Physiotherapy "help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice" (https://www.csp.org.uk/careers-jobs/what-physiotherapy). In my understanding and experience, I would say physiotherapists are the specialists of rehabilitation, exercise and postural advice, and in educating people with self-help. In UK they also use massage technique (and sometimes dry needling) to treat the painful condition. On the other hand, osteopathy is more focused on hands-on treatment. We use various technique to mobilise the joint, release the tension in the muscles, fascia, ligaments and tendons, to establish the better alignment and function of the body. Another difference is the approach towards examining the body. Physiotherapists are more aligned with medical approach and they tend to localise and distinguish the problematic area. Whereas, osteopaths tend to look at the whole body as a unit. This is the unique philosophy that distingush osteopathy from any other types of complementary therapy. We try to look for a hidden cause to the problem, to see if there is any other area straining the painful area. In this way, we try to maximise the effect of the treatment so that it will last longer and better.

Chiropractic is invented by D.D.Palmer, who was once a student of A.T. Still, who invented osteopathy. Therefore, there are a lot of similarities in the both treatment modalities. However, there are some typical differences between those two. Chiropractors tend to use a lot of joint manipulation (get a click out of your joints, especially on the spine), and they spend relatively short duration to treat you, typically 15-20 minutes. Osteopaths often use a lot of long lever technique, i.e. using legs or arms as a lever to gently manipulate the spine. I mainly use fascial release / fascial unwinding / cranial techniques, which are a lot gentler and subtler than joint manipulation technique. I gently hold and move the joint, and wait for the tissue to soften rather than forcing the tissue to move. Hence I spend 45 minutes for each patients. This, in my opinion, is the typical difference between two profession but the treatment style can vary between practitioners, as well as the treatment modalities.

When you are in an acute pain, you should not start a new exercise yet. When you are in pain, you are often in a "lesion pattern". You probably are a bit twisted, or putting weight on legs in a unnatural way. If you try to push yourself to do some exercise, you probably exaggerate this lesion pattern and you may end up being in more pain. I recommend that you should consult a manual therapist before you start exercising. After your body is properly aligned again, exercise will help you to promote the good posture and probably prevent further painful episode. We osteopaths are very much skilled in assessing the posture and re-aligning it!

Here is the extract from Sutherland Cranial College of Osteopathy (https://scco.ac/osteopathy/what-is-cranial-osteopathy/) Cranial osteopathy is not different to osteopathy, it is the name given to a subtle and refined approach to osteopathy that follows all the principles of osteopathy, and it is used throughout the body not just in the head. The name cranial osteopathy simply refers to the fact that it includes the structures inside the head. Cranial osteopaths use a highly developed sense of touch to feel subtle changes of tension and tissue quality in the living anatomy of the whole body, and to diagnose areas of strain or dysfunction. The osteopath is often drawn to areas in the body that have been affected by past events, such as old accidents and injuries. The body may have learned to compensate for a traumatic event or injury and the patient may be unaware that there is anything wrong, but the effects may still be present and relevant to current symptoms. Diagnosis and treatment are intimately linked as the osteopath works to activate the innate ability of the body to heal itself, and by offering gentle and specific support where it is needed to bring the tissues into a state of balance and release, to restore it to health. Using this approach, the osteopath learns to listen to and be guided by the body’s inner knowledge of what is wrong, which may be different to the patient’s opinion and the osteopath’s opinion. This helps the osteopath to understand and treat the cause of the symptoms, to reduce the chance of symptoms returning in the future. Cranial osteopathy is a gentle, safe and effective approach to treatment of a wide range of problems in the whole body.

We osteopaths mainly work on the frame of the body, i.e. muscles, joints, ligaments, tendons, fascia. However, in visceral osteopathy, we consider the anatomy and funciton of the internal organs to treat the musculoskeletal problem. Sounds strange? Maybe not - all the organs have nerve supplies, and it all connected back to the spines. Also organs have fascial connections to the front and back muscles and bones. Therefore, function and movement of the organs affects the musculoskeletal system. I often consider gut connection to the lumbar spine, and diaphragmatic tension to the thoracic spine and ribs. I am finding that considering the anatomical connection of the organs to the spine is very useful and often very powerful to release a deep-seated joint lesion.