Which approach / professional should I choose?

by Jean-Félix Perreault | July 12, 2020

As the Sera project evolves, different approaches will be added to the provision of accessible services. We will therefore see the following questions being asked more and more often: "Who should I consult for my back problem?" Which professional treats migraines best? etc. "

To my knowledge, there is no precise methodology on how to choose the approach that is sure to suit us. However, today I present 3 strategies for making an informed choice.

Strategy # 1 - Get informed

So let's start with some definitions (found online) of osteopathy, physiotherapy, chiropractic and massage therapy.

What is Osteopathy? (Osteopathy Quebec):

Osteopathy is a manual approach whose objective is to restore the functionality of the structures and systems of the human body in order to optimize its capacity for self-regulation. This practice is based on in-depth knowledge of the health sciences and interactions specific to the body's balance.

Thanks to a fine and precise palpation, a complete and global evaluation makes it possible to investigate the cause of the neuro-musculoskeletal, visceral and cranial dysfunctions. Each osteopathic treatment is specific and individualized.

What is physiotherapy? (Order of physiotherapists of Quebec)

Physiotherapy is a science of health whose role is to allow you to regain the maximum of your physical capacities so that you can carry out your daily activities, accomplish a job, practice a hobby or a sport, and this, according to your condition and your potential for recovery. It thus promotes your autonomy while allowing you to remain active in your personal and social life.

What is chiropractic? (Quebec Order of Chiropractors)

Chiropractic is a health profession concerned with the diagnosis, treatment and prevention of neuromusculoskeletal disorders (NMS), as well as the effects of these disorders on a person's general health. The emphasis is on manual treatments, including spinal and joint manipulations and soft tissue techniques.

What is massage therapy? (Quebec Federation of Massage Therapists)
Massage therapy is a set of complementary manual techniques based on a holistic conception of the person and framed by educational intervention processes.
As a whole, the discipline aims to assess the soft tissues (e.g. skin, muscles) and joints of the body (e.g. tendons, ligaments, joint capsules) with the aim of treating and preventing injuries, pain or other physical dysfunctions that can occur in an individual.

Now, after reading each of these definitions, you will potentially find yourself in a mental blur and inability to make a real distinction between each of these approaches. Nothing more normal. Each of these approaches attempts, in its own way, to solve the same problems that arise in the human body. It is therefore normal that each of these definitions speaks of restoring health through the application of manual techniques.

Now let's talk about what really sets these approaches apart.


Osteopathy: The profession of osteopath is not currently supervised by a professional order. This is why it is essential to inform yourself about the training of your osteopath. While the World Health Organization suggests 4,200 hours of training for osteopaths, some schools in Quebec are still far from this total.

Chiropractic: The chiropractor must complete an undergraduate university doctorate of 245 credits, offered only (in Quebec) at the University of Quebec at Trois-Rivières. This program totals nearly 5,000 hours of training over five years; more than half of these hours are worked in an 18-month internship.

Physiotherapy: The physiotherapist must complete an integrated baccalaureate-master's program totaling 135 credits, including 21 internship credits, spread over four and a half years.

Massage therapy: Massage therapists are not part of a professional order and their training varies greatly. The FQM, the main association of massage therapists, requires a minimum training of 400 hours. On the other hand, there is no legal framework for more than 20,000 practitioners in Quebec alone.
In addition to training, the general experience of a consultation will vary greatly from one approach to another, and sometimes even from one professional of the same approach to another. This is why it is difficult to describe a typical session without falling into the generalization. Let's play the game anyway.

In general, an osteopathy session lasts about 1 hour. The consultation takes place in a closed office. The osteopathic approach is often described as gentle and non-intrusive. The techniques are generally painless. We often hear from people who consult for osteopathy “I don't know what he did to me, but it works!”. We therefore understand that part of what is done in the care of the osteopath goes beyond the feeling and understanding of the patient. The subtle manipulations are aimed as much at the muscles as at the joints, organs, the skull, liquids and sometimes magnetic fields! Finally, an osteopath rarely sees his patients more than once a week, or even two weeks to give the body time to heal between each session.

The physiotherapy session generally lasts 1 hour for the first evaluation, and 30 minutes for the following sessions. Sometimes the consultation takes place in a large open room, sometimes in closed offices. Physiotherapy care most often consists of manipulations aimed at muscle, joint and ligament mobility. Many physiotherapists also use electrotherapy machines, ice or heat at the end of their sessions. The frequency of consultations can be up to 3 to 4 times a week.

The chiropractic consultation can vary greatly in duration. While a large portion of chiropractors meet with their clients for less than 15 minutes, some others go up to an hour of consultation. The offices are often "semi-closed" as at the dentist. The manipulations mainly target the joints but also the nervous system and muscles. Sometimes very intrusive, chiropractic care will appeal to clients who like to feel the results of the techniques performed concretely and quickly. Like physios, chiropractors sometimes see their patients several times a week.

Massage therapy varies in duration, from a few minutes to 2 hours. The questionnaire is very short and the meeting focuses on the manual aspect. Massage therapy varies greatly in its applications. From a "relaxing" massage to a form of massage more geared towards relieving tension and pain, there is a wide variety of styles. However, although the pressure can vary, the care is generally directed towards the skin and the muscles directly under the skin.

Strategy # 2 - Get to know yourself

The most popular way to find your therapist in a long time has been with referrals. I strongly believe that if we have no idea who to choose, it is a good idea to seek advice from those around us. However, you have to know who to ask.
Why? Because we know today that our beliefs about the approach chosen influence our healing. This means that your chances of getting better are the better if you are confident in your choice of professional.

Before going around your contact network to get a large number of opinions and especially a variety of references, you should ask yourself the following questions:

What kind of person are you? Are you more rational, down to earth? Do you need a scientifically proven approach? Or, on the contrary, are you comfortable in the unknown, with professionals who base their approach on their internal feelings?
Do you need to build trust and intimacy with your professional? Or do you want to get it over with as soon as possible, without going into the details of your personal life?

Do you want to entrust your healing to someone else with close support or do you feel in control of your healing and see this professional as a tool?

All these questions will allow you to better dialogue with the person who offers you his reference. Tell her what you're looking for and see if it matches who she is suggesting to you.

Strategy # 3 - Test for yourself!

Would you like to find the right approach? The professional who will match your needs perfectly?
Ultimately, there is nothing like experience. When you go to see a professional, you never have to commit to a long-term treatment plan.

I suggest that you choose 1 or 2 approaches that appeal to you more, and go and consult 1 or 2 professionals in each of these approaches. Listen to your feelings, your sensations during, immediately after and a few days after the session. Leave spaces of a few days between these sessions to really feel how you are feeling.

Ideally, the answer will come on its own. And remember, you are allowed to see more than one at the same time. It is even a beneficial practice to combine the approaches!

Hoping that this article will have been able to guide your thinking and clarify it for you!

by Jean-Félix Perreault

community health

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