Patients sometimes ask me, “What is the difference between a Chiropractor and an osteopath?"

Before I start I should make clear a few things. First, this issue tends to be an emotional one for both sides.  The remarks I make are very general.  There are many exceptions to both sides.  Since it is a common question, I thought it best to at least try to give it some attention.  Lastly, I am a Chiropractor.  I am sure asking an osteopath the same question could give another version.

Chiropractors, like me (and there are varying types of chiropractors that I would save for another article), look at a persons overall health.  An osteopath is of the same school as most medical doctors and tends to be symptom based.  Chiropractors do not prescribe medication or do surgery whereas osteopaths can prescribe on a regular basis.
Chiropractors look for vertebral subluxations.  These are misalignments of the spine caused be stress (mental/emotional, physical and/or chemical).  They are the only doctors that are trained to detect this.

The process of correcting a vertebral subluxation is called an “adjustment.”  It is a method of allowing the spinal bone to return to its proper position, thereby removing the interference to the vital information transmitted over the nerves.  There is a procedure in osteopathy called “manipulation” in which various bones are moved.  This is probably the single biggest reason why most people try to compare chiropractic and osteopathy.   Though they may both deal with the human body and, in fact, some of the procedures used appear to be similar, the goals and, therefore, technical considerations are quite different.  The procedure of osteopathic manipulation is not directed toward the correction of vertebral subluxation and, so, it will not be applied with the same technical considerations or evaluated based upon the same analyses.  In other words, manipulation is non-specific whereas a vertebral segmental adjustment is.  Chiropractic adjustment and osteopathic manipulation are not interchangeable terms or procedures at all.

At osteopathic school, there is a joke that the difference between an osteopath and a chiropractor is “$96,000 after five years” because the chiropractor would have seen a lot more patients by then.  It is true that a chiropractor will tend to see a patient more then the average osteopath.  The reason again comes down to fundamental philosophy.  Usually a osteopath is very much symptom based.  Chiropractors look beyond the symptoms to correct the cause and increase overall health and wellbeing.  In this regard anyone looking at increasing their overall health may be a good candidate for chiropractic care.  This doesn’t limit a chiropractor to just a symptomatic or flared patient. 

Example case:
A common example of a patient that might present to an osteopathic and chiropractic office.
Patient is a 40 year old female that is of moderate health presents with chronic headaches becoming more constant the past 5 years.  Seems to come on most when stressed at work.  Both doctors find tenderness in the neck and through a more detailed history and various orthopaedic tests determine that the headache is cervogenic (coming from the neck).  The osteopath might try to manipulate or simply give medications to reduce inflammation, muscle tension and pain.  Perhaps all of them.  If the patient was given advice to follow up and the pain was gone then most likely case is closed.  Seems fine right?

For the same patient a chiropractor would probably take or send out for xrays.  Having done this he/she could have found the patients neck severely degenerated.  This means the problem had been developing for a long time.  Should we expect the problem to disappear in a day if it has been developing for 10 years?  A chiropractor would set this patient on a program that would focus on not only getting rid of the pain but stabilizing the issue as to prevent or slow the degenerative process from going further.  This may include exercise and nutritional advice.  Having done this the patient prevents (or reduces the chance of) relapses whereas with the osteopath, a relapse is almost assured.  All medical doctors, including osteopaths will be the first to tell patients that a vast majority of medications (including pain meds, muscle relaxants and anti- inflammation meds) do not solve any problems, they mask the symptoms.  Most chiropractors tend to take this seriously and therefore move towards correcting the cause, not just the symptom.

In conclusion, it is obvious that both practitioners get into their respective fields to help people and not to deceive.  The truth is I have worked with osteopaths in the past as well as many other different practitioners.  In my eyes, we all have something to offer.  It is also my opinion that people vote with their feet and wallets.   Where they spend their health care dollars speaks volumes.  This is especially relevant as most health insurances will cover osteopathic care and not chiropractic (or very limited).  This simply means that people go to and refer to what works.  I don’t have any data for specifically osteopaths but studies are showing a dramatic increase in alternative health care visits (which chiropractors are by far the leader in).  Studies are also showing a decrease in office visits to medical doctors (which an osteopath is considered in the group of).  People must find something effective in what chiropractors do and the way they do it. 

In health,
Dr Brett Van Norman D.C.