A patient asked me today: What’s the difference between a physical therapist and a chiropractor? What do you think? Is that a fair question? Have you asked yourself the same question before? I will give you definitions for both professions but first let me ask you some questions which will help you answer the question by yourself. If your mother had a stroke would you take her to the chiropractor? How about if your child had cerebral palsy? Chiropractor or physical therapist? If you were dizzy and fell a lot would you call a physical therapist or a chiropractor? Here is a harder question: what would you do if you had back pain?
Let me begin by giving you the definitions provided by the professional associations of these two professions.
The American Physical Therapy Association states that a physical therapist should be:
-Examining individuals with impairment, functional limitation, and disability or other health related conditions in order to determine a diagnosis, prognosis, and intervention.
-Alleviating impairment and functional limitation by designing, implementing, and modifying therapeutic interventions.
-Preventing injury, impairment, functional limitation, and disability, including the promotion and maintenance of fitness, health, and quality of life in people of all ages.
-Engaging in consultation, education, and research.
Here is how the American Chiropractic Association defines chiropractic:
- A drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling. The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.”
I would say that the biggest difference is that physical therapy addresses functional impairment as related to pathology. In other words if there is something wrong with your body (trauma or strain or stroke….etc) you will have certain functional limitations. A physical therapist will assess these limitations and help you regain the function lost.
More on chiropractic in a later post.
For now, have a healthy, beautiful day. We’ll see you at OCDPT!
September 12, 2007 at 10:49 pm
I will tell you the difference. Chiropractors falsely claim that they are realigning the spine – nothing could be further from the truth. Just the other day a chiropractor told me his motto was “Align Your Spine for Better Health”. Show me one shred of evidence that would suggest that the spine goes out of alignment and that subluxations exist. While one technique that most chiropractors use, manipulation, may be appropriate for some patients, it probably has little value for most others.
Here is the kicker! Go to a chiropractor and you will almost always get manipulated – no matter what your problem is. Degenerative disc – chiro treatment is manipulation. Back pain – chiro treatment is manipulation. Herniated disk – chiro treatment is manipulation. I thought modern medicine took us out of this “dark age” approach of “one shoe fits all.” Who ever heard of a doctor prescribing the same drug for all ailments? Ridiculous! Bottom line is that physical therapists evaluate the patient and provide the treatment that is best based on the evaluation findings. If you want good care, appropriate care, cost-effective care, so a physical therapist! Think it is just my opinion, go to http://www.chirobase.org for their perspective.
Kudos to OCDPT for putting this nice blog up. I hope everyone in the community reads it.
Dave
September 12, 2007 at 11:28 pm
Thanks Dave! I fully agree that chiropractors apply manipulation to everything! I have had patients which have been treated with manipulation for anything from carpal tunnel syndrome (non-cervical related) to cancer!!!! It is either the world’s best discovery (manipulation is) or the greatest chiropractic hoax.
By the way, for the patients that are reading this….we are not in any way denying that manipulation should be used judiciously in situations shown by research to be helpful. Let’s keep asking questions and figuring out how to combat pain!
September 26, 2008 at 12:38 am
I am in currently in chiropractic school, and I will give everyone a clear idea about chiropractic in 2008. Just as in any profession, you cannot judge it by it’s founding ideas… Every profession strives for more, and builds upon its past. If you were to take a walk through a medical museum, it would look more like a torture chamber than anything close to resembling medicine. The same with chiropractic…The present has built upon the past and no chiropractic college teaches the theory of “bone compressing nerve”, this we know to be untrue for the most part. Current chiropractic education is based on research of a more complex model. The fact is, our bodies take a beating everyday ranging from emotional stress to physical trauma and the effects can easily be seen in our musculoskeletal system. And yes, our vertebrae do go out of alignment, and this has its effects. The effects can observed at a biochemical and histological level ultimately leading to an inflammatory process and then degeneration. With manipulation, chiropractic can mobilize the fixated segments/align the spine decreasing the inflammatory process and thus decreasing pain. Furthermore, chiropractic schools do not teach us that we can reverse scoliosis, cure organic pathologies and save the world. However, there have been miraculous instances where chiropractic has helped some incredibly ill individuals… I have seen it with my own eyes and I can hardly believe it myself. But in NO way are we taught to go out and preach these cure all spinal manipulation miracles, thats quackery. Next, we are highly educated in Differential Dx, and are legally PCP’s. We take literally thousands of hours of anatomy, physiology, biochemistry, pathology… and YES these classes are taught by PhD’s and MD’s. But NO, I would not trust my own diagnostic ability with pathological conditions, but I would trust my ability to find abnormal and refer to the proper specialist. Here is and example: one of prostate cancers most common place to metastasize is the spine… as a chiropractor we have to be able to distinguish b/w musculoskeletal and pathology. Am I being clear?
