Picking specialist for back pain treatment

Flat feet can be a significant contributor to back pain affecting many individuals in Kenya. FILE PHOTO | SHUTTERSTOCK

Ever had back issues and you do an online search but are unsure of the rehabilitation medicine that you should be going for? You are not alone, with medical systems becoming more specialised these days, it can be hard for a patient without any prior knowledge or experience in the medical field to know the difference between the different disciplines.

Let’s analyse the difference between a physiotherapist, osteopath and a chiropractor to help you make an informed decision.

These disciplines are promoted separately nowadays, mostly due to marketing interests, but you can still see the similarities that bring them together for the greater good of the patient.

Let’s start with the similarities:

ALL THE PROFESSIONS CLAIM TO SEEK THE “ROOT CAUSE OF THE PROBLEM”’

•They all treat musculoskeletal pain conditions.

They all have protected titles, meaning that a therapist cannot call him/herself a chiropractor, osteopath or a physiotherapist, unless they have completed the relevant accredited course.

They all have tertiary-based education (typically between three and five years)

They all require a system of Continuing Professional Development (CPD) to remain accredited.

In most countries, chiropractors and osteopaths are primary healthcare providers – that means that people present to them for diagnosis, treatment and potential referral without the intervention of a general practitioner.

There are more similarities than differences between these professions. Simply put, the difference between a physiotherapist, a chiropractor and an osteopath are in the philosophy of each profession and the modalities and/or techniques used to achieve the therapeutic goal.

Differences between the three disciplines:

Osteopaths work from the viewpoint that the “body is a whole” and all the systems are interconnected and able to self-heal so long as proper function is restored. For example, when treating your back, an osteopath might want to work around the hip area, or the legs to analyse your posture in order to determine where the compensation patterns are coming from. All these help with finding the root cause of your problem.

Conversely, physiotherapy is more closely aligned with traditional Western medicine. The focus is more on the problem area presented and treatment is specific to the affected area, rather than the whole body.

Also the scope of practice for physical therapist is wider, in terms of rehabilitation in various body systems.

Neurological (stroke, multiple sclerosis, parkinson's)

Neuromusculoskeletal (back pain, whiplash associated disorder, sports injuries, arthritis)

Cardiovascular (chronic heart disease, rehabilitation after heart attack)

Respiratory disorders (asthma, chronic obstructive pulmonary disease, cystic fibrosis).

Chiropractors, like osteopaths, work from the idea that the body should be understood and treated as complex, whole organism that has the ability to heal when the system is allowed to function correctly.

For example, you might present with tightness in your upper back and neck with a tendency for headaches. You chiropractor will identify the specific issues related to this and present a package of care that might include work to the directly affected area, as well as any associated problems in other areas of the body. In modern practice, physiotherapists, osteopaths and chiropractors would each take into account all relevant indications of the presenting complaint and try to find the best strategy for dealing with the specific pathology.

Treatment modalities:

Chiropractors typically use a variety of manual techniques to improve the functioning of your body and equip you to maintain that function going on into the future. They train for five years to hone their skills in the diagnosis and treatment of neuromusculoskeletal problems.

Osteopaths typically use gentle manual techniques for improvement of mobility and range of movement but are also trained to do spinal and joint manipulation as well. This enables them to execute the same techniques as chiropractors.

Osteopaths undertake four years and 2,000 hours of “touch therapy”, making them experts in palpation without the need to rely on X-rays. Whether you plan to see a physiotherapist, chiropractor or an osteopath, the most important thing is to find a practitioner who "operates under an evidence-based paradigm”. The techniques and exercises have already been tested through scientific trials and come up as beneficial.

The writer is PhysicalTherapist, Chiropractic & Physiotherapy Health Centre.

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