Physiotherapists vs. Chiropractors: which one should you choose?

Batman

I get asked at least twice a week what I think about chiropractors.  Some people have this belief that there is an ongoing rivalry between the two professions, but it is just not true.  There is room in the allied health field for practitioners with different approaches; in fact we are all better off for it.   As a physiotherapist, I am obviously biased, but I think for some people, chiropractic treatment may be the best thing for them and for others it may be the worst thing they could do for their pain and that is where the big difference between the two professions is the most evident to me.

Physiotherapy has a much broader scope of practice than chiropractic treatment does.  A well trained physiotherapist should have the ability to manipulate the spine, perform muscle release techniques, use acupuncture or IMS needling treatments, teach core stability exercises, help work on your posture and balance or build a sport specific training program for you.  Most chiropractors focus purely on joint manipulation with a smaller percentage also using muscle release techniques like Active Release (A.R.T.) or Trigenics.  Chiropractors may be the best at using manipulation as a treatment technique by virtue of pure experience and practice, but I would prefer a clinician that has the ability to manipulate me (if need be), needle me (if need be), use myofascial release (if need be) and spend the time with me to help me prevent the problem from arising again.  A good physiotherapist should be able to do everything a good chiropractor can do and more.

The problem is that not every physiotherapist is well trained and just like any profession there are ‘good’ ones and ‘bad’ ones.  The same holds true for chiropractors.  Some physiotherapists will bring their clients in hook them up to three different machines over the course of an hour and barely pay any attention to them.  Some chiropractors will treat six people per hour for a pop, pop, pop and have their clients come 2-4 times per week for the better part of a year.  Sometimes the business can get in the way of the healthcare and interfere with optimal care.  The model of practice the physiotherapist, the chiropractor or the family physician choose to work in can unfortunately dictate the modality of treatment more than the actual needs of the patient.

The one glaring difference I should mention is the number of clients I have treated that have been injured by their chiropractors.  I do support the use of manual therapy, manipulation and ‘adjustments’ but have found that some chiropractors tend to be either too aggressive, or manipulate a joint when they shouldn’t due to a lack of other treatment options or lack of time spent.  Well trained physiotherapists will perform a lot of spinal adjustments, but you will typically find their technique to be more on the conservative side than your average chiropractor.  There are risks and rewards to spinal manipulation.  Just make sure you are comfortable with the potential risks and the competence of the person treating you.

I have treated just as many people that have been dissatisfied with their previous physiotherapy experience as I have people that have been put off by their chiropractor.  With previous physios, clients usually developed resentment from being ignored and felt like they weren’t accomplishing anything; with chiropractors clients usually developed a sense of dependence when they were looking for empowerment.  In both cases, the clients just want someone to take the time to explain what the problem is, what the clinician can do to help that problem and what they can do to help themselves.  Ten minute appointments, or juggling four clients at a time don’t provide that opportunity.  The best allied health professional you can find to help you is the one that is well trained with a variety of skills and works in a model that he has the ability to spend enough one-on-one time with you to address your problems.

If you live in the Metro Vancouver area, here are links to a few good physios and chiros that I know:

 

There are more, but use these clinics as a measuring stick to assess if you are getting the best quality of care by your allied healthcare practitioners.

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63 Comments ↓
  • Matt Giammarino

    An interesting and well written article Brent! I had never thought about the difference between these two clinical jobs, and it was an interesting read.

    • Nice topic to make comaprisonbetween these two.But these both are different form each other. i have some doubt in the starting, but when i have made a visit to Chiropractic and Collaborative Care Center in ottawa. Their get to know how physiotherapy & chiropractor these both are different form each other. Mr. chad wilson introduse me how they differ from each other. Such a nice guy he is. iwll suggest if anyone going through these type of pain make visit ot Chiropractic and Collaborative Care Center in Ottawa.

  • Amanda Louca

    As a 2nd year Chiropractic student attending the Canadian Memorial Chiropractic College (CMCC), I feel it is a bit unfair to make the claim that physiotherapists have a broader scope of practice. I understand that this article was not meant as an attack but it does not provide the general public with ALL of the facts. As a student, I myself am currently being trained in soft tissue therapy, along with spinal manipulations. Correct me if I am wrong, but in order to treat patients with A.R.T, acupuncture, etc, external courses, which are not a part of the core curriculum, must be taken for physiotherapists. The same holds true for Chiropractors. I for one am currently being trained in M.R.T (a variation of A.R.T), and will be taking A.R.T training courses, along with completing my training in Graston and acupuncture all before I enter my fourth year as a Clinical Intern.

