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 care. There are some similarities between the two professions, but there are also some distinct qualities. 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. They each might, however, recommend natural, over-the-counter dietary supplements and vitamins.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. Neither can prescribe medication that is not over-the counter, though there are some states that are considering allowing this to change in the future.2 Both chiropractic care and physical therapy could treat mental health disorders. The exercise that comes from physical therapy is supposed to help relieve symptoms of mild to moderate depression as well as, possibly, alcoholism and substance abuse, anxiety, and cognitive functioning. Further study on the effects of exercise on other disorders, such as schizophrenia, needs to be done. The International Organization of Physical Therapy on Mental Health are looking into the connections between physical activity and its effects on mental health. Any patient that is able should incorporate physical activity into their daily routine, as should everyone.3 Similarly, chiropractic care may help to treat the patient’s mental health issues. Chiropractors deal in treating and optimizing the function of the nervous system, which has been found to remove “nerve interference allowing regulation of the sympathetic nerves which control the fight or flight mechanism of the brain”. Studies have shown that patients are more relaxed after receiving chiropractic treatment due to changes in hormones such as oxytocin and cortisol. Increased blood flow from regular chiropractic care also plays a large part in the restoration and healing in mental health.4 Sometimes, mental health disorders could develop due to injury. The prolonged pain, lack of sleep, or misalignment can play a part in affecting the mental state of the patient. Chiropractic care and physical therapy can both treat the cause of the physical issues, which in turn helps the mind to heal from the other side effects of the physical injury. The American Chiropractic Association (ACA) organizes chiropractors.5 Physical Therapists’ professional organization is the American Physical Therapy Association (APTA).6
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.”7 Often, because of their differences, chiropractors and physical therapists will refer the other to their patients so that everyone can work together to provide the patients with the best possible care. Of course, unless the patient’s doctor recommends one over the other, the patients themselves may choose one, the other, or both depending on their personal preferences.
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”.8 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.9 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”.10 “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).11 The two professions are brought together by their mutual desire to provide their patients as much care as they can to prevent medications and surgery becoming a necessity.