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Differences between osteopathy and physiotherapy

Written by Dr Irene Clavijo

At times, osteopathy and physiotherapy can be confused as many professionals specialise in both disciplines, at times mixing both in practice and furthermore the two disciplines can be used to treat the same health problems. Here we will explain to you some of the most prominent differences, in a simple way:

Objectives of treatment

The physiotherapist aims to restore or remedy a functional loss through physical treatment (massage, ultrasound...) that acts mainly (but not exclusively) on the patient’s muscles, whether at the level of the osteoarticular apparatus (bones and joints) or at the level of the respiratory, urinary, gynaecological, neurological apparatus...

On the other hand, the osteopath explores the health problem and looks for its CAUSE in order to treat it manually. This discipline considers the human body as a unity of interconnected functions in which an intrinsic mobility of its parts is necessary for its proper functioning. When there is a restriction of this mobility, a localised or remote problema will occur in one of these areas.

Types of treatment

The physiotherapist uses massage, active and passive body mobility exercises, instruments such as weights, balls... and devices that use cold, heat or electricity.

The osteopath only uses their hands and according to the section of oseopathy that they practise, they will use specific techniques to return mobility to the ‘blocked’ area.



They share some symptoms, but the treatments offered by each discipline seek different outcomes that often complement each other.

As we have said, the physiotherapist works on each area that has lost mobility or function. Some examples are:

  • Lower back pain (lumbago), principally from muscular contracture (tightened tissue)
  • Problems with your gait, for example, in a person who has been bedridden for a long time due to illness or ageing
  • After a cerebral vascular accident to compensate for the after-effects in one part of the body, strengthening other parts and promoting neuronal plasticity

The osteopath treats symptoms or diseases finding where there are restrictions of mobility or blocks that are causes these same symptoms. The evaluation is of the entire body, not only the symptomatic part, thus the symptoms are extensive. Some examples:

  • Osteoarticular problems such as lumbagos, chronic lumbar pain, cervical pain, tendinitis... the doctor will look for the "blockage" or "compression" that is causing the muscular contracture or tendinitis.
  • Problems with headaches, migraines... the doctor will look for compressions or restrictions at a local level (occipital, cervical area) or remotely.
  • Visceral problems, digestive pains, painful periods... the doctor will look for visceral tensions or at the level of the diaphragm or sacrum.
  • Sensation of instability, vertigo... the doctor will check the cranial mobility, the existence of restrictions at the level of the temporomandibular joint, the cervical spine...


In Spain, physiotherapy is recognised and integrated in the public health system and is an esteemed university degree.

Differently from other countries like France, USA, Canada, UK and others, the practice of osteopathy is not regulated in Spain so there are important differences in training. Osteopathy is not funded by the public system despite studies suggesting that the cost of osteopathic therapies is lower than other forms of medical care, is likely to decrease the need for medication and may expose the patient to fewer diagnostic tests. (Benchmarks for training in Osteopathy OMS 2010 ).

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