What is the difference between Chiropractic, Osteopathy and Physiotherapy? Part 1 – History
This is a common question, which seems simple, but it does not come with a simple answer. People working in these fields have their own individual views about what is right with their discipline and what is wrong with the others. Prospective patients, with no prior knowledge, struggle to see any difference between the three.
All of these practitioners are regulated health professionals, required to be government registered in Australia and all are university trained. They can all practice as primary care health professionals, meaning that members of the public can consult them without any medical referral.
This is where most of the similarities cease and the differences become apparent.
Many Physiotherapists work in a hospital setting with in and/or out patients while other physiotherapists work direct with the public, in private practice. Chiropractors and Osteopaths both generally work in private practice or education in their respective fields.
Each of these three professions developed independently, for different reasons and they have different methods. A concise answer to the question requires some consideration of the History, Philosophy and Method. This will be discussed in a three part blog series beginning with History.
The birth of the Chiropractic profession can be traced to a specific time and place. It was in Davenport Iowa, on September 18th, 1895, when DD Palmer adjusted the fourth dorsal vertebra of a Mr Harvey Lillard. Palmer had been practising as a magnetic therapist and had contemplated repositioning Mr Lillard’s spine after he reported that he had been in a cramped position and felt something give up in his back. Since his injury, Lillard had been so deaf that he could not hear the noises on the street. Palmer reported “I replaced the displaced vertebra by one move, which restored his hearing fully”.
Palmer called his new discovery “Chiropractic” to mean “done by the hand only” and he developed it for other patients with differing complaints. He soon had a busy practice and by the early in the 1900’s he began teaching his Chiropractic method to students, including his son B.J Palmer who took over the Palmer School in 1906 and rapidly expanded the development of Chiropractic.
Osteopathy began in the USA in 1874. Its founder Alan Taylor Still intended the term to refer to the bone or “osteon” from which he could determine the cause of pathological conditions. A.T Still was a physician and surgeon from Baldwin Kansas, where he developed his practice of Osteopathy.
The USA currently recognises a branch of the medical profession as Osteopathic Physicians who must first obtain a degree in medicine. They are trained to practice all modern medicine and have completed a postgraduate degree to qualify them to practice Osteopathy also. In Europe and other countries around the word, Osteopaths are not required to study medicine first. They are trained and certified to practice only in manual osteopathic treatment for muscular and skeletal conditions.
Physiotherapy is a branch of physical medicine and rehabilitation using mechanical force, movements and electrical therapeutic modalities, with ultrasound being one example. While Chiropractic and Osteopathy developed independently of the medical profession and currently remains alternative to medicine in most of the world, physical therapy developed within medicine in response to the need arising from surgery and other medical services.
Late in the nineteenth century, when orthopaedic surgeons began operating on children with disabilities they employed women trained in physical education and remedial exercise. These treatments were later promoted and applied in response to the polio outbreak in the mid 1910’s and to the rehabilitation of injured soldiers. In the 1940’s physiotherapy treatment mostly consisted of exercise, traction and massage. Manipulation to the spine and extremity joints commenced in the 1950’s when Physiotherapists were a normal occurrence in most western hospitals. Later in this decade Physiotherapists started to move out of hospital based practice into orthopaedic clinics, health centres, rehabilitation centres and nursing homes. The progression of Physiotherapists into their own solo private practices started in Australia in the 1970’s. While Physiotherapists are regarded as primary care practitioners, much of their work comes from referral by medical doctors.
I hope this has given you some insight into the differing histories of Chiropractic, Osteopathy and Physiotherapy. Next week I will discuss the philosophy between the three techniques, so stay tuned!