Physiotherapy and chiropractic treatment share many of the same qualities, but each form of treatment has its own benefits. First, it’s important to remember that physical therapy and physiotherapy are the same thing. Like physiotherapy, chiropractic treatments are often used to correct and treat various physical ailments, from back and joint pain to migraine headaches. However, chiropractic care requires continuous support, while physiotherapy is intended to prevent your problems from happening again. It’s also important to note that chiropractic care can actually worsen some injuries, while physiotherapy takes a more gentle approach. This guide lists five comprehensive reasons why physiotherapy comes out on top in the debate between physiotherapy vs chiropractic therapy.
1) Physiotherapy Covers More Aspects of the Human Body
Physiotherapy is a comprehensive treatment that helps patients regain the abilities they had prior to injury. Physiotherapy may also reduce the amount of pain you’re in from various conditions that cause chronic pain. On the other hand, chiropractic care focuses on the nervous system, skeletal system, and the muscles in the body that enable movement. Unlike physiotherapy, chiropractic therapy is also centered around the spine, regardless of whether or not the patient has a back injury. In most cases, chiropractors will adjust the spine even if the injury is related to an arm or a leg, but a therapist who practices physiotherapy will not unless it’s necessary. Physiotherapy wins this round of comparison between physiotherapy vs chiropractic therapy because it focuses on a wide range of problems, from sports-related injuries to weakness caused by strokes.
2) Therapists Who Practice Physiotherapy Have Better Sets of Skills
Therapists who practice physiotherapy are trained to do many of the same things chiropractic therapists can do, including manipulating the spine and releasing painfully tight muscles. The debate between physiotherapy vs chiropractic therapy has a clear winner when it comes to knowledge, because well-trained therapists who practice physiotherapy are able to perform a variety of techniques. These techniques include acupuncture, acupressure, and physiotherapy exercises that stabilize your core. A therapist trained in physiotherapy can also build a specialized program that will help you exercise and enjoy sports again. Unlike chiropractic therapists, physiotherapists also put a strong emphasis on comprehensive therapeutic techniques that will make your body stronger and healthier. Make sure you send time finding the best physical therapist in your area — it can make a big difference.
3) Chiropractors Cannot Treat Many Problems
Although many chiropractic therapists focus on multiple areas of the human body other than the spine, chiropractic therapists as a whole use manipulation of the skeleton and muscles as their primary method of treating injuries. In some cases, chiropractic therapists only use manipulation and no other treatment techniques. Therapists who practice physiotherapy know much more about the way the body works and treat it as a whole instead of focusing on just one region, even if that one region does tend to have a significant effect on the rest of the body. Therapists who practice physiotherapy have been trained to recognize a variety of conditions and injuries, and this knowledge helps them treat injuries or weaknesses that you might not have known existed. Because chiropractors usually focus on spinal issues, they do not tend to look at the whole picture to find out if anything else is wrong.
4) Chiropractors May Cause Additional Injury
Unfortunately, in some cases, going to a chiropractor instead of a physiotherapy clinic can result in worsened or additional injuries. This is especially true of chiropractors who focus more on muscle and skeletal manipulation than any other technique. Some patients do not respond well to these techniques. On the other hand, physiotherapy often relies on ultrasounds to examine injuries, sore spots, and weaknesses prior to applying treatment. Ultrasounds and other physiotherapy methods ensure you’re treated properly instead of going into the situation blindly and applying a technique that could make the problem worse. Even if you do have a spinal injury, physiotherapy is frequently a better option because of the variety of ways a therapist who practices physiotherapy will examine you to make sure nothing else is contributing to the problem. Because of the technology available to physiotherapists, physiotherapy wins this round of the debate between physiotherapy vs chiropractic therapy as well.
Is Physiotherapy Better Than Chiropractic Therapy?
Since physiotherapy encompasses everything chiropractic therapy covers, you usually don’t need to go to a chiropractor. The debate between physiotherapy vs chiropractic has a clear winner when you remember that a therapist who practices physiotherapy can do everything a chiropractor can and more. Becoming a therapist who practices physiotherapy is an arguably more difficult process, which acts as a form of quality control. This is also important when it comes to getting insured for physiotherapy; because of the training to become licensed, physiotherapy tends to have better coverage from insurance companies. In nearly all cases, patients are better off with a therapist who practices physiotherapy than they are with a chiropractic clinic.
You can still make an argument for chiropractic care, though, so have a look at our argument why chiropractic care is better than physiotherapy.
There will never be a consensus on which is better and really in the end it is up to the consumer. Some interesting points you bring up here, but also some pretty broad generalizations about both physical therapy and chiropractic.
