Chiropractor VS Physiotherapist?

“Should I be seeing a chiropractor or a physiotherapist?”, is an age-old question that arises within chiropractic and physiotherapy clinics and among the public. Patients often do not completely understand the difference between these two professions, and not to mention other manual therapists (i.e., osteopathy or naturopathy). People who suffer from musculoskeletal injuries, which are injuries affecting the muscles, bones, or joints, may be confused, and discouraged on where to seek out care. They may believe that chiropractors exclusively deal with spinal pain while physiotherapists solely provide supervised exercise, although these beliefs are not exactly true. Common questions that myself and my chiropractic colleagues often hear include, “Can you treat me even though my injury does not seem to be related to my spine?”, or “Do I have to see a physiotherapist for exercises and stretches?”. To answer these questions, it is important to clarify the education, designation, and scope of practice that chiropractors and physiotherapists obtain. It is also crucial to explain the concept of patient-centred care and shared-decision making between patients and their chosen healthcare provider.

First, I would like to talk about the differing education between chiropractors and physiotherapists. Chiropractors must have an undergraduate degree before applying to chiropractic school. Next, they will enter the chiropractic program which consists of a four-year education. The program includes three years of classroom work incorporating subjects such as anatomy, diagnosis, orthopedics, radiology, nutrition, biochemistry, pathology, and much more. While the fourth and final year involves a twelve-month, hands-on clinical internship at two separate clinics. This final year is where students put their classroom knowledge into practice and begin to refine their hands-on skills, and upon successful completion and training, they will graduate with a Doctor of Chiropractic degree.

To become a physiotherapist, you must also have an undergraduate degree to apply to the program. Physiotherapy school demands a two-year program which includes classroom studies and various placement opportunities. About two-thirds of the education is in the classroom where they learn subjects such as anatomy, physiology, biology, physics, chemistry, and behavioural sciences. The clinical placements provide opportunities in a varying degree of settings including acute hospitals, rehabilitation centers, and community clinics. After finishing the two-year program, those individuals are rewarded a Masters of Physical Therapy.

Secondly, I would like to differentiate the scope of practice between these two healthcare providers. Scope of practice is defined as the procedures, actions, and processes that a healthcare practitioner is permitted to undertake within their professional license. Although, this may differ within the provinces and among countries. The practice of physiotherapy is defined as “the assessment of physical function and the treatment, rehabilitation and prevention of physical dysfunction, injury or pain, to develop, maintain, rehabilitate or augment function or to relieve pain”. While the practice of chiropractic is defined as “the assessment of conditions related to the spine, nervous system and joints and the diagnosis, prevention and treatment, primarily by adjustment of disorders arising from these structures”. As you can see, both professions have a very similar scope, although chiropractors have more emphasis on the diagnosis of a musculoskeletal condition. Chiropractors are well-known for adjustments or spinal manipulative therapy (i.e., the cracking noise). Both physiotherapists and chiropractors can perform spinal manipulative therapy, but a physiotherapist must have extra training and a certification to do so. Both professionals are trained to work on all joints and muscles in the body, from the jaw to the baby toe. While physiotherapists can specialize in non-musculoskeletal areas such as the cardiorespiratory system and pelvic floor.

Lastly, and most importantly, you should ask your chiropractor or physiotherapist what type of treatment plan they can offer you. A major emphasis in our practice is on the importance of self-management strategies, which include personalized stretches, exercises, and life-style modifications, along with traditional chiropractic care. Many physiotherapists and chiropractors will practice this way, but you will only know what services they provide if you ask them questions. Asking questions may allow you to become a collaborator in your healthcare, rather than just a recipient. Your manual therapist should be able to work with any age or any condition, and if the condition is out of their scope of practice, they should be comfortable in referring you to the appropriate healthcare provider. Whichever provider you choose, they should aim to provide “patient-centred care”, involving the patient in their health decisions and treating them with dignity and care.

Chiropractors and physiotherapists will use their evidence-based judgement, learned clinical skills and previous patient experiences to formulate an individualized treatment plan while keeping in mind the patient-centered care model. Whether you tweaked your back or sprained your ankle, both chiropractors and physiotherapist are suitable professionals to provide treatment. I hope that you have learned that either profession may play a role in the treatment of your musculoskeletal condition, each with their own approach. Now your role as a patient is to be an inquisitive and active participant in your treatment plan. Whichever healthcare provider you may choose, they should strive to be advocates for healthcare, leaders in their community and participate in life-long professional growth.