A doctor of chiropractic is a professional who is engaged in the diagnosis of conditions throughout the body and focuses on the treatment of mechanical disorders of the musculoskeletal system. A traditional osteopath is a professional trained in the field of osteopathy. Though these professionals target similar areas of the body, the courses and the degrees awarded are different, as are their methods of treatment.
Osteopathy is a branch of healthcare that focuses on the importance of the musculoskeletal system in health and disease. These professionals are different from allopathic physicians or "Doctors of Osteopathic Medicine" (DO) who have a degree in "osteopathic medicine".
The chiropractic profession is better known than osteopathy. Though they treat similar kinds of ailments, osteopathic treatments focus on "longer lever" manipulations and manipulation of all the joints in a problem area. Doctors of chiropractic treatment is more specific and focused on a smaller area in a particular region. Both professions use some techniques that are gentle and some that are a bit more forceful. Fortunately for patients, there are a wide range of techniques both practitioners have at their disposal.
|Residency and Internship||One-year internship that coincides with clinical courses while in training. NO Residency required, but have the option to complete if accepted and desire to.||Any licensed DO can practice OMM. Residency varies, but is typically at least 3 years. These are considered the most demanding residencies in the world, with up to 80 in-hospital hours per week.|
|Practice||Private practice clinics, generally. However, some are employed by health systems and hospitals. Generalist practice, neurology related, orthopedic related, and general alignment restoration dealing with the skeletal system.||Public Hospitals, Private Clinics, Family Practices, Community Clinics, Surgical Settings|
|Treatment Techniques||Chiropractic adjustment (grade I-V) ranging from soft tissue mobilization to joint adjustment. Electrical Stimulation. Acupuncture, Pain Management||Manual therapy (known as osteopathic manipulative treatment, or OMT). Myofascial, Deep Tissue, High Velocity-Low Amplitude, and Counter-Strain techniques. OMM is also used to treat sinus infections, earaches, headaches, and respiratory issues|
|Can prescribe medication||No. New Mexico recently allowed limited prescription rights to DCs||DOs have full medical licenses in the U.S. and can prescribe any medication when needed.|
|Medical Licensing Exam (MLE)||National Board Exam (NBCE). Parts I, II, III IV (practical) and state boards.||COMLEX I, II, IICS, and III, most also take the USMLE (I & II) for different residency options. These are considered the toughest professional exams in the world|
|Years of medical school||4-5 undergraduate years (Bachelor's required / state dependent), 5 Chiropractic school, 1 year residency, minimum 10 years||3-4 undergraduate years (Bachelor's Degree Required), 4 years Medical School, 3 years board certification (residency), minimum 10 years|
|Board Certification||National exam, Chiropractic Board at the State level and Diplomate specialty boards.||At least 3 years for residency training. Most OMM specialists complete OMM subspecialty training (1-2 years after 3 year residency)|
|Status||DC stands for Doctor of Chiropractic. They are not medical doctors, however for insurance purposes, some states consider chiropractors health care providers, some do not.||D.O.s are fully-licensed medical physicians like their M.D. colleagues. Not all D.O.s practice OMM; some are family physicians, brain surgeons, dermatologists, etc. All DOs are trained in OMM during medical school.|
|Surgery||Minor surgery in some states. DCs are non-pharmacologic and non-surgical clinicians who are experts at conservative treatments within their scope of practice. However, do perform MUA in surgical setting.||DOs can do any surgical procedure if they are trained to do so (residency).|
|Specialization||Orthopedics, Pediatrics, General Rehab, Internal Disorders, Radiology, Neurology, Nutrition, Occupational Health, Sports Med, Forensic Sciences.||D.O.s apply to the same specialty residencies as their M.D. colleagues|
|General Expertise||DCs have evidence to support their expertise in the adjustment of the spine. Their knowledge extends into the scope of Physical Therapy and general Medicine as well as radiology and neurology.||DOs are full medical physicians, like MDs. Many specialize in fields where they do not use OMM, but some choose to specialize in OMM. They are trained in all body systems like their MD colleagues, but are also trained in OMM.|
|Diagnosis||DCs diagnose joint subluxation complexes, and most medical conditions, depending on state law. Treatment of many acute non spinal or traumatic conditions may require referral of the patient to the correct specialty practitioner.||DOs diagnose any neuromusculoskeletal disorders, as well as any other medical issue.|
|Use and application of Chiropractic Manipulation & Physical Therapy.||DCs are the only practitioners with the expertise in Chiropractic Adjustments. Some states have laws preventing any other practitioner from performing these interventions. Chiropractors perform therapeutic modalities in most states.||DOs are the only physicians allowed to perform OMM on patients.|
|Differences between formal education||5,200 instructional hours. 4 years of undergraduate required for admission into DC school. Programs may vary. Not required to have a Bachelor's degree prior to admission. Total time = 6-8 years post graduate depending on undergraduate course work.||4 years of Undergraduate education, and 4 years of medical school in the U.S.. DOs complete a medical residency, around 3-8 years. Some DOs do a fellowship for an additional 2-4 years. >11 years total|
|Average Undergraduate GPA||2.90||3.50|
Differences in Principles
There is a significant division within the chiropractic profession as to its future. Some chiropractors believe the main principle of their treatment is that the human body contains an innate intelligence that helps rid the body of diseases. These chiropractors reject the "medical model" of research and care. Some doctors of chiropractic have embraced the trend toward "evidenced based medicine" and the overwhelming majority of their schools have followed suit. Some states now allow chiropractors, with additional training, to use prescriptive items in their offices. It seems this is a fairly recent trend within the chiropractic profession.
