Differences between Chiropractic, Manual Therapy and Osteopathy

We are regularly asked: what is the difference between a chiropractor, a manual therapist and an osteopath? All these professions deal with the musculoskeletal system, yet there are essential differences.


More than 120 years ago, the origins of chiropractic and osteopathy took place in America.

The origin was the same, but a split took place at the end of the 19th century. And in 1897 the first chiropractic training was started by D.D. Palmer called the “Palmer School of Cure”.

It was not until 1968 that the first chiropractor settled in the Netherlands.

Manual therapy originated from chiropractic: In 1960, after a personal experience with a chiropractor, Ir. F.J. Philips brought the chiropractor Cyril Phelps into the Philips company. This was the impetus for the first manual therapy training in Eindhoven.


A manual therapist is originally a physiotherapist who then specializes in manual techniques through a part-time training.

In the manual therapy training, 60 contact days are spread over 3 years. Also for osteopathy, part-time training is followed, spread over a number of years. Sometimes the consumer gets a distorted picture because it is said that the training lasts 3 years while in reality this is only 60 days. This is a fundamental difference from chiropractic.

A chiropractor follows a full-time university education (master degree) for 5 years, followed by a GEP year (internship year) in which he / she is supervised by an experienced chiropractor. Due to this intensive training, the chiropractor is extensively trained to make a diagnosis, to make a good treatment plan and is also trained in determining when it is better for the patient to contact the GP or a specialist. The chiropractor (unlike the other practitioners) is also trained to take X-rays and to be able to assess X-rays and MRI and CT scans.

Chiropractic approach

Chiropractic takes a holistic view of the body. This means that the focus is not only on the location of the pain, but the cause of the pain is sought. The intake lasts 45 minutes and it is also discussed with the patient which factors play a role such as pain perception, activities and expectations. However, the focus is on the musculoskeletal system and nervous system. This allows the recovery of the body to be optimized.

Different techniques

There are several specific techniques that can be used to promote joint mobility. So it is not the case that a chiropractor just manipulates, but a chiropractor has had the most training in these techniques. Due to the many contacts during the full-time training, the chiropractor has a wide range of treatment techniques and a very extensive practical training in these techniques (for more information read: treatment methods).

There are different schools of thought within manual therapy. In one of these schools manipulations are performed and in the other school only mobilizing techniques. The musculoskeletal system is also treated in manual therapy, but there is less emphasis on the whole being. Osteopaths do work holistically but more often treat by mobilization. A big difference is that they are mainly concerned with complaints related to the organs and the rhythm of the cerebrospinal fluid. The osteopath tries to improve the mobility and circulation of organs by means of specific techniques, while the chiropractor does this by influencing the control of the body (the nervous system).

and finally

The chiropractors in our practice have both completed 2 part-time specializations of 2 or 3 years after their chiropractic training. Imke is also a sports chiropractor and an animal chiropractor. Margreet has a specialization in functional neurology and pediatric chiropractic. This makes them two of the most highly trained chiropractors in the Netherlands.