The fact is, chiropractic is not living in the dark ages anymore, we are advancing just like every other profession. So please stop judging us after one guys ideas in the 1800’s, and become more educated about our profession. Who knows, you make like it? And trust me… chiropractic students don’t go around bashing the physical therapy profession. I personally would love to work with PT’s, MD’s, DO’s, etc. I am the first to admit, there are some ridiculous chiropractors out there, but I am very confident as the years pass, these quack like chiros will fade away with age. Current chiropractic is more evidence based. I will also be the first to admit that chiropractic does need more research, and I can tell you we are doing that as well, and a lot of it. I am very confident that you will soon see more evidence based chiropractic and I look forward to someday working with fellow healthcare practitioners. So lets please swallow our pride and understand that there is more than one way to help someone.
October 3, 2008 at 3:16 pm
Dear Jake,
Thank you for your message. I appreciate you taking the time to give me your side of the story. It is interesting to hear what you have to say. However, it is also very clear that you exhibit the enthusiasm and positive attitude of a student who’s eager to experience the real world and even thinks that he has the ability to change it. I actually hope that you do change it. I know about the level of education chiropractors get and I also think that you are very well suited for treting pathology of the spine. I often refer patients to chiropractors and I expect nothing but the best. However, I am afraid, as I detect in your message, that mor eoften than not you will get into areas where you have no business being. You will see that as a clinician in the real world (not the fantasy world of the school) whenever you are short on business it will be very tempting to dab into “novel” practices that attract a new base of patients. I suspect this is what usually happens. I see things from the outside and I rarely meet physicians that like chiropractors and therefore will not refer patients. Therefore you guys have to go out and attrct these patients somehow. I have gotten some of the advertisements myself. One day I might tell you about my experiences.
One more thing just to be fair. There are physical therapists that practice bogus therapies such as cranio-sacral manipulation but at least out professional organization doesn’t support these things and publishes research exposing it.
November 30, 2008 at 6:23 pm
Please allow me to begin that I enjoy responding to both pro and anti chiropractic blogs and find it facinating when I read of the numerous reasons why other health care professions are so concerned or envious of the attributes and successes of chiropractic.
What I write next may surprise some or all of you. It has been told numerous times and is verified at all levels of investigative science and publication. Don’t bother asking me to provide it to you. You all need to find it yourselves, including the young future, and hopefully successful chiropractic doctor Jake. The scientific literature is out their in mass. Look for it. You most certainly will be amazed that most of it is written by PHD’s, DC’s, and MD’s, and various other scientists, and is almost entirely takes a pro- chiropractic position.
Before I begin, please allow a remark aimed towards physical therapists and chiropractic student, Jake. This may explain the animosity between the DC and the PT.
I am both particularly interested and concerned for your future, chiropractic doctoral student Jake. It is imperitive that you perform an indepth research or reconnection into the philosophy, education, and purpose of yourself as a chiropractic doctor. If you do not heed to this advice, I fear you will fail as did the two chiropractic doctors I adjust each week and the hundreds of chiropractic doctors each year who missed the “Road” to chiropractic. When researching those who failed as chiropractors doctors, you will most certainly find that they confused their duties with that of the very neccessary physical therapist, who rightfully applies themselves as they were designed (with the exception of those who wrongfully apply spinal adjustments; “Physical therapractors”).
The physical therapist, a well educated clinician and expert in physical rehabilitation, has a very valid reason and cause of action against chiropractic doctors that encroach on physical therapy, otherwise infamously known as “Chirotherapists”. In the same vein, chiropractic doctors have a very valid reason and cause of action against any profession claiming to the education, knowledge, or reason for the application and training to apply spinal adjustments, or manipulation if thats what you want to call it. Some states restrict moving vertebrae except when performed by a DC (ex: Nebraska).
There are very few similarities or purposes between the DC and PT. The only tresspass is that the DC must go through the soft tissues to reach the spine and its related structures and vice versus for the PT. Both simply should shake hands and recognize each other when “Passing by”. It’s as simple as that! No reason to quarrel or biker. Just two health care professions “Working towards different goals while working on the same turf”.
The DC’s counter part is the MD (and up to 1950, the DO too). Both have very similar educational curriculae with the DC nudging past the MD’s by 500 hours. You cannot compare the DC and MD in the same arena. Each arrives at a working diagnosis utilizing the same methods of differential diagnosis but obviously utilizing different tools. The DC is not solely a musculo-skeletal clinician, but also a clinician of neurology, orthopedics, and visceral physiolgy. If a patient (member) of a chiropractic office has run him/her self down to the point of crisis, the DC will refer to the appropriate MD whilst continueing to apply (or apply when stabile) the appropriate chiropractic technique to strengthen the body. This is a process that most MD’s refuse to accept, claiming concern for their patients safety, when in reality it is they who pose more of a threat to the patient (prescription medication and surgery kill 500,000 americans each year, making medicine the third largest cause of death). Chiropractic is the safest of the primary care providers (no deaths) I pay $1500/year malpractice insurance.