Osteopathic philosophy believes in four major principles. Osteopathic physicians (D.O.) and non-physician osteopaths focus on the link between the musculoskeletal system disease and symptoms to the whole body. According to these principles, the body possesses self-regulatory mechanisms and has an innate capacity to defend and repair itself.
Medical Education and Training
The academic degree for chiropractors is called Doctor of Chiropractic or "DC". The World Health Organization (WHO) also lists other potential paths for pursuing this fulltime: B.Sc (Chiro) a 5 year integrated bachelor program and a 2-3 Masters program (M.Sc. Chiro) following a bachelor’s degree. Candidates can apply to a DC program after completing a four-year undergraduate degree. The DC Program is a four or five-year full time program. Post-graduate residency is available in specialized spheres of chiropractic like orthopaedics, radiology and neurology. Although chiropractic is the third largest doctor level health profession, it suffers a credibility problem as compared to other medical professions due to some chiropractic practitioners' rejection of "evidence-based medicine".
The practice of osteopathy began in the United States in 1874 and the term "osteopathy" was coined by Andrew Taylor Still. Although, the term osteopathy and osteopathic medicine are sometimes used interchangeably, the former is considered a restricted form of complementary medicine, whereas the latter is a specialized field practiced by physicians in most countries, including the United States.
The osteopathic profession has evolved differently in different parts of the world. In the UK, Australia and New Zealand, osteopaths have to undergo training similar to physicians and are considered primary healthcare professionals. In Australia, some universities offer osteopathic medical courses which consist of a bachelor’s degree in Osteopathy followed by a master’s degree. In Canada, colleges of Osteopathy offer courses in this field, though graduates from these schools cannot register for practice in Canada. However, this field in the United Kingdom, Belgium, France., Finland, and most other European countries is well established. There are over 25 osteopathic medical schools in the United States who serve to produce full osteopathic physicians.
Treatment techniques and Specialization
There are at least 20 types of techniques used by chiropractors. These include manipulation of the spine and other joints--referred to as "extremity adjusting", Activator techniques (in which the chiropractor uses a hand held instrument), Cox Flexion-Distraction (which targets compressed spine and relieves back pain), Thompson technique (method of adjustment in which the length of legs in analyzed to determine the type of misalignment and uses a “drop table”), Gonstead (looks at misalignment of spine causing pinched nerve), Sacro-Occipital technique (addresses the dysfunction of the base of the spine), which aims to correct vertebral and pelvic misalignments. Other modes for relieving pain are physiotherapeutic modalities like ultrasound, cryotherapy (ice packs), electrical stimulation and laser, exercises, nutritional and dietary recommendations, stress-relieving and relaxation techniques, disease prevention advice, and for many advanced trained chiropractors, acupuncture.
In Europe and commonwealth countries, osteopaths rely on non-surgical, non-pharmaceutical approaches and are considered in line with chiropractor and physiotherapists. Osteopathic treatment usually employs a range of direct and indirect techniques along with dietary, postural and other exercise regimes. Counseling may also be provided to patients to help them recover from disease or pain. Osteopathy can be used to treat lower back pain, tension headaches and in some cases, attempt to treat asthma, middle ear infections, menstrual pains and the like. Osteopaths can specialize in cranial or visceral osteopathy.
Common techniques include high velocity low amplitude treatment, muscle energy, counterstrain, fascial and myofascial release, balanced tension, lateral fluctuation, CV4/EV4 and others. The treatment is done keeping in mind that any structural problem does not affect only that part of the body but the whole body as a unit.