    I feel that this post does not highlight on all the great qualities that Chiropractors posses and simply disregards the amount of training that is required in this extensive 4 year doctorate program. It does not highlight the fact that we are overall health care practitioners with intensive diagnostic training, which is highly regulated by the government. Most of the core courses held at various Chiropractic institutions mimics those that are taught at medical schools; many of which are taught to chiropractic students by medical professors. These courses include but are not limited to everything from neuro-diagnoses and radiology to immunology and toxicopharmacology.

    To say that the Chiropractic scope of practice, relative to that of a physiotherapist’s, is limited simply is not true. I agree with the fact that there is not a rivalry between the two practices, however, it is important that patients be provided with accurate, unbiased information so they can truly make an informed and well thought-out decision regarding their treatment plan.

    Furthermore, I am extremely interested in the claim that you made that the physiotherapist’s manipulation is more conservative than that of a chiropractor’s. I do not completely understand how a statement of such magnitude can be made without sufficient research to back up that claim. Chiropractic students attending CMCC are exposed to a state of the art, force sensing/simulation lab. The force plates, which have been placed in the Chiropractic table, provides students with instantaneous feedback on the force and speed of their adjustment. As such, this ensures that only the necessary amount of force needed to create movement through the joint is used. I am not arguing that injuries have not occurred as a result of manipulations, just as I cannot argue that injuries have not happened with any form of manual therapy, including those provided by physiotherapists.

    I appreciate that you did not disregard the fact that there are good Chiropractors. However, I just felt the need to clarify some large claims that were made in your post.

  • Chantalle youkhana

    I disagree with you on one front, though I think it more a clarification than a disagreement. Physiotherapists must take spinal manipulation as an external course, however, chiropractors have extensive in class training during our years at school in manipulative therapy. This is something I believe greatly separates us from physiotherapists and other health practitioners, as adjusting is what we should be the best at, our bread and butter 🙂

  • Brent

    Thanks for your post Amanda. I was waiting and hoping to get some responses from chiropractors on this post. In response I would have to say that I posed this article in the framework of it being my opinion based on my 9 years of experience working with clients and interacting with chiropractors in the community, not as scientific research that was attempting to make "large claims." I admitted that I was biased a couple times in the article so that readers to take the information with a grain of salt. Your post will help people gain some information on chiro’s training.

    To answer your question: yes, in order to train to do manipulation, acupuncture, IMS, etc as a physio you have to go for post graduate training. The main reason for that is because the scope of physio training in Universities is so broad that in order to be a "good physio" in the orthopaedics field you need to learn more than what you get in school. In school physios are required to work in hospitals and clinics working with people with neurological conditions like spinal cord injuries, strokes, parkinsons, cerebral palsy, bina bifida. We work in hospitals on the medical floor dealing with cardiorespiratory issues and getting people to move again after various surgeries. We get to be there before, during and after medical procedures. Physiotherapy is integrated into the medical system both in University training and the real world. We also get to work in the private practice setting and the public system when it comes to orthopaedics.

    So by the time a physio is a "new grad" I can confidently say they have gained a broader scope of knowledge that a chiropractor has. The new grad chiropractor I’m sure has better manual therapy skills than the physio, but I believe the ability to take new courses and layer on skills after you graduate translates into better knowledge and practice of what you have learned because you have more experience working with people to integrate your new knowledge. This is something true to both professions and you will see once you start working.

    From what you are saying, chiropractor’s training may be broader than I had eluded to, but I still maintain that in practice most chiro’s rely very heavily on manipulation where physio’s tend to provide more options to their clients.

    Comments are welcome….thanks for the discussion…

  • Jenny Anderson

    Usually those that have the tendency to market themselves in a "hard sell" approach unfortunately need to utilize a convincing and manipulative tactic to the public which uses a comparison and places that comparison study(whatever it may be) as the inferior or less than tho. It is unfortunate that in a time of continuously changing health care; in what is now condisered to be a melting pot, does a dogma still exist. As in any profession, one should take pride in their practice and the training which they have graciously recieved by any institution, rather than playing the devils advocate. Accept what you do as a profession and avoid pointing fingers at others to provide a cushy platform for which you base your opinion. The patient is the final and ultimate decision maker, NOT the clinician. Using a "hard sell "marketing technique such as this to convince future clients to choose one profession over another really only places a question on your integrity as a clinician. I understand that this is your opinion, and so this is mine. Just to summarize my point: In a pepsi challenge, people can be persuaded when they are blinded by the marketer!

  • Brent

    wow Jenny. This article and discussion was totally not intended to be a "hard sell." I am more than busy in my practice to use any form of hard sell and the point of this website is not to generate clients.

    I agree the client makes the decision….see the last line of my article:

    "The best allied health professional you can find to help you is the one that is well trained with a variety of skills and works in a model that he has the ability to spend enough one-on-one time with you to address your problems."

    I think there is overlap in what both professions do and the client should pick who works for them or even better have a physio and a chiro.