Yes, there are many chiropractors with alterior motives and work contrary to their design and purpose. But it has been assured that there are a great many more MD’s out there displaying this very same flaw. Numerous studies have revealed that most medications and surgeries are performed without regard or knowledge of their efficacy or inherent dangers (remember the half million Americans senselessly killed each year!).
Go to YouTube, type in “chiropractic miracles”. You will find television news sations, celebrities, and MD’s reporting visceral (eyes, ears, nose, throat, blood pressure, asthma, allergies, etc.) and even musculo-skeletal disorders; remedied by chiropractic.
To the moderators, PT’s, skeptics, DC’s, and chiropractic doctoral candidates; a DC refers to a PT those that have derangement or evulsions of the large joints ie. shoulders, hips, knees, ankles, elbows, feet, and muscles.
Jake, though you had not disclosed your chiropractic school, this information may explain the fatal flaw in your position in this blog, which by the way is not the official position of most of the major chiropractic schools and organizations.
Well…its time to tell my story
In 1986, on my first day at Life chiropractic College (now Life University), I was a witnessed to a most unique experience in the history of the health care professions. Though this event was not unique to chiropractic, it has happened before over the 125 years of chiropractic. This grander scale I will now briefly describe.
Each student was required to describe how they were attracted to chiropractic. To our surprise, there were four MD’s,(one became our microbiology lab instructor) two emergency room RN’s (one had a PHD in anatomy and subsequently became one of our anatomy dissection instructor), one podiatric surgeon (DPM), and two physical therapists.
The basic premise of the four former allopaths switch to chiropractic: the allophathic method did not possess the two critical constituents that comprise ” True Health Care” (not to be confused with crisis or trauma care) that chiropractic truelly possesses. They are: prevention (wellness) and crux (cause) of dis-ease.
The basic premise for the PT’s to become DC’s was: Aside from appropriate attention to the obvious sprain/strains of avulsed muscles, tendons, ligaments, and derangement of joints, they eventually realized that when none of the above applied, no matter how they applied physical or physiotherapic methods, the muscles and/or joints rarely responded except when addressing their foundations and neural supply; the spine and the nervous system. One PT came this realization while working exclusively with patients exhibiting partial denervation.
Oh, almost forgot! You wonder why successful chiropractic doctors frequently adjust? Answer: Adjust the spine and advise a healthy lifestyle in times of both wellness and dis-eases (intervention).
My professional profile: 20 years and 500 patient visits/week. My private doctors office volumne is the largest of any type of health care provider in my area.
Regular referral to and from MD’s. regularly refer to PT’s but never recieved a referral from PT’s? Then read above.
December 3, 2008 at 9:42 pm
I have read your message and plan to respond. I just got back from a vacation so I need to catch up. Hold that thought. Thanks for taking the time to answer.
December 6, 2008 at 5:46 pm
I wrote a long message and I lost it. I don’t think I have the patience to re-write everything. Let me just say that you re-confirmed what I think about chiropractors. When it comes to treating the spine, even though I don’t agree with your approach I think there is enough good you guys do to justify the business. However, you re-confirmed the fact that chiros love to mess with things they’re not supposed to.
You made me laugh with your comments on the first day of school. You said: “The basic premise of the four former allopaths switch to chiropractic: the allophathic method did not possess the two critical constituents that comprise ” True Health Care” (not to be confused with crisis or trauma care) that chiropractic truelly possesses. They are: prevention (wellness) and crux (cause) of disease.” What exactly is it that these MD’s were not able to fix that they sought help from chiropractic? Was it cancer, or diabetes, or perhaps heart problems? Was it gastrointestinal, or endocrinological? I am just curious. Eevryone that makes these blanket statements about allopathic medicine risks to sound like a sore loser. Chiropractors have quite a chip on their shoulders so I constantly hear these ridiculous stories about these MD conversions. There are probably 100 times more chiros becoming MD’s that viceversa.
And let me close with my personal chiro story. Very funny! Wait for it!
I decided to attend a back pain seminar at the local chiropractic office. I thought that there must be a few things I can learn from others. About twenty minutes into a naturopathic presentation the chiro asks me if I ever have back pain so I said yes. He gets me up front and through some minor palpation decides that the membrane of my femoral artery on the right side is compromised, thus the problems in my back. As thiswas not crazy enough he proceeds to “fix” my problem right on the spot teling me that now my femoral artery is just fine and so will my back. I walked out on the guy.