Physical therapists, by name are therapists. This means they do not diagnosis conditions. This is why they cannot write scripts for x-rays. In fact, physical therapists in general work under another’s referral. Referrals can come from MD’s, podiatrists, dentists and chiropractors. Other than Medicare, chiropractors can write a script for patient’s to go to physical therapy. In the same venue, chiropractors DO NOT need a prescription to treat patients. There are a couple of states that have open door access for physical therapy, but even in those states, insurance companies will not reimburse physical therapy treatment without a doctor’s prescription. Just because it is a state law providing open access, that state law does not govern insurance company compliance.
Chiropractors on the other hand are not therapists. They are trained as doctors, trained to diagnose, and trained to know when to refer and when not to refer. A good bulk of chiropractic education goes towards differential diagnoses, even of conditions beyond the chiropractor’s scope of treatment. Although chiropractor’s are not trained to diagnose all conditions, they are trained to diagnose conditions. A DPT is a doctor of physical therapy degree. This makes them doctors like a PhD is a doctor, not like an MD is a doctor. The APTA (american physical therapy association) has something called Vision 2020, where they want to upgrade all physical therapy degrees to a DPT degree. To do this, they created a DPT transition program. Under the DPT transition program, a PT with a MS degree can go ONLINE and get a DPT degree in 18 months or less. Would you really consider a graduate of an online program be truly effective as a doctor?
To say that physical therapists are trained better than chiropractors I think is too broad. Don’t get me wrong, there are great PT’s out there, but there are also great DC’s too. To say PT’s can adjust like a chiropractor is just not true. I know several PT’s and not one of them will do manipulations coming out of school. The reason is because they cover manipulations in one class for about a week or less. As a patient, I don’t think that is the person I would want adjusting me. In fact, many PT’s I know won’t even do the adjustment because they are just not comfortable with it, even after many years of practice. There is however a PT out there who has made money selling something known as “osteopractic”. The PT sells “certifications” to teach PTs how to adjust patients. Funny thing is that they allow MD’s, DO’s, and PT’s to join their certification to become an osteopractor, but not DC’s. Wonder why that is? Perhaps they know some super secret adjusting techniques? Oh, and he has been investigated by the authorities more than once, and his certification classes are not recognized by the APTA for continuing education purposes.
To say that chiropractors don’t do acupressure, core stabilization, and acupuncture is misleading. DC’s are taught soft tissue techniques and many DC’s use them daily. Core Strengthening? You really believe that DC’s don’t know what to do to strengthen one’s core? To practice acupuncture you typically need to get certified and both DC’s and PT’s can do that. In fact, many don’t practice acupuncture, usually DC’s and PT’s practice something called ‘dry needling’ which is like acupuncture but not exactly the same. A PT or DC does not need a special license to dry needle, but most get certified to do it since there is some risk to patients.
I do agree that some chiropractic adjustments can be painful and yes, any high velocity, short amplitude thrust can be harmful if not applied correctly, but that takes skill and practice. This brings me back to my point above, regarding how much time PT’s in school spend learning to adjust. Also, sometimes the things that can be helpful can also be harmful if done incorrectly. In fact, an Ultrasound machine when used incorrectly at best provides no therapeutic effect, but at worst causes periosteal burns. In the end, everything comes down to how one uses their treatment modalities.
Assuming chiropractors don’t know how to do rehab like a PT is again a somewhat broad statement. Perhaps, the question is not whether they know how to or not, but rather why is it not done? The reality is, chiropractors are taught to go through rehabilitation techniques, including strengthening, mobilization, stretching, gait training, electrical modalities, etc. But, did you know that Medicare does not reimburse chiropractors for doing anything other than adjusting? In many states, insurance providers follow Medicare guidelines, so if you follow reimbursements, you will see that chiropractors tend to be more limited on reimbursements for therapies than physical therapists. It’s sad to think that money would affect how one practices, but the truth is what it is. BTW, chiropractic adjusting codes cannot be billed by physical therapists, but manual therapy, therapeutic exercise, electrical modality codes, etc are all the same between chiropractic and physical therapy; only the Evaluation and adjusting codes are different.