    I find your accusations off base, but c’est la vie!

  • Jenny Anderson

    You do play devil advocate! Talk about acusations off base! Your entire article was based on acusations regarding another profession.

    Speaking as a patient that has first hand exposure to the "tug of war" of alternative therapies; it is views such as this that provide a reasonable doubt in the publics’ opinion, which therefore influences the decision to continue to seek medical attention for non emergent care in walk in clinics and emergency rooms.

  • Ricky Singh

    Excellent article Brent! The points brought up by both you and Amanda really highlight great points between the two professions.

    In every profession, theres the good , the bad and the ugly.
    If both Chiropractors and Physiotherapists only studied the basics from their core curriculums, then both would be equally incompetent in treating and helping a wide variety of health conditions. Professional Colleges provide very basic information that forms a foundation for further studying. Much of the information taught is either outdated or has been proven not useful.

    Furthermore, the inclusion or exclusion in the scope of practise for either profession is simply semantics/politics/legalities. For example, musculoskeletal injuries are in the scope of practise for both professions, but there are chiros and physios out there who don’t know a thing about how to rehabilitate a patient suffering from low back pain. The title says very little about the ability to perform in my opinion.

    Research is being published exponentially and new techniques are constantly being validated and falsified. In both cases, the health care professional must engage in continuing education and go beyond their institutional education to be well trained in treating patients.

    Ultimately, a health professional that is well informed, stays up to date with the emerging literature and who actively attends continuing education seminars is far superior than both a Physiotherapist or Chiropractor.

  • Brent

    Couldn’t agree with you more Ricky. I am a big advocate of the allied health field in general. I think it is our responsibility to promote health and keep people out of the medical system as much as possible. There are so many new treatment and assessment techniques out there now that as long as the individual health care practitioner takes advantage of learning and using a variety of therapies it shouldn’t matter if they are wearing a physio hat or a chiro hat.

    The general public just needs to know that all physio’s are not the same and all chiro’s are not the same both in the extent of their post graduate training and in the model of practice they choose to work in. People should do their homework when picking a clinic to go to and when picking which person to see in that clinic. People should also be open to seeing more than one health pro concurrently because they may gain significant benefit from the different approaches. A good, confident health professional should know his/her limitations and be able to refer their clients to others and be willing to work with other health pros if the client chooses to see multiple people.

    I am lucky enough to work with 4 other physios, 2 RMTs, 2 Kinesiologists and 4 clinical Pilates instructors. We also have 2 chiros and 2 naturopaths just downstairs. If you put a lot of smart people with overlapping knowledge bases under the same roof good things happen.

    People just need to know that they have choice and they should explore their options if things are going their way. Picking someone to help you with your health should not be solely based on physical proximity to your home or work….find the people that best fit your needs.

  • Matt

    As a fourth year Kinesiology student at UBC trying to decide between physiotherapy and chiropractic, I found this article to be a nice break from the rather extreme opinions some people have towards both professions (especially chiro). Do you think that through post-graduate learning and courses it is possible to almost combine the two careers and work as someone somewhere in between a chiropractor and a physiotherapist, or are they too fundamentally different for this to work? In other words, in your opinion do you ever think it would be possible to combine the more advanced manipulation skills of a chiropractor (requiring a chiropractic degree) with the broad skills of a physiotherapist and practice free of the negative stigma that haunts chiropractors?

    I’m leaning towards going to CMCC to become a chiropractor, but after seeing the negative attitude many people have towards it I’m not so sure it’s the right choice.

    Hope that made a bit of sense, as you can tell this career choice decision is making my head spin.

    • Brent

      Hey Matt
      I think with enough post graduate training you can become a good well rounded therapist whichever root you choose. The further you expand your skill set the more and more you will start to overlap with other professions and the line between chiro and physio can get more blurred. You won’t change the public perception of what a generic chiro or a generic physio is…..if you tell someone at a party you are a chiro they will immediately assume you just crack people’s backs all day even though you may have trained to do much more. If you tell that same person you are a physio they will inevitably tell you about some injury they have had in the past and then ask if you specialize in a particular area. Chiros can and do branch out into broader areas of treatment, but i think it is easier to stick with manipulation because you get more actual training on treatment techniques in school. Physio you get let out of school and have more of a choose your own adventure to pick what you want to be good at. I promise you that if you go the physio root and want to be a really good manual therapist, the training is out there to allow you to be just as good or better than any chiropractor if you put the time in.
      I did HKin at UBC and found physio a great and natural transition to build on the knowledge I had already learned. I can’t speak to what chiro school would be like, but my biased opinion would push you to the physio side. Either way as long as you commit to learning beyond school you will enjoy it and be successful….there is no shortage of people hurting themselves out there….especially in an active city like Vancouver. Hope that helps…good luck!

