What's the Difference Between Chiropractic and Physical Therapy?

Over the years I have been asked what is the difference between chiropractic and physical therapy, and which one is a better option over the other?

How a chiropractor is educated and treats, varies from a physical therapist, and which one you choose for your treatment will depend on a number of factors.

What are the differences between a physical therapist and chiropractor?

1. Their Education

In order to gain entrance into a professional three and a half year chiropractic program one must first attend a four-year undergraduate college with an emphasis in science including biology, chemistry and physical science. Upon successful completion of the undergraduate education the three and a half year doctorate program in a specialized chiropractic school is required. Upon meeting all clinical and didactic requirements of a chiropractic school, a degree in chiropractic is granted. The licensed chiropractor will then be considered a doctor who specializes in the area of musculo-skeletal disorders as it relates to the spine and extremities.

A physical therapist (PT) currently has two levels of education, a Masters in physical therapy and a Doctorate in physical therapy. The Masters program is five to six years of education and the Doctorate is six years.

2. No Referral Needed

A patient can come to a chiropractor without a referral from another doctor or specialist. The chiropractor is responsible to diagnose the complaint as either musculo-skeletal or not. For example, back pain due to a sprain/strain or from a bladder infection. The chiropractor has the ability to order diagnostic tests which may include, MRI, CAT scans, X-rays, and blood tests, in order to make a clear diagnosis.

The PT will have access to the patient without a referral from a doctor but will not have the credentials to refer for diagnostic testing. The patient must be referred to a physician within the first thirty days of care if there is no change in the complaint or no improvement from treatment.

3. The Treatment

There are differences in treatment for back or neck pain. In the chiropractic office, the patient will be examined to determine the cause of the problem and a treatment plan will be explained to the patient. The treatment will be detailed with the goals and time frame and the expected results. The risks of treatment are also explained. Any referrals necessary are made after the examination and usually before treatments begin.

The chiropractic treatment plan is broken down into three phases 

  1. Pain relief - primary treatment is adjustment or manipulation
  2. Strength and conditioning - rehabilitation through exercise or movement
  3. Maintenance - to keep the gains achieved

The Physical therapist may run the treatment plans in a similar fashion. However, the emphasis is usually on the passive modalities such as electric muscle stimulation, ultrasound, and/or hot and cold therapy for pain control. In the second phase of physical therapy likewise exercise and movement are the main focal points. Finally, the objective is to develop a home program, which usually does not include follow up visits with the therapist. A physical therapist may attend a weekend seminar on manipulation but this is not required and most are not trained in chiropractic therapy.

When might physical therapy be a better option over chiropractic?

In my practice I refer patients to physical therapists when an individual needs more training in exercise and their insurance will not allow me to do the training. Otherwise, a chiropractor is the most trained and skilled physician to handle a non-surgical back related complaint.

Do you need treatment for pain relief? Are you taking steps towards preventive musculo-skeletal disorders? Do you have more questions with regards to overall health? Please ask or leave your comments in the box below.

Pain is not a life style. Click book online in the upper right hand corner to request an appointment today. 


Dr. Lori Nuzzi

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