the difference between a physiotherapist, osteopath or chiropractor.

By Citro partner nib

Australia is blessed to have a range of different allied health professionals to treat aches and pains, especially those that might affect our backs, shoulders, knees and hips.

There are physiotherapists, osteopaths, chiropractors and an abundance of other registered professionals who can treat minor to major injuries as well as aches and pains.

But who does what and which is the best choice for your particular ailment? To find out more, nib asked an osteopath, chiropractor and physiotherapist to explain what they do and which injuries and issues they specialise in treating.

What is an osteopath and what do they do?

Osteopathy Australia President Michelle Funder says osteopaths diagnose injuries and create appropriate treatment plans to help people recover from injuries or pain affecting muscles, tendons, joints and ligaments.

“Osteopaths are known for considering the entirety of the person when diagnosing, not just the area that is causing pain,” Michelle says. “We typically see sporting injuries such as strains, tears and sprains.”

Osteopaths also work with clients who have chronic pain conditions or spinal issues, such as lower back pain, pain from poor posture, headaches, neck strain and stiffness, and jaw pain. 

“Treatment with an osteopath can include, but is not limited to, manual therapy (massage, stretching, mobilisation, manipulation and dry needling), exercise prescription and rehabilitation advice, and lifestyle advice and education to help empower the client to reach their goals,” Michelle says.

Common benefits of seeing an osteopath

Osteopaths take a whole-body approach when diagnosing and treating an issue, Michelle says. “We don’t just assess the physical site of pain, but the surrounding areas, tissues, and how the rest of the body interacts with this, plus any environmental and psychological factors that may be impacting your injury.”

How long it takes until you see an improvement depends on the injury, but an osteopath will let you know what the usual ‘prognosis’ is for your condition, Michelle says.

Osteopaths work to identify the cause of pain or injury and develop a safe and effective course of action to manage it.

“During a first visit they may receive some manual therapy and exercise prescription to help reduce their presenting symptoms,” says Michelle. “By the end of their first visit, each patient should leave feeling they understand what their injury is and what the plan is going forward to reach their health goals.”

What is a chiropractor and what do they do?

A chiropractor diagnoses, treats and prevents conditions of the spine and musculoskeletal system and can treat a variety of conditions such as:

  • Lower back pain
  • Sciatica
  • Headaches 
  • Knee pain 
  • Shoulder pain

“Contrary to popular belief, we don't just crack backs!” says Pacific Sport and Spine chiropractor Mitchell Foord. “Back and neck pain is the most obvious form of pain that people associate with chiropractors, but we can help treat a variety of issues including disk injury, muscular pain, sciatica, headaches, tendinopathy, bursitis and chronic pain.”

Chiropractors also see patients who aren't necessarily in pain, but just want to improve their range of movement. “We regularly see athletes looking to improve performance or even office workers who've become accustomed to sitting a certain way,” Mitchell says. “These people see a chiropractor to receive treatment and guidance to maximise their ability to move or just correct their posture and alignment, particularly if they've been staring at a computer for hours each day.” 

Like a physio or osteo, a chiropractor is an allied health professional but Mitchell says chiropractors focus on biomechanics, or how the body moves, and specialise in muscles, joints and nerves. 

“We use a range of approaches to treat injuries including adjustments, needling, soft tissue work, rehabilitation and exercise prescription.”

Common benefits of seeing a chiropractor

“Chiropractors look into the lifestyle factors that might be affecting the way your body has adapted,” Mitchell says. 

If you're doing the same task for multiple hours a day, for example, your muscles and joints become good at completing that task. “The moment you're required to physically move outside that pattern, however, it can place stress on your body and lead to pain and injury in the surrounding areas.”

Chiropractors help diagnose and treat injuries and provide health and lifestyle advice and guidance.

“Your body is all connected, so it's important to remember that if you've sprained an ankle it's not just about fixing the area you've hurt,” Mitchell says. “Chiropractors look into why you were injured in the first place, and may also check whether the weight distribution between your legs is different, your balance and proprioception is poor, or you’ve had a past injury that may have led to ligament damage.”

