What is the difference between an osteopath, a chiropractor, a physiotherapist, a massage therapist, an acupuncturist, and a kinesiologist?

What is the difference between an osteopath, a chiropractor, a physiotherapist, a massage therapist, an acupuncturist, and a kinesiologist?

These are all healthcare professionals who can help people dealing with pain or injuries. There are several differences between these professions, particularly in:

• The training received
• The presence or absence of a professional order.
• The basic principles of the profession
• The types of treatment offered

Differences in training

In terms of training, chiropractors, physiotherapists, and kinesiologists have university-level education. Acupuncturists have a college-level (technical) education, while osteopaths and massage therapists are trained in private schools (neither university nor college).

Chiropractors, physiotherapists, and acupuncturists are regulated by a professional order. The purpose of this order is to establish a framework for the practice of the profession in order to ensure the protection of the public. Massage therapists, osteopaths, and kinesiologists do not have a professional order.

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Osteopathy 

An osteopath diagnoses by touching different parts of the body (organs, bones, muscles, etc.) with their hands. The basic principle used is that the body has the ability to heal itself, and that manipulations of the organs, bones, and muscles can restore the function of the affected tissue. To date, science has not been able to validate this theory. From the outside, some manipulations and the benefits one can derive from them may resemble manipulations in physiotherapy, but the explanation used is not the same.

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Physiotherapy

A physiotherapist makes a diagnosis based on the history of the injury (mechanism of injury, progression since the injury), the behavior of the pain (what increases and decreases the pain), as well as a thorough physical assessment. They assess, among other things, the flexibility and mobility of the joints, muscles, and nerves, as well as strength and muscle control. They then establish a treatment plan that includes specific exercises, advice on managing activities/postures/sports, and applies manual therapy treatments to improve the mobility of the body's structures if needed.

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Chiropractic 

A chiropractor often diagnoses with an X-ray of the spine or a joint, and by touching the spine with their hands. The basic principle is that the joints (vertebrae of the neck, back, etc.) can be displaced (what they call "subluxations") and prevent the electrical current of the nerves from circulating properly, which can lead to pain or health problems. The emphasis is therefore often placed on joint manipulations that they call "chiropractic adjustments." In layman's terms, you might be told that your vertebra that was "displaced" has been "put back in place." It should be noted that this way of practicing is not as common as it used to be, since the scientific basis of this practice has been invalidated. Therefore, there are several chiropractors who have a practice that could be similar to what a physiotherapist does.

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Massage therapy

A massage therapist uses various massage techniques to work on the muscles in order to reduce pain or stiffness.

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Acupuncture

Acupuncture is based on traditional Chinese medicine. The principle behind this medicine is that there is an energy, called "Qi," that circulates through meridians in the body. When the circulation of this energy is disrupted, pain or illness can develop. The acupuncturist therefore uses techniques to stimulate this energy, often with needles, to restore the circulation of energy. Although many people can be helped by acupuncture, the basic principle of the intervention described above has no scientific basis. It should be noted that not all acupuncturists practice with the theory of traditional Chinese medicine.

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Kinesiology 

A kinesiologist is a healthcare professional specializing in training and physical activity. They use physical activity as an intervention tool. They assess a person's physical condition and establish a muscle and/or cardiovascular training program to improve physical abilities, prevent risk factors associated with a sedentary lifestyle, and optimize athletic or physical performance. They can work with any type of person, from sedentary individuals to high-level athletes.

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To learn more...

To learn more about the differences between these professions, our physiotherapist Alexis Gougeon was invited to the podcast: "Tête-à-tête avec la science" and talks about it in more detail. Find the excerpt at the following link starting at 23 min 30 sec:

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Sources:

https://www.ordredeschiropraticiens.ca/fr/la-profession-chiropratique/quest-ce-que-la-chiropratique/

https://www.chiropratique.com/fr/chiropratique/qu-est-ce-que-la-chiropratique.html
Marcon AR, Murdoch B, Caulfield T. The “subluxation” issue: an analysis of chiropractic clinic websites. Arch Physiother. 2019;9(1):11.
Homola S. Real orthopaedic subluxations versus imaginary chiropractic subluxations. Focus on Alternative and Complementary Therapies. 2010 Dec;15(4):284-7.
Mirtz TA, Morgan L, Wyatt LH, Greene L. An epidemiological examination of the subluxation construct using Hill’s criteria of causation. Chiropr Osteopat 2009;
https://www.osteopathiequebec.ca/quest-ce-que-losteopathie
https://www.aomtl.ca/losteopathie-au-quebec
Guillaud A, Darbois N, Monvoisin R, Pinsault N. Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review. BMC complementary and alternative medicine. 2018 Dec;18(1):1-2.
Guillaud A, Darbois N, Monvoisin R, Pinsault N. Reliability of diagnosis and clinical efficacy of cranial osteopathy: a systematic review. PLoS One. 2016 Dec 9;11(12):e0167823.

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