4 Reasons Why Physiotherapy Is Better than Chiropractic

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?

This article, and it’s sister ‘why chiropractic is better’ are two appalling poorly written articles.
Even though they are by the same author, they both directly contradict each other. One or the other – most likely both, are either chock full of errors or simply lying.
They read like the author was just making stuff up – not a single reference or piece of evidence.
I’ve not visited this site before, but if the rest of the articles are this biased or just this wrong, I doubt it’ll be worth my time reading any of them.
So disappointing.

I’ve had many treatments from physios, osteopaths, chriropractors and myotherapists. Hands down chiropractic beats them all. There is no comparison in my personal opinion between the benefits of Physio therapy over that of chiropractic. Physio has caused me to have migraines. Chiropractic can stop a migraine from coming on. Pain is diminished immediately with chiropractic. I have never had this happen with Physio therapy . I do not understand this age old debate . I think physios must be told at university to hate chiros. My Physio constantly bags chiros but my chiro never does, in fact he will even refer to a Physio when his treatments are not having the outcomes that he feels they should. There is room for everyone. Doctors and physios just sound bitter and egotistical when they bag another profession. Just get over it and get on with it.

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.