For weeks your neck has felt tight and your shoulders have been creeping up towards your ears. A friend tells you to see a physio, your sister-in-law swears by her osteopath and someone at work mentions a chiropractor. And you wonder, quite rightly: isn’t it all the same thing? It isn’t. Here we explain the difference between chiropractic, physiotherapy and osteopathy, plainly and with respect for all three professions.
The essentials in 30 seconds
- In Spain, physiotherapy is a health profession regulated by law, with an official 240-credit university degree.
- Osteopathy and chiropractic are not recognised health professions in Spain. Many osteopaths are physiotherapists who later trained in osteopathy.
- Chiropractic focuses on the mobility of the spine and joints, with gentle chiropractic adjustments and a personalised plan. In Europe, the benchmark training is 5 years of full-time university study accredited by the ECCE.
- None of the three is “the best” for everyone: each has its own approach, and they can complement each other.
- If you have any discomfort that is intense or worries you, your doctor is always the first step.
What is the difference between chiropractic, physiotherapy and osteopathy?
The main difference between chiropractic, physiotherapy and osteopathy lies in training, approach and legal framework. A physiotherapist is a regulated health professional in Spain. An osteopath works with a global hands-on approach. A chiropractor focuses on the mobility of the spine and joints, using chiropractic adjustments.
All three work with their hands, which is why they look so similar from the outside. But each was born at a different time, with its own way of looking at the body. Understanding those differences helps you know who to turn to and what to expect.
A word of honesty before we go on: none of the three is “the best” for everyone. It depends on what you are looking for, what your doctor has advised and how comfortable you feel with each way of working.
- Spine and joints
- Assessment of mobility, strength, balance and posture
- Gentle, tailored chiropractic adjustments
- Personalised plan with regular reviews
- Regulated health profession in Spain
- Exercise, hands-on techniques and physical agents
- The go-to after surgery or an accident
- Available in the public system and privately
- Hands-on techniques, often gentle
- A whole-body view
- Training varies by school
What does a physiotherapist do?
A physiotherapist is a health professional with an official university degree of 240 European credits, usually four years. They work with exercise, hands-on techniques and physical agents such as heat, cold or electrical stimulation. You will find them in hospitals, health centres, sports clubs and private practices.
In Spain, physiotherapy is expressly listed among the qualified health professions in Law 44/2003 on the organisation of health professions. The degree requirements are set by Order CIN/2135/2008. Of the three, it is the only one with that official recognition.
That has some practical consequences worth knowing:
- It is part of the public health system, and your doctor can refer you to a physiotherapist.
- It is the go-to profession after surgery or an accident, or when your doctor prescribes an exercise programme.
- Many physiotherapists go on to specialise: sport, pelvic floor, respiratory… or osteopathy itself.
If you have just had surgery or a serious fall, the sensible thing is to start with your doctor and your physiotherapist.
What is chiropractic and what does a chiropractor do?
Chiropractic is a profession focused on the mobility of the spine and joints, with an eye on how you move and feel in your daily life. A chiropractor listens to what you would like to get back to, assesses your mobility, strength, balance and posture, and makes chiropractic adjustments: precise, gentle hands-on movements, always explained and only with your agreement.
It began in the United States in 1895 and is now practised all over the world. The benchmark training is specific university study: in Europe, five years full time on programmes accredited by the European Council on Chiropractic Education (ECCE), covering anatomy, physiology, biomechanics and supervised practice.
Support with a plan over time
After an initial assessment, a chiropractor will usually suggest a personalised plan: clear goals, a frequency of sessions and regular reviews to see how you are getting on. Alongside it come simple tips for your daily routine, because what you do between sessions matters too.
Many people turn to chiropractic when they recognise themselves in scenes like these:
- You wake up stiff and need a while to “get going”.
- You reach the end of the day with a tired back after hours at the computer.
- You find it hard to turn your head when parking or to look over your shoulder on the bike.
- You no longer move like you used to at padel, golf or running, and you want to keep going for years.
- You simply want to move more freely and feel more energetic.
If you are curious about the famous sound, we explain it in detail in what the chiropractic “crack” is and whether it has to happen.
What does an osteopath do?
An osteopath works hands-on from a whole-body perspective, with techniques that are often gentle, on joints, muscles and soft tissues. In Spain it is not regulated as a health profession in its own right, and many osteopaths are physiotherapists with a postgraduate qualification in osteopathy. If this approach appeals to you, ask where and for how long they trained.
The legal framework in Spain
In many European countries, such as the United Kingdom, France, Portugal, Italy and Switzerland, chiropractic is regulated by law. In Spain it is not yet listed among the health professions in Law 44/2003, and there is no official Spanish degree. Practising it is legal, and the Spanish Chiropractic Association (AEQ) has been working towards regulation for years. In the meantime, chiropractic centres operate outside the public health system.
At Ôlin, our chiropractors hold the five-year university training that is the benchmark in Europe. We see chiropractic as wellness-focused support that does not replace your doctor or your physiotherapist.
