What is the difference between physiotherapist and osteopath ?

My name is Laurent Lemière and I am a masseur-physiotherapist-osteopath based in Le Vésinet in the Yvelines since 2001.
I often meet foreign patient and though not fluent in English, I think this page may be of some help for those who do not master these concepts in French.
This page will gives you answers about one enquiry my patients often ask me about:

“What are the differences between a masseur-physiotherapist and an osteopath?”

Concepts :

  • Both disciplines are manual interventions inscribed in a therapeutic approach.
  • On one hand, Physiotherapists use of adjuvants such as electric currents, thermotherapy (hot), cryotherapy (cold), ultrasonics, shockwaves, vibrations, depressotherapy…
  • On the other hand, though Osteopaths may use external harmless products, they mostly work with their hands.

For more details, you can access the two official definitions by clicking here:

Requirements :

  • A physiotherapist receives its state diploma after 4 to 5 years. The physiotherapist school can be accessed passing the national exam that requires from 1 to 2 years of intensive class training. It leads way to a three-year specific class before one the right to call himself a physiotherapist. Most of the time, the physiotherapist is officially appointed, he is officially recognized as a “Health Professional”. He charges patients following prices given by the Caisse d’Assurance Maladie. These acts are eligible to refund as for generalists.
  • On the opposite, osteopaths graduates after a 5 years course with no exam at the entry. He is free to set his fees and only some health insurance will refund. Patients come without medical diagnostic, it is the osteopath who will make his own diagnostic and set the adequate treatment.

Therapeutic field :

  • Physiotherapists can practice on every patient, no matter what the pathology or antecedents may be.
  • Osteopaths will not accept patients suffering from underlying diseases or pathologies that may present danger. They master at fixing small but annoying mechanical dysfunctions (pain in the back, the neck, headaches…), intestinal movement or neuro-vegetative irregularities… In other words, every minor troubles with no medical contraindications.

Speaking practical :

    • Physiotherapists can practice as well on a premature baby with a severe heart disease, an athlete with a chronic tendinitis or an older person suffering from the Parkinson syndrom. The range of therapeutic skills engaged is large.


    • The patient usually comes with a medical prescription that mentions the diagnostic. After a global physiotherapeutic check-up, the physiotherapist adopts the best strategy that fits every patient. The sceance lasts about 30 minutes. In addition the teletransmission, via the Carte Vitale, grants quicker and automatic refund process from the Sécurité Sociale and, eventually, private insurance companies.


    • These therapeutic acts are standardized, biomechanically and anatomically justifiable and verifiable.


    • Yes, the physiotherapist eases pains, but most of all, he reeducates, he delivers a process leading to functional comfort. That means he is strongly involved in the Health Professional chain alongside medics, nurses, orthoptists, speech therapists, podiatrists…


    • The osteopath can practice on any kind of patient but his action may be disturbed or cancelled by contraindicated pathologies. In other words, osteopaths will globally accept patients in good shape. That may sound paradoxical but it is directly linked to the therapeutic skills engaged in the process. Though some “soft” exercises exist, the osteopathy aims at intense and in depth changes and normalizations.


    • The osteopath is not restricted to one specific problem or irregularity. Considering that the human body in one global entity, in which every muscle or anatomic element is linked to one or several other and work complementarily. In osteopathy, the main question is: WHY?


    • Finally, most of osteopathic technics remains so far unverified. They are passed on from one osteopath to another, from teacher to student, from generation to generation. Though they might be proven worth in future, these technics can sometimes evolve in something almost esoteric.

To conclude :

These two disciplines are often antagonists:

      • the job over the title,
      • accurate analysis against global apprehension,
      • scientific against empiric,

All in all, these two disciplines are different focus of the same target: the patient.
The most important point to bear in mind is that it is up to you to choose which method convinced you more or suits you better.

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