It’s normal to get confused when you have a musculoskeletal issue like back pain or joint ache and you have to see an expert. Some people might recommend you see a chiropractor while others may suggest you consider a physical therapist (physiotherapist). Since the two experts are experienced in dealing with issues that affect the muscles and joints, who should you see exactly?
Before we go any further, it’s important to know what these two practices are all about. Chiropractic is a hands-on manipulation technique meant to adjust the spine and correct restricted mobility. The technique is aimed to not only treat most musculoskeletal conditions but to also prevent them. From low back pain to tension headaches, they can all be managed by chiropractic.
Physical therapy, on the other hand, is a manipulation technique done on the body to promote healing and restore mobility. While chiropractic specifically targets spinal manipulation, physiotherapy focuses on the specific part of the body that has a problem. But just like chiropractic, physiotherapy is mostly administered using manual techniques like massage therapy and exercises.
To help you understand the two practices further, here’s a quick guide:
Training and Certification
For one to become a chiropractor, they first have to pursue an undergraduate course from a certified chiropractic school. The undergraduate training can take 3-4 years and is followed by a doctorate training that also takes the same duration. Undergraduates are also expected to complete a one-year internship program and pass the board exams. In the United States, chiropractors are accredited by the American Chiropractic Association.
Physiotherapists are also expected to complete a 4-year undergraduate program that is followed by a 3-year doctorate program. They also need to complete an internship program that runs for 30 weeks and to pass the physiotherapist board exams. In the United States, physiotherapists are certified by the American Physical Therapy Association.
You’ll notice most chiropractors going by the title Doctor of Chiropractic (DC). This, however, doesn’t mean that chiropractors are medical doctors. As for physiotherapists, they are referred by the title Physical Therapists (PTs). Just like chiropractors, physical therapists are not medical doctors. In some states, both DCs and PTs are considered health caregivers while in others they are not.
Chiropractors and physiotherapists have different philosophies for administering treatments. Chiropractors focus particularly on the nervous system (more so the spine) and the musculoskeletal (muscles and joints). They manually adjust these areas to bring relief and alleviate pain and discomfort. According to them, the issues are caused by a condition called subluxation (misalignments on the spine).
Physical therapists, on the other hand, focus on the specific part of the musculoskeletal system that has a problem. It could be your hand, leg, or hip. The whole idea is to restore mobility, balance, and strength through a personalized rehabilitation program. Thus, every treatment program is different and is suited for the problem that the patient is dealing with.
Chiropractors are generally experienced in detecting subluxations. This is done before they can administer treatments. Through the diagnosis, they can recommend the most suitable treatment for your underlying condition. The diagnosis can be done using physical techniques like:
- Handgrip tests
- Trigger point analysis
- Muscle testing
- Sensation tests
- Straight leg raise tests
Additionally, chiropractors can turn to MRI, x-ray, and urinalysis if it’s necessary to discover the principal condition.
Physical therapists can also do diagnosis but their approach is very different. They diagnose mobility issues and musculoskeletal complications within their work scope. Often, they use the following diagnosis techniques:
- Chat assessment (question and answers sessions)
- Movement-based tests
Overall, both experts don’t diagnose medical complications but know how to identify them and recommend the right medical experts to see.
Chiropractors administer adjustments using their hands. Some of the techniques they popularly use are:
- Tissue mobilization
- Joint adjustment
- Spinal adjustment
- Exercise therapy
- Massage therapy
Physiotherapists also administer manual therapies just like chiropractors. Popularly techniques that they use include:
- Rehabilitation exercises
- Activity modification
- Gait training
- Muscle coordination
- Wound care
- Sports enhancement
- Massage therapy
Ideally referred to as spine experts, chiropractors possess extensive knowledge to deal with different issues originating from the spine. This has forced them to explore other fields like physical therapy and human medicine. So, expect these experts to know a few things about what goes in the office of a physiotherapist and that of a general practitioner.
Physiotherapists, on the other hand, possess expert skills to understand and correct mobility-related dysfunctions. They also borrow from other fields like human medicine and chiropractic. This explains why chiropractic and physiotherapy are often confused.
Even though both experts can perform general diagnosis and treatment of different musculoskeletal issues, they have specific fields where they are most suited. Clinically, chiropractors can specialize in the following areas:
- Sports Medicine
- Occupation Health
Physical therapists are more conversant with manual therapies. Clinically, they are better suited to these fields:
- Cardiovascular rehabilitation
- Joint/tissue mobilization
- Sports Medicine
Traditionally, chiropractors are not expected to administer medications. However, some states are allowing these experts to prescribe pain alleviation drugs to some special cases. A good example is New Mexico.
Physiotherapists are also not expected to prescribe drugs to patients. They can only be allowed to do so if they are in the military and it’s an emergency case. Their advantage over chiropractors is that they are trained in pharmacology. So, they have a general knowledge of drug prescription, effects, and side effects.
Just like chiropractors are not expected to prescribe medications, they are also not expected to do surgery. Their expertise is conservation treatment and they are expected to stick to it. Chiropractic is globally popular because it’s known as a non-drug treatment. Thus, most patients go for it because it’s not associated with the side effects that medical drugs are associated with.
Physical therapists are also not expected to perform surgeries. However, unlike chiropractors, physiotherapists can perform wound care. This is more important if they are the only health professionals around and the wound is looking bad. In general, surgical procedures should be done by trained and licensed surgeons.
Without a doubt, there’s a big difference between chiropractic and physical therapy. The experts in these two fields are trained to handle musculoskeletal issues differently and their techniques are also different. So, you can use the above guide to decide on who between the two you should see.