December 8, 2008 at 12:24 am
As the moderator of this blog I need to maintain a certain level of civility. I also appreciate people that make some kind of sense. People that write and have an actual point. Since a new message from Seth does not meet neither the requirements of civility nor the part about making sense not to mention spelling, I have chosen not to publish it. You can try again and if it looks better maybe I won’t ban you. I would love to continue the discussion with well reasoned arguments not overused banners and insults.
December 8, 2008 at 5:49 pm
Seth and his wife (perhaps his mommy too) are sending a lot of spam so I had to send them to spam. It has become obvious that the chip off his shoulder is much larger than I or even he thought. His insecurity is staggering. That’s why no respectable physician will refer their patients to some of these guys.
December 8, 2008 at 6:55 pm
I am going to get back to the issue at hand. In a previous comment a chiropractor was stating that he delivers “true healthcare”. That means to me that he is truly addressing patient’s concerns about their health in a way that is comprehensive, efficient, and satisfactory to his patients. He states that he sees 500 patient a week. Assuming that he works five days a week he is seeing 100 patients a day. I am curious what you, the patient, think about receiving care from a guy who gives complete and “true” care by seeing 100 of you a day. That’s about 12 patients an hour or 5 minutes per patient. Your problems gone in just 5 minutes!!! That sound revolutionary!
December 8, 2008 at 9:44 pm
I am going to repost a website mentioned by Dave. I hope that it would shed some light on chiropractic so you, the patient, can make an informed choice.
http://www.chirobase.org
It seems that I really touched a sensitive nerve with Seth who kept bombarding me with insults. It is not my purpose to insult anyone. I want a civilized discussion and he was not able to have one in his condition.
September 4, 2009 at 9:39 pm
This argument seems so one sided. Can PTs diagnose? Would you agree that DCs can? If not your government does, so what is the comparison. I was a D 1 college athlete and a navy helo pilot that had a lot of back and neck problems. I went to the military docs (flight surgeons) and PT both civilian and military. After the first couple of year with a military PT I just assumed I getting better because they didn’t know what they were doing. Call it a bias, so I asked to see a civilian. I got the same result. Waste of the time and the governments money. At the time gov. insurance didn’t pay for chiropractic medicine I think because I payed a small amount each visit. Guess what problem solved just that quick. Years have gone by and my back and neck problems have come back. Surgeons have said its not bad enough for surgery, we are going to send you to a PT. And I am wasting time again but the neck massages are great.
Now the military and just about everyone else allow patients to see chiros some even as primary care physicians.. what a difference a few years makes…
September 4, 2009 at 9:41 pm
lol I will proofread my post next time before submitting it.
September 7, 2009 at 3:22 pm
I have entered this website looking for answers on what course of therapy I should consider, but have, instead gotten into a philosophical discussion.
I am currently in PT for Achilles Tendonitis, and a collapsed arch. I also believe that I dislocated a vertabrae two months ago in my neck or upper bsck, due to the chroni pain in my right shoulder region. Lower back pain and the resulting foot tendonitis led me to my PCP who did lower back e-rays. Nothing wrong there. I think the problem originated in my upper neck region and I exacerbated the problem by walking (alot) in flat shoes all summer while away. My question is a simple one. Can the PT alleviate the back pain if I have a vertabrae out of alignment or do I need to see a chiropractor for that specific problem.\
Thank you for any help you can give.
September 7, 2009 at 7:44 pm
@flyboy….Thanks for posting your comment. I have a hard time understanding your point. I think you are right…you should proofread before submitting a comment. However, let me address a few points. You say that my argument seems one-sided. I am curious if you even read my post. I simply asked a question and I listed the definitions of the respective rofessions by quoting their respective associations.
I am very happy anytine tells me they got better, regardless of who treated them. I am sure that there are a lot of patients who get excellent care for their spine problems everyday. That was not my argument. One can always bring up examples of how he or she was helped or made worse by a particular professional. You could have seen another PT and been better or you could have seen another chiro who would have not helped you. Fortunately you met the right chiro at the right time. I am more concerned with the overall practices of chiropractic. Read my other comments so I don’t have to repeat myself.
September 7, 2009 at 7:48 pm
@Kathy De Santis
Sorry for the fact that this post is more “philosophical” than helpful. It was meant to be that way. If I wanted to write about Achilles tendonitis and back pain the title of the article would have mentioned that.
Having said that let me try to answer your question. Yes, I treat people everyday for back problems, and “out of alignment” vertebrae and yes, they get better. So do chiropractors. You have to make the decision. Read previous comments if you want to know my opinion.