Chiropractic vs. Physical Therapy

Physical Therapy

For alternatives to invasive traditional medical treatments for pain or injuries (such as medications or surgery), there are some options, such as physical therapy (PT) or chiropractic.  There are some similarities between the two professions, but there are also some distinct qualities.

Chiropractic vs. Physical Therapy Training

Both chiropractic and physical therapy treat injury and trauma to the body.  A physical therapist, or physiotherapist, is a medical professional who assists with the restoration of mobility and function.  A chiropractor is a professional who diagnoses and treats “mechanical disorders of the musculoskeletal system”.  Both are certified by their respective boards.  Chiropractors have “7-9 years of training”, internship, and residency, with a resulting “4,200 instructional hours”.  PTs have 7 years of training, internship, various residencies, and “>3,200 instructional hours”.  Neither prescribes medication, but both have knowledge of pharmacology.1

Areas of Expertise

Chiropractors can be midwives and rehabilitate pre- and post-partum women.  PTs can treat pelvic dysfunctions.  Doctors of Chiropractic (DCs) have expertise in manipulating the alignment of the spine.  They have knowledge in PT, general medicine, radiology, and neurology.  They are qualified to recognize conditions and ailments, and they are specialty practitioners in terms of insurance.  PTs are also specialty practitioners.  They have expertise in restoring movement, with knowledge of chiropractic and general medicine.  They can diagnose “movement, musculoskeletal, and functional related conditions”, and, like DCs, can recognize conditions and ailments. Neither perform surgery.2  The American Chiropractic Association (ACA) organizes chiropractors.3  Physical Therapists’ professional organization is the American Physical Therapy Association (APTA).4

Different Techniques

Physical therapists use manual therapy to manipulate joints.  They also do “neurologic rehabilitation, sports performance…wound care, tissue mobilization, massage…water therapy”.  Chiropractors manipulate soft tissue and joints.  They also use electrical stimulation and at least 20 types of techniques, such as “Activator techniques…exercises, nutritional, and dietary recommendations, cryotherapy.”5

Similarities and Differences

In a New England Journal of Medicine Study (1998) of low-back pain, physical therapy and chiropractic manipulation were provided to patients for one month, with 2 years of follow-up study of the patients.  “The McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs”.6  Some facilities offer both types of care.  Historically, PT has been part of other medical practices, while chiropractors have operated independently.   The chiropractor works mainly with the spine to promote overall health.7  There can be overlap between the two professions.  In general, “PT is…concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential”.8  “Chiropractic is…concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects…on general health.”  Chiropractic is often considered a complementary and alternative medicine (CAM).