      • Matt

        Thanks for getting back to me Brent. After doing a bit more research it looks like physio looks like it may be a better fit for my personality and future career plans. The ability to practice a wide range of techniques as part of a team and to be a part of a profession that is well-regarded in the medical community really appeals to me.

        On a separate note, did you do your physiotherapy training at UBC? And if so, how competitive was the application process and are there any suggestions you would make to a potential applicant? No worries if you can’t answer these questions, I’m just looking for as much advice as I can get. Thanks.

        • Brent

          Hey Matt
          I got into UBC and U of Toronto physio but opted to go to McMaster because of their unique program. The process is competitive with all of the schools but I am pretty sure they have made the schools bigger since I was there. As for advice….look at more than UBC and compare the programs even if you don’t want to go anywhere else….learn about the schooling and the profession. If you get an interview….talk to people that have done it in the previous few years because a lot of the questions they ask are pretty much the same from year to year. Good luck

  • Jamie

    I am considering to become whether physiotherapist or chiropractor.
    For me, money is important. I know both professions are great but physio is more scientific. Also, many people go for physio when they get injured.
    Anyone please tell me which profession makes a lot more?
    I red an article that a physiotherapist made 400k last year.
    sorry for my bad english!
    -Gr.12 high school student, thinking to go to BA kinesiology at york university. –

    • Brent

      Hi Jamie

      To be honest I would guess the average Chiro makes more than the average physio but they are comparable. Owing a big clinic and having multiple clinicians working for you as part of your business is how either profession can make higher incomes. To make that much you have to be interested in being both a good clinician and a good business person

  • Jamie

    Thanks for your comment Brent!

  • Rob

    I am heading into my final year of Exercise Science undergrad degree at CCSU. My father has had his own chiro practice for the last 26 years. I work in his office as a therapy assistant helping patients with heat, EMS, etc. I am torn between chiro and pt. From my research I’ve found that I can legally treat patients the same way with either degree (DC vs DPT). How ever like I am conflicted because like Jamie I want to choose the one that will give me the best career. Ive learned from my dad that over the years insurance reimbursement has gotten progressively worse for chiros. He says he has to do twice as much work for half the return. So Brent, have you noticed the same trend as a physio?

    • Brent

      i haven’t experienced that Rob. Most of my clients pay out of pocket and then recoop their money from their insurance companies. I set my own rates and don’t worry much about what insurance companies are doing. It is a different system in Canada vs the States. Each profession’s scope is overlapping enough that I would agree you could treat the same way with either degree, but the expectation of the client will probably be more specific if you choose chiro, i.e. wanting spinal adjustments. I think either way you choose, if you are good at what you do and are somewhat business minded you will make a good living. Again…my biased opinion….pick physio, unless you want to take over your dads place…..good luck with your career

  • billy

    I too get asked whats the difference between PT and Chiro regularly. I always say that PTs have greater all round knowledge. This of course is true isnt it?
    Whilst training in the UK I dont recall ever seeing a Chiro on the Orthopaedic, Surgical, Medical, Paediatric, Psychiatric, Geriatric,Obsteric /Gynaecology, Burns and Plastics,Neurology,Gymnasium etc etc wards.
    Consequently for 6 of my qualified 24 years as a Physio I have worked in Hospitals observing many many patients and Physiotherapists.
    With a large base such as this it is much easier to diagnose conditions other than MSK and refer red flagged patients appropriately.
    Now I work in my own Clinic in Beresfield NSW Australia.

    However I am disgusted when patients advise me that they have been to a Chiro 23 times in 26 days (excluding Sunday) and 19 times in 26 days. Without any improvement. With the Chiro’s staff telephoning them and demanding they attend for their "adjustment".
    Chiros here also have a great tendency to scare patient into attendance.
    Several years ago a local Chiro even managed, in a paid advertisement in the local paper to change the laws of gravity by saying that it pushes! He did so so that it justified his script.

    I believe the Chiros I mentioned are just money hungry scammers, who never provide any exercise advise and always advise patients to use ice on their chronic injuries, rubbing their hands together in the knowledge that the patients muscle spasm will intensify and they will get more money. Indeed they offered one patient a "discount" for 19 treatments if she paid up front.

    • Brent

      lol….tell us how you really feel 😉

  • billy

    Could I just add another observation or 3.
    Chiros are obviously more talented than PTs as I do not have the ability to "crack" a spine and "cure" bedwetting, deafness, poor school grades, Asthma, ADHD,Autism ,restless legs, true carpal tunnel, Achilles tendonitis, or ATFL injuries to name but a few.
    Neither can I jiggle a patients legs and equalise their leg length difference for any longer than they are lying down for. Although I can give them a heel raise.

    But then again I cant keep ’em coming in for more unnecessary treatment ,if I do that.

    