Choosing Care

Chiropractor vs. Osteopath: What’s the Difference?

Reviewed by Dr. Dustin Dukart, DC

The two get mixed up a lot, partly because the word “osteopath” means different things in different countries. Here’s a plain comparison, using how the terms are used in the United States.

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In the U.S.: a DO is a fully licensed physician who can prescribe and operate. A DC is a conservative-care specialist focused on the musculoskeletal system — no prescribing, no surgery, usually no referral needed to see one.

Doctor of Osteopathic Medicine (DO)

In the U.S., a DO is a fully licensed physician — the same practice rights as an MD. DOs complete four years of medical school and a residency, can prescribe medication and perform surgery, and work in every specialty from family medicine to cardiology to emergency medicine. Their training additionally includes osteopathic manipulative treatment (OMT), a set of hands-on techniques, though many DOs practicing in specialty fields use it rarely or not at all. If you see “DO” after a doctor’s name, you’re seeing a physician.

Doctor of Chiropractic (DC)

A DC completes a doctoral program focused on the musculoskeletal system — especially the spine — diagnosis, and conservative, hands-on treatment: spinal manipulation, mobilization, soft-tissue work, and exercise prescription. In most U.S. states a DC does not prescribe medication or perform surgery. Chiropractors order and read imaging, refer to physicians and specialists when a problem is outside their scope, and often co-manage cases with a patient’s medical team. The focus is narrower than a physician’s, and deeper on manual care for spine and joint problems.

The Overlap

For everyday mechanical back and neck pain, a DC, a DO who uses OMT, and a physical therapist are all doing broadly similar hands-on-plus-exercise work, and outcomes for that kind of pain are generally comparable across manual-therapy providers. The practical differences: a DO can also manage the medical side of your health and prescribe; a DC is a dedicated conservative-care option you can usually see without a referral.

One Caveat on the Word “Osteopath”

Outside the United States — the UK, Australia, much of Europe — an “osteopath” is typically a manual-therapy practitioner, not a physician, with training closer in scope to a chiropractor or physiotherapist. So the same word describes a physician in the U.S. and a non-physician elsewhere. If you’re reading advice online, check which country it’s from.

Deciding Who to See?