What physiotherapy involves
Physiotherapists assess how you move and why you hurt, then treat with a mix of hands-on techniques such as joint mobilisation, manipulation where appropriate and soft tissue work, alongside exercise to build strength, mobility and control. The exercise element is central: the aim is to change the underlying problem so it does not return. Physiotherapists also treat conditions beyond the spine and joints, including sports injuries, post-surgical rehabilitation, tendon problems, balance and neurological conditions. They are regulated by the Health and Care Professions Council.
What chiropractic involves
Chiropractors focus on the spine, pelvis and joints, using manipulation, the quick thrust that produces a click, as the primary treatment. Many also use soft tissue techniques and give exercise advice, but manipulation is the core. Chiropractors are regulated by the General Chiropractic Council. Treatment plans often involve more frequent visits, particularly at the start.
What the evidence says
For low back and neck pain, NICE guidance supports a package of exercise, manual therapy and advice, which physiotherapists deliver as standard. Manipulation, whether by a chiropractor, osteopath or physiotherapist, has modest evidence as one part of that package rather than a standalone treatment. Neither profession has evidence for treating conditions unrelated to the musculoskeletal system.
Which to choose
If you have a specific injury, a problem that keeps recurring, pain after surgery, or anything involving strength, movement or sport, physiotherapy is the broader tool. If you have acute spinal stiffness and want manipulation specifically, chiropractic is a reasonable option. Many physiotherapists, including ours, are trained in manipulation, so you do not have to choose between the techniques.
At Omnia
Our HCPC-registered physiotherapists in Chiswick assess first and then use whatever combination of manipulation, mobilisation, soft tissue work and exercise suits the problem. Where acupuncture, manual therapy or red light therapy would help, they are available in the same clinic.