Chiropracty and osteopathy
Chiropractic and osteopathy are both manipulation-based therapies used for treating problems associated with bones, joints and the back. The two therapies have much in common, but chiropractors tend to focus on the joints of the spine and the nervous system, while osteopaths put equal emphasis on the joints and surrounding muscles, tendons and ligaments.
How they work
Chiropractors and osteopaths share conventional medicine's view that the human body is like a machine and that any disease is due to a breakdown of part of the machine. However, they also believe that many health problems can be traced to poor posture and to misalignment of muscles and joints (and, with chiropractic, particularly the spine). They suggest that, if the structure of the body is improved and the spine put back into alignment, its function will improve, problems will be alleviated and good health restored. Misalignment is usually thought to be due to an external cause, such as a fall or other accident (even one that happened years before), or to long-term poor posture.
What they are for
Osteopaths and chiropractors both mainly treat back and neck pain. But they are also treat other health problems, such as headaches, migraines, vertigo and tinnitus (ringing in the ears).

Some practitioners also treat a wider range of diseases, including:
  • heart and circulatory problems
  • arthritis
  • sports injuries
  • digestive problems
  • asthma, and
  • period problems
Are they effective?
While osteopathy and chiropracty are well accepted by many conventional medical practitioners, the scientific evidence for them is relatively sparse, and very few medical studies have compared the two therapies with each other. However, the evidence is stronger for chiropractic than osteopathy, with a few studies showing that chiropractic is effective in treating lower back pain.
There have also been several studies of spinal manipulation and mobilisation techniques (by osteopaths, chiropractors, physiotherapists and doctors) for lower back pain. They suggest that the techniques, whoever does them, do provide short-term relief from pain, and improvement in mobility. There have not been as many studies of manipulation and mobilisation techniques for neck pain.
At a consultation
A first consultation with a chiropractor or osteopath generally takes about an hour. The chiropractor or osteopath will ask detailed questions about your general health, lifestyle, emotional state, and medical and family history. He or she will also perform a physical examination, with you sitting, standing, walking and possibly carrying out other movements. He or she may test your reflexes with a reflex hammer, and measure your blood pressure. Some chiropractors (but not usually osteopaths) also use X-rays and other conventional medical tests to help them make a diagnosis.

Later sessions usually last about 30 minutes. The number of treatments you will need and how often you need them will depend on your problem. However, the practitioner should give you an idea of this at the first treatment session.

Treatment is usually carried out with you lying down in various positions. Chiropractors mainly use a manipulative technique on the spinal column and pelvic area consisting of short, rapid forceful movements called high-velocity thrusts. These are designed to realign and mobilise the spine, and may result in an audible sound - a clicking similar to knuckles being stretched.

Osteopaths also carry out high velocity thrusts on the spine, but these play a much smaller part in treatment than in chiropractic. Osteopaths also use a wide range of other techniques, from stretching of soft tissues and massage to rhythmic joint movements and manipulation, on other parts of the body as well as the back. And, they may use only gentle 'release' techniques with some people, particularly children and older people. These are called muscle energy techniques and are used to release tension in specific muscles. Some osteopaths also do cranial manipulation (see below).
Related therapies
Physiotherapists and doctors sometimes use spinal manipulation and mobilisation techniques similar to those used by chiropractors and osteopaths.

Some osteopaths do cranial manipulation, also called cranial osteopathy. This consists of gentle manipulative techniques on the cranium (skull). A belief underpinning cranial osteopathy is that childbirth, an accident or long-term muscle tension can cause compression of the cranium. This, in turn, can affect how fluid called cerebrospinal fluid flows in the spine and around the brain, and so can result in disease. Practitioners claim that gently manipulating the bones of the cranium can correct the flow of cerebrospinal fluid, by restoring the skull to its natural shape.

Craniosacral therapy is similar to cranial osteopathy. It differs in believing that the flow of cerebrospinal fluid affects every cell in the body.
Side effects and risks
The most serious potential risks of chiropracty and osteopathy are spinal cord injury or stroke after manipulation of the neck. These are rare, though there have been calls for research to establish how significant the risk is.

There is a general consensus that osteopathy is less risky in terms of spinal injury because osteopaths usually use less forceful manipulation techniques on the spine.

Less serious, but more common, side effects include discomfort or mild pain at the point of manipulation, mild headaches or tiredness, which should disappear within 24 hours of treatment.

There are certain situations where forceful manipulation can be dangerous and should never be done. These include if you are pregnant or if you have osteoarthritis of the neck, or osteoporosis of the spine.

However, chiropractors and osteopaths are trained to check patients for these and other risk factors.
Further information
American Chiropractic Association

American Osteopathic Association

General Chiropractic Council

General Osteopathic Council
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email :
Homepage :

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
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