Three professions that can complement each other
Chiropractic, physiotherapy and osteopathy do not need to compete. Each brings its own perspective, and they can often sit side by side in the same person’s routine:
- Chiropractic: assessment of mobility, strength, balance and posture, chiropractic adjustments and a personalised plan with follow-up.
- Physiotherapy: exercise, strengthening and recovery, especially after surgery or an accident.
- Osteopathy: global hands-on work, often gentle.
What matters is that each professional knows what you are doing with the others, and that your doctor’s advice always comes first.
It is not about picking a side: it is about finding the support that suits you at each stage.
Comparison table: chiropractic, physiotherapy and osteopathy in Spain
In short: physiotherapists hold an official degree and belong to a health profession; osteopaths are often physiotherapists with a postgraduate qualification or have private training; chiropractors train on specific five-year university programmes. The approach, the main tools and the way you access each one all differ.
| Aspect | Chiropractor | Physiotherapist | Osteopath |
|---|---|---|---|
| Usual training | Specific university programme; in Europe, 5 years full time accredited by the ECCE | Official university degree (240 credits, about 4 years) | Often a physiotherapist with a postgraduate qualification in osteopathy; programmes vary |
| Legal framework in Spain | Not recognised as a health profession | Regulated health profession (Law 44/2003) | Not regulated as a health profession in its own right |
| Approach | Mobility of the spine and joints, in the service of your everyday wellbeing | Movement, exercise and function, with a wide range of specialities | Whole-body view, gentle hands-on techniques |
| Main tools | Assessment (mobility, strength, balance and posture), chiropractic adjustments, everyday tips | Exercise, hands-on techniques, physical agents | A variety of hands-on techniques |
| Follow-up | Personalised plan with regular reviews | Depending on the referral, often in blocks of sessions | Often one-off, widely spaced sessions |
| How to access | Private centre | Public system (via your doctor) or private practice | Private practice |
How to find your way between chiropractic, physiotherapy and osteopathy
If you have had surgery or an accident, or your doctor has prescribed an exercise programme, a physiotherapist is your go-to. If a gentle, global hands-on approach appeals to you, look for a well-trained osteopath. And if you are after support focused on your mobility and wellbeing, with a clear plan over time, chiropractic may be a good fit.
And if you notice discomfort that is intense, does not improve or worries you, your doctor is always the first step, whatever you choose afterwards.
Five questions you can ask any of the three
- Where did you train, and for how long? It is a perfectly normal question and you are entitled to ask it.
- What does the first visit include? Ideally, a proper conversation and an assessment before anything else.
- Will you explain what you are doing and why? You have the right to understand.
- How much does it cost and what does each visit include? It is normal to ask before you start. We explain how we do it at Ôlin in your first chiropractic visit.
- Will you send me to my doctor if something doesn’t add up? Knowing when to refer is a sign of professionalism.
Whatever you choose, what matters is that they explain clearly what they do, what they don’t do and when it’s best to see your doctor.
One last reminder, whatever you choose: your best ally is still moving. The WHO recommends that adults get at least 150 minutes of moderate physical activity a week, and estimates that 31% fall short of that.
Important: this article offers general information about wellbeing and healthy habits. Chiropractic at Ôlin is wellness-focused and does not replace medical care. If you notice any symptom that worries you, please see your doctor.
Frequently asked questions
Is a chiropractor a doctor?
No. A chiropractor is not a medical doctor and, in Spain, not a health professional. They train on specific university programmes which, in Europe, last five years full time when accredited by the ECCE. If you have any question about your health, your doctor is always the first step.
Is chiropractic regulated?
It depends on the country. In many European countries, such as the United Kingdom, France, Portugal, Italy and Switzerland, it is regulated by law. In Spain it is not yet a regulated health profession, although practising it is legal.
Are an osteopath and a chiropractor the same thing?
No. Both work with their hands and share an interest in the joints, but they have different origins, training and approaches. Osteopathy starts from a whole-body view with techniques that are often gentle; chiropractic focuses on the mobility of the spine and joints through chiropractic adjustments.
Can I combine chiropractic and physiotherapy?
Yes, they can sit side by side without any problem. What matters is that each professional knows what you are doing with the other. If your doctor or physiotherapist has given you specific advice, that comes first.
Does the Spanish public health system cover chiropractors or osteopaths?
No. In the public system you can access physiotherapy through your doctor. Chiropractic and osteopathy are offered privately, so it is worth asking the price of the first visit and of later sessions before you start.
How do I know if a chiropractor is properly trained?
Ask where they studied and for how long. In Europe, the benchmark is five-year full-time programmes accredited by the European Council on Chiropractic Education (ECCE).
Curious about what a first visit looks like?
We walk you through what happens, how long it takes and how to prepare.
Sources
- BOE — Law 44/2003 of 21 November on the organisation of health professions (2003)
- BOE — Order CIN/2135/2008, requirements for official university degrees qualifying for the physiotherapy profession (2008)
- European Council on Chiropractic Education (ECCE) — Accreditation of chiropractic education programmes
- World Federation of Chiropractic — Legal status of chiropractic by country
- Redacción Médica — Spanish Chiropractic Association’s position on regulation (2016, in Spanish)
- World Health Organization — Physical activity, fact sheet (2024)