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

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SpineLet me just start by saying that physical therapists and chiropractors have a similar amount of education in terms of the number of years that they study in their field, and they both have to pass a board or licensing exam in order to practice. The main difference between a physical therapist who performs manual therapy techniques and a chiropractor is the extent and focus of the treatment delivered.

Chiropractors perform adjustments or manipulation for perceived spine subluxations. According to Wikipedia, subluxations cannot be seen on X-ray, but nonetheless, most chiropractors give every patient an X-ray at their first visit, use this to demonstrate to the patient that subluxations exist, and perform adjustments to address the subluxations. The patient returns several times per week for this adjustment, for weeks or months at a time.

A physical therapist will perform a thorough exam of the spine without any imaging such as X-rays, and will develop an individualized treatment plan based on the results of the 30-45 minute evaluation. The treatment plan typically includes soft tissue mobilization, some type of spine mobilization or manipulation in an attempt to improve spine motion, exercises to improve flexibility, strength, and stabilization of the spine, and training on posture, ergonomics, and body mechanics training to help prevent the pain from re-occurring.

The primary treatment difference between a manual physical therapist and a chiropractor is that the goal of the physical therapist is to empower the patient to care for themselves through the performance of a home exercise program performed daily and instruction in posture and how to change faulty movement patterns that caused the pain to begin with. With 45 minute appointments, the result is full relief of back or neck pain symptoms, with no or infrequent flares, so the patient can manage any further care on their own for the rest of their life.

While many people feel good pain relief from chiropractic care, their symptoms frequently return in the weeks, months, or years after their treatments have ended.  Chiropractors do not typically include exercise instruction, since the length of their appointments is brief and does not allow time for this. There comes a time for many patients when chiropractic care is no longer resulting in the long term symptom relief, which is when a complete physical therapy program that includes hands-on manual therapy treatment and an individualized exercise program can be very helpful.

 

Part of our Ask a PT series.