In the same venue, perhaps reimbursement is a reason why physical therapists DON’T adjust. If you review journals like JMPT and JAMA, you will see many interesting research articles written by PT’s about how manipulation can be more effective than traditional manual therapies. I have seen articles relating to back, neck, headaches, and shoulders. It seems that even PT’s believe adjusting joints can speed up the rehabilitation process, but why aren’t more of them doing it? I believe the answer is two fold: 1) they are not ready to do it out of school because they don’t get the proper amount of time needed to master it and 2) Insurance does not pay for adjusting for PT’s (they pay for mobilizations, of which a Grade 5 mobilization is an adjustment). But that’s where reimbursements (especially outpatient) becomes important. Usually in outpatient therapy, billing is by time spent, where a minimum of 8 minutes if billed as 1 unit. Typically in 1 hour, a PT will bill 4 units. Chiropractors have a manipulation code, which is not time specific. So, chiropractors can spend 5 minutes or 30 minutes adjusting and still get paid the same amount. A physical therapist will not get paid to spend 2 minutes adjusting, because they have to bill it under manual therapy, which requires at least 8 minutes of documented work to be billable. Should chiropractors spend more time doing strengthening and rehabilitation? Yes. Are chiropractors trained to do it? Yes. Unfortunately, people don’t relate chiropractors to doing rehabilitation, but sometimes I wonder if that is more because they don’t think they can do it. That perception is something chiropractors, in my opinion, need to step up and change.
Overall, both professions overlap, but it’s just misleading say:
“The debate between physiotherapy vs chiropractic therapy has a clear winner when it comes to knowledge, because well-trained therapists who practice physiotherapy are able to perform a variety of techniques”
You live in Oregon, did you know that chiropractors there have a very broad scope of practice? In fact, in Oregon, chiropractors are allowed to perform minor surgery, proctology, and obstetrical procedures. They also employ “chiropractic diagnosis, treatment and prevention of body dysfunctions, correction, maintenance of the structural and functional integrity of the neuromusculoskeletal system and the effects thereof or interferences therewith by the utilization of all recognized and accepted chiropractic diagnostic procedures and the employment of all rational therapeutic measures as taught in approved chiropractic colleges” (FCLB, 1996). Chiropractors practicing in Oregon may utilize physiotherapy devices, perform venipuncture to collect blood specimens for laboratory diagnosis, give nutritional advice, and dispense nutritional supplements from their offices. Three other States share the characteristics of an expansive scope of practice: Idaho, Ohio, and Oklahoma.
Tell me again how chiropractors have less knowledge than a physical therapist and how they can treat less things?
great post!!! As a office manager and co-owner of a chiropractic practice with my wife, I think both PT and DC should be one in the same and both should attend a year of additional school and training to combine both fields. Both have merit and it’s silly that one thinks the other is better. PT adjust and DC perform the same type modalities and therapies that PT does but it’s a question who gets paid more. To all the PT the only reason you get paid more is cause for years you had the MD backing you cause they owned your clinic and now they are trying to put you back into their pockets so you can see patients without them, at the same token all MD don’t like chiros and tell patients you will die if you get adjusted. Why? Cause they are losing patients to DC and can’t be drug dealers anymore or rush people to surgery. Another reason they prefer and refer to PT and DC n the past is cause PT couldn’t diagnose and DC can. So rather than fight an argue about who is better all PT and DC should partner up and open clinics so patients could benefit from both… Give me your thoughts
Bart, thanks for your comprehensive message. Our article is admittedly a bit simplistic and you’ve probably noticed that the same author wrote a counter-article discussing “why chiropractoric care is better than physical therapy”. This article is scheduled to be updated and when it is, we will reflect more closely on your feedback (and others who have commented here).
I would say the old turf war between chiropractors and physiotherapists is stupid and old. It boils down to difference in philosophy and perspective and the two professions are coming closer and closer together as many chiropractic school debunk the theory of subluxation.
