Here’s How Chiropractors and Physical Therapists Are Different

If you are injured or ill and are not moving well, you may need to visit a healthcare professional to help you decrease pain and improve mobility. One such professional may be a physical therapist, and another may be a chiropractor.

There are some similarities between physical therapists and chiropractors. After all, they both help people move better and feel better after an injury.

But there are several differences between physical therapists and chiropractors as well. Understanding these differences can help you decide whether to see a physical therapist or chiropractor for your particular injury.

Chiropractor adjusting neck of patient

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Similarities

Similarities between physical therapists and chiropractors may include:

  • Both are trained at a doctoral level. (Some physical therapists are grandfathered in the profession and may practice with a bachelor’s or master’s degree.)
  • Both may prescribe exercises to improve strength or range of motion.
  • Both use physical modalities, like electrical stimulation or heat, to help you feel better.
  • Both use nonsurgical techniques to help you move better and feel better.
  • Both must pass a board or licensing examination to practice.

The goals of physical therapy (PT) and chiropractic care are similar: to help you move better with less pain after an injury or surgery.

Differences

While it may seem that physical therapy and chiropractic care are the same, there are several differences between the two. Differences may include:

  • Chiropractors often perform manipulations for perceived or known spinal subluxations.
  • Chiropractors often attempt to correct spinal malalignment, believing that this is placing pressure on nerves.
  • Chiropractors often limit their treatment to the low back and neck, while physical therapists tend to be general practitioners who treat the spine and extremities.
  • Chiropractors routinely order X-rays to examine bony anatomy that helps guide treatment, while physical therapists use their clinical examination to make treatment decisions, and many do not rely on diagnostic imaging to guide treatment.
  • Chiropractors often offer nutrition advice, and many sell dietary supplements in their clinics.
  • Physical therapists often work to help you prevent injury.
  • Physical therapists often prescribe home exercise programs for their patients to perform daily in order to achieve their rehab goals.
  • Physical therapists work in a variety of settings like hospitals, schools, clinics, and nursing homes, while chiropractors typically only work in an outpatient clinic setting.

Both chiropractors and physical therapists have the goal of helping you move in pain-free ways, and both use different techniques and treatment paradigms to help you achieve that goal.

What to Expect From Physical Therapy

When you visit a physical therapist, you can expect to start your care with an initial evaluation. Your therapist will ask questions about your injury and how it is affecting the way you move.

If you have had surgery, they will ask about the procedure performed and your pre- and post-operative course. Your therapist will also ask about your past medical history and your prior level of function.

Once they have a detailed history, your physical therapist will likely perform an examination, looking for issues that may be causing your pain or functional limitation.

Your physical therapist may test:

  • Strength
  • Range of motion
  • Functional mobility and gait
  • Flexibility
  • Balance
  • Skin and scar tissue integrity

Once your physical therapist has gathered information about your function and your impairments, a rehab plan of care will be established, and goals for therapy will be discussed with you.

During your course of physical therapy, you can expect to visit the clinic one to three times a week. Most appointments last for 30 to 60 minutes.

Your therapist may perform manual techniques like joint mobilizations, scar tissue massage, or passive stretches. Various methods may be used to decrease pain or inflammation.

You may also work on functional mobility and balance or gait training if you are having difficulty walking. Exercises will be performed in the clinic, and a home exercise program will be prescribed and updated regularly as you improve in therapy.

If you are hospitalized, a physical therapist may come to your room to help improve your functional mobility related to walking and stair climbing.

When You Might Need PT

So when is a good time to visit a physical therapist and engage in a course of rehab? If you are feeling pain that limits your ability to walk, sit, or engage in your normal work or recreational activities, then you may benefit from working with a physical therapist. A home therapist may visit you in your house if you are unable to leave it due to your injury.

Likewise, if you have had surgery and are not moving well, working with a physical therapist may be a good idea. Your therapist can help you regain full mobility and help you return to your previous level of activity.

What to Expect From a Chiropractor

Most, but not all, people visit a chiropractor because of back or neck issues. If you have back pain, neck pain, or sciatica, you may consult with a chiropractor.

During your meeting, the chiropractor will ask questions about your pain, what brought it on, and how your symptoms are behaving. A thorough past medical history will be obtained.

Chiropractic Assessment

Your chiropractor will conduct an examination of your condition. Areas assessed may include:

  • Spinal range of motion
  • Neurological screen, like neural tension tests and deep tendon reflexes
  • Strength
  • Examination for possible spinal subluxations

Once your chiropractor assesses your condition, they will provide treatment. A variety of treatments are often used. These may include:

  • Heat or ice
  • Electrical stimulation
  • Spinal or peripheral joint manipulations to correct perceived subluxations
  • Exercises for flexibility, posture, or strength

Joint manipulations are the most common treatment to receive when visiting a chiropractor. A manipulation is used to correct a joint subluxation. It occurs when a chiropractor “cracks your back,” and it has been to shown to decrease pain and improve spinal or peripheral joint motion.