The aim is to not only fix the problem but also minimise the risk of future injury, Mitchell explains. “If you've come in suffering lower back pain, we might also identify that you're experiencing inflammation and make dietary recommendations to help counteract this. Or, if you're experiencing regular headaches, we might find that it's coming from incorrect technique while overhead lifting at the gym, and we can help you correct your form.”

As for when you’ll see an improvement, Mitchell says it comes down to the specific injury and how long you've had it. 

“In most cases, my rule is that if you haven't experienced any improvement after four treatments, it's time we relook at the diagnosis and change the approach.” 

How physiotherapists can help 

A physiotherapist diagnoses and treats disorders of movement and function, typically affecting the musculoskeletal system. 

“Physios work across a range of healthcare settings, from sports to private practice, hospitals, rehabilitation centres and workplaces, and from paediatrics all the way up to aged care,” says Ethos Health physiotherapist Chris Morton.  

“Each of those groups presents with completely different issues, but a physio can usually help.”

Physios help people recover from injury, reduce pain and stiffness, increase mobility and prevent further injury. 

“Physios treat neck pain, headaches, shoulder pain, tennis elbow, wrist and hand pain, carpal tunnel syndrome, back pain, hip and knee pain (including hip and knee arthritis), foot pain, ankle sprains, ligament injuries and more,” Chris says.

The Australian Physiotherapy Association says physios use a wide range of treatment methods, including: 

  • Exercise programs to improve mobility and strengthen muscles
  • Joint manipulation and mobilisation to reduce pain and stiffness
  • Muscle re-education to improve control
  • Airway clearance techniques and breathing exercises
  • Soft tissue mobilisation (massage)
  • Acupuncture and dry needling
  • Hydrotherapy

Common benefits of seeing a physiotherapist

Physiotherapy is an evidence-based clinical health science, with practitioners specialising in rehabilitating and improving a person’s ability to move and function. Physiotherapy treatment can help to improve strength, range of motion and endurance, correct posture, muscle imbalance and joint mobilisation and reduce stiffness and pain.

A physio can also provide assistance with the use of aids, splints, crutches, walking sticks and wheelchairs to help you get back on your feet and move around post-injury or surgery.

How to know whether to choose a physio, osteo or chiro

“Physios, chiros and osteos are all similar in that we all specialise in musculoskeletal pain or injury,” chiropractor Mitchell says. “All three health professionals have similar years of education, and all have their benefits, so it's really about finding a practitioner that you connect with and a treatment plan that works for you.”

Mitchell’s biggest tip is that if you aren't seeing improvements, particularly after months of treatment, make sure to ask why and consider trying another approach.

Physiotherapist Chris agrees. “In most cases, you should feel better (not necessarily fixed but on the right path) after the first session,” he says. “If you’re not improving after three consults, then you should discuss with your physiotherapist whether there’s something that needs further support, investigation or referral to another healthcare professional.”

What happens in your first physio, chiro or osteo appointment?

Regardless of which type of treatment you choose, your practitioner will begin with an initial consultation, taking a detailed medical history, so bring along any relevant reports, ultrasounds or scans to your appointment. They will also need to conduct an examination, so wear loose, comfortable clothing.

Firstly, if you’re not sure which of these three health professionals to visit, have a chat with your GP, who’ll be able to help you make a decision based on your concerns. Alternatively, ask a friend or family member if they’ve had any experience dealing with a physio, osteo or chiro – often they’ll be able to recommend someone locally! To find a physiotherapist in your area, check out the First Choice network, nib’s community of specially selected health providers who have agreed to set lower than average treatment fees for nib members.

If you have Extras cover with nib and would like to make an appointment to see a physio, chiro or osteo, make sure you search nib's network of healthcare professionals before booking to ensure the provider is recognised by nib and that you are entitled to receive a benefit before making a claim.

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