Firstly I have a huge respect of many chiropractic physicians and have seen them do phenomenal work. As a profession I’m not such a fan. I do feel for chiropractors in what they have had to face in being called quacks etc but many chiropractors do little to integrate themselves into the medical system, hence it can be a bit ‘mixed’ story. I’ve seen many sports chiropractors with previous ATC/LAT degrees and the DACBSP do amazing rehabilitation work. I’ve seen some vitalistic chiropractors use applied kinesiology and nutrition to heal chronic conditions naturally. I’ve see some use SOT with head injuries. I really do respect some I have seen and worked with. But two semesters of ‘physiotherapy’ in chiropractic school doesn’t make them qualified to say they can do physiotherapy and or physical therapy. Actually a lot of the physio I have seen applied by chiro’s is terrible and has zero evidence base. What ‘gets my goat’ is this. I would in no way use the term chiropractor or chiropractic ever as I am not one. I never block chiropractors or tell chiropractors what their scope of practice is. What I have experienced is chiropractors using ‘physiotherapy’ which in most countries is a legally protected title and is in many states and that they can perform physical therapy. When it comes to manipulation or adjusting as is used by the chiropractic profession. In CA recently the chiropractic profession tried to stop PT’s from applying joint manipulation. Everytime I argue with a chiropractor they communicate like they own it. Manipulation has been used since ancient Greek times. Last time I checked the Osteopaths were using it years before DD Palmer. The fact is that many physio’s are trained to DPT level, are orthopaedic residency trained and undergo 18-24 month fellowships with AAOMPT to learn how to manipulate it. Not once in any country has a DO claimed they own it. I actually learned from DO’s. Hence what i’m saying it we both manipulate but for different reasons. A PT to open a joint for increased AROM and for reduction in paraspinal activity and a chiropractor for ‘innate healing’ if vitalistic and for other reasons if a mixer. You can treat organs systems I dont. I am working on the human locomotor system. Now if the ACA and APTA were to get together and make a deal on the number of hours required for training in spinal manipulation then maybe you have an argument. I would respect that. You talk about certifications classes in spinal manipulation. He doesn’t offer it to DC’s? Why wont chiropractic schools/chiropractors allow PT’s on ‘adjusting’ courses???? Every argument I’ve heard against PT’s from the chiropractic profession is usually economic in undertone. Fact is the professions are very similar. However all I’ve heard from DC’s is they own spinal manipulation and are real Doctors while PT’s are just therapists. Well it DC’s own spinal manipulation why don’t you go after the DO’s???? Most i’ve seen are terrible at it in the US. Because they are a medical profession and you’d be taking on goliath. But their is an irony in the situation I’d say how state chiropractic associations will go after PT’s.
Physical therapists study to a doctorate level. Differential diagnosis is entrenched in PT education. I’ve sent patients back to physicians when I’ve believed their problems are non mechanical and require the attention of a physician. Again many PT’s in private practice are residency in and fellowship trained as you will see with OCS and or FAAOMPT. Can’t order X-Rays?? In the US military system physical therapist do just that. In the UK physical therapist an work as extended scope practitioners order all sorts of imaging and are able to prescribe certain classification of drugs for the musculoskeletal system. There is also direct access in many states and in most western countries like Canada, Australia and the UK direct access is common place. Anyway I could go on and on.
To wrap up. I wasn’t a big fan of this article as there are good and bad in every profession. However your reply had a fair share of bias ta’boot. Again i’ve worked with incredible chiropractors and have referred to them in the past. But this back and forth argument on everything from manipulation to scope of practice is just stupid and comes down to economic viability and turf war. I have in no way ever told a chiropractor who they are or what they can do. I could say what would you do for a patient who require surgery or how would you diagnose cancer? But I have never said so to a chiropractic physician out of respect. On the other hand I have had the opposite. I once did a course at a US Chiropractic school and the instructor said to me “its a joke that physical therapy is doctoral and a joke that they call themselves Dr’s” knowing I was a PT!!! Highly rude and highly offensive. I mean this post with no intention of ad hominem ‘sentiment’. I wish you well in your practice.
I went to a chiropractor with chronic upper and mid back pain. i ended up with a neck problem and a lower back and hip problems. and my upper and mid back problem were never cure. so you can debate with all the faCts. but my experience tells me dont go to a chiropractor unless you are 200% sure the chiropractor is very skillful and very experienCe. Going to a chiropractor is a very high risk. i mean manupulating the spine. what if it was manipulated wrongly. and thats what happen to me. your spine is in the hands of the manipulator.
Well I am neither a PT or a DC but I have seen a PT last week for 3 days. The reason I went is bc my lower back injury felt to fragile to be seen by a chiro. Once the PT got me to my “normal” back pain level I switched over to the chiro. I don’t regret either one. I feel PT are softer with their techniques and while chiro gets to the core of my problem much faster. However I had to switch iver to chiro bc honestly PT was just to damn careful and I was getting tired of not getting a faster fix like I do with my chiro. As mentioned b4 I don’t regret seeing either one. If i feel like my pain is to fragile for an adjustment thenI will continue to see PT first.
This is so poorly written. And, your hope is to turn people off to chiropractors, really sad.
Wow.. just amazing that it is 2016 & the crazy subluxation crowd is still fleecing the public with their nonsense.
Chiropractic was made up in 1895 by a Grocer who also peddled magnets – he said he received Chiropractic from the “other world”… yep.
It is somewhat also disillusioning that an individual that is in pain would not spend just a few minutes to research this straightforward comparison between a disciplined science based profession & one of the more wackier alternatives.