When You Might Need It

If you have an acute spinal problem that is limiting your movement, a visit to your chiropractor may be in order. They can assess your condition and provide a spinal adjustment to help you move better and feel better. Some chiropractors can also treat acute joint injuries, like shoulder pain or hip pain.

Physical Therapist vs. Chiropractor

Should you choose a physical therapist or a chiropractor for your condition? If you have an acute problem with your back or neck, then a chiropractor may be the best route for you to take. Your chiropractor can quickly assess your condition and provide a spinal adjustment that may quickly relieve your pain and improve your mobility.

A physical therapist may also assess and treat acute spinal problems, but they may not approach treatment the same way. They may offer exercises that slowly improve range of motion and strength to help treat your pain.

Both chiropractors and physical therapists should offer you guidance and strategies to keep your pain away and to prevent future problems.

If you have had an injury or surgery and are experiencing a loss of functional mobility, then working with a physical therapist is a good idea. Your therapist can work with you to improve your ability to perform your day-to-day work and recreational activities.

Research has shown that working with a chiropractor or a physical therapist for various spinal conditions produces similar outcomes.

Paying for Services

Paying for your health care should also be considered when deciding on a physical therapist or a chiropractor. Both may be participating providers with your insurance, but many chiropractors are cash-based, meaning they will not accept insurance for your care.

Osteopath

An osteopath is a medical doctor with a degree in osteopathic medicine. Part of an osteopath’s training involves spinal and peripheral joint manipulations, and some osteopathic doctors utilize manipulations to help their patients improve mobility. Some people choose the services of an osteopath if they develop back pain, neck pain, or sciatica.

Keep in mind that not all osteopathic doctors perform spinal manipulations. Although it is one component of their training, some osteopaths practice like a physician, ordering tests and prescribing medicine for people in pain.

How to Choose

So how do you choose between a physical therapist and a chiropractor? While no one can make the decision for you, there are some variables to consider that may make the choice clear.

In general, if you have an acute spinal condition like neck pain or sciatica, then a quick visit to a chiropractor may be just what is needed to help you get moving again. Keep in mind that the chiropractor you choose may not accept health insurance, so be prepared to pay for the services in full.

If you are having trouble moving due to peripheral joint pain, a sports injury, or surgery, then working with a physical therapist is probably your best choice. Your therapist will likely prescribe treatments and exercises to decrease pain and improve functional mobility. They will also likely accept your health insurance for payment, but you may have to pay a deductible or co-payment for each session of therapy.

Summary

If you have an injury that limits your mobility, then working with a physical therapist is a good idea. If that injury involves back pain or neck pain, then choosing a chiropractor may be the choice that helps you recover quickly.

Since many factors should be considered when deciding on a physical therapist or chiropractor, a conversation with your physician may be in order to help you make the right choice. If you intend to use insurance for your care, consult your insurance company to find out if the healthcare provider you want to see is in your network.

A Word From Verywell

Performing daily tasks can be greatly inhibited by an injury, but there are many kinds of providers that can help. Seeing the right healthcare professional can make a difference in your recovery process and how this injury affects your life. Listen to your body and seek professional care when you need it.

Frequently Asked Questions

When should you see a chiropractor?

If your back “goes out” and you are having acute back pain, neck pain, or sciatica, then a visit to your chiropractor is a good idea. They can quickly adjust your spine to obtain optimal alignment. This often quickly reduces pain and improves your mobility.

What does a chiropractor do for lower back pain?

If you have lower back pain, a chiropractor can determine if spinal subluxations may be to blame. They can then perform joint manipulations to help realign your spine, decreasing your pain and improving your mobility. Your chiropractor may also teach you exercises and postures to help prevent future problems with your back.

What is the difference between a physical therapist and a physical trainer?

A physical therapist is a healthcare professional educated at the doctoral level who has extensive knowledge in anatomy and physiology, kinesiology, and exercise prescription. Your therapist can use various modalities and joint mobilizations to help you move better and feel better.

A personal trainer holds a certificate from an accrediting organization for trainers. They often have college degrees, but the level of their required education is far less than that of a physical therapist. Personal trainers are excellent at motivating you during exercise and are able to effectively prescribe exercises for you to achieve your fitness goals.

1 Source
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  1. Blanchette M-A, Stochkendahl MJ, Borges Da Silva R, Boruff J, Harrison P, Bussières A. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review of pragmatic studies. PLOS ONE. 2016;11(8):e0160037. doi:10.1371/journal.pone.0160037

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.