Most of these comments from “chiropractors” are quite hilarious when they try to justify themselves & the original “innate intelligence” claims – 30 & 40 years of cracking peoples backs to alleviate all manner of medical conditions while taking a nice little pay check … but of course you will need many follow up appointments to really keep on top of it..!
Please use some critical thinking skills before going to see one of these Chiropractic quacks – Also don’t get caught up in the anecdotal hype perpetrated by anyone who is making a buck from any of this pseudoscience. some studies & articles that do say that Chiropractic may help with some lower back problems but the evidence is still out on this .. possibly a placebo effect.
But don’t take my word for it… type “chiropractic scam” into google & read the first page links. If this does not change your mind about throwing your money down the drain you at least can go broke knowing that a skilled charlatan gave you a bad back massage.
Using a Chiropractor over a Physiotherapist is ridiculous to say the least…
Wow.. just amazing that it is 2016 & the crazy subluxation crowd is still fleecing the public with their nonsense.
Chiropractic was dreamt up in 1895 by a Grocer who also peddled magnets – he said he received Chiropractic from the “other world”… yep.
It is somewhat also disillusioning that an individual in pain would not spend just a few minutes to research this straightforward comparison between a disciplined science based profession & one of the more wackier alternatives.
Most of these comments from “chiropractors” are quite hilarious when they try to justify themselves – 30 & 40 years of cracking peoples backs to alleviate all manner of medical conditions while taking a nice little pay check … but of course you will need many follow up appointments to really keep on top of it..!
Please use some critical thinking skills before going to see one of these Chiropractic quacks – Also don’t get caught up in the anecdotal hype perpetrated by anyone who is making a buck from any of this pseudoscience.
Using a Chiropractor over a Physiotherapist is ridiculous to say the least…
Wow so much bias here it is hard to know where to start.
I’ve read in so many places Physio can manipulate the spine such as a Chiro can. For starters I’ve seen courses for physio’s for “manipulation” go for 4 hours a week for 9 weeks and that includes other content, so a total of 36 hours for a course that includes other content would most likely equal average about 15 hours. This is nothing compared to 5 years worth of training.
Secondly most places do physio in 4 years. Chiropractic takes a min of 5 – 6. The extra years are there for a reason, more training is required.
My previous experience is I’m unbiased and have tried numerous physios and chiros. Some chiros are bad some are good and some great.
The problem I have with physios and I’ve spoken to a lot of people who agree, I go and visit on, I’m still in pain when I leave. This is not the case with a good let alone a great chiro. I leave pain free. And a great chiro will tell you how to maintain that pain free state.
Most people however are too busy for exercises that chiros give them and alas the problem returns, hence why chiros keep getting returning customers, not because of the type of treatment they do.
Wow so much bias here it is hard to know where to start.
I’ve read in so many places Physio can manipulate the spine such as a Chiro can. For starters I’ve seen courses for physio’s for “manipulation” go for 4 hours a week for 9 weeks and that includes other content, so a total of 36 hours for a course that includes other content would most likely equal average about 15 hours. This is nothing compared to 5 years worth of training.
Secondly most places do physio in 4 years. Chiropractic takes a min of 5 – 6. The extra years are there for a reason, more training is required.
My previous experience is I’m unbiased and have tried numerous physios and chiros. Some chiros are bad some are good and some great.
The problem I have with physios and I’ve spoken to a lot of people who agree, I go and visit on, I’m still in pain when I leave. This is not the case with a good let alone a great chiro. I leave pain free. And a great chiro will tell you how to maintain that pain free state.
Most people however are too busy for exercises that chiros give them and alas the problem returns, hence why chiros keep getting returning customers, not because of the type of treatment they do.
You site is a public health risk and reasonable people should look at outcome studies vs. biased rhetoric to help prevent the perpetuation of the opioid epidemic and other negative sequella because of the inability of physical therapy to make meaningful changes for mechanical spine changes. I am a chiropractor that teaches in both chiropractic and medical academia at various levels.
I also embrace wholeheartedly physical therapy for what it’s benefits bring. Remember, “it takes a village to heal a country? and your “isolationist manifest” for whatever personal gain is to the detriment of anyone who seeks counsel from this site.
Mark Studin DC
Okay. Are you guys serious? I just graduated from chiropractic school and we learned physiotheraypy. We spent many months learning and applying it and even had a National Board to test our knowledge (one of 5 National Board Exams). We do not just focus on the spine. I think you need to do more research before you make an entire blog. I apologize if I come off too straight forward, but you have the wrong information. I know first hand and I have chosen, like many chiropractors, to focus on the whole body. If you need to, please contact SCU in Whittier to get the full curriculum so that you can make a more realistic blog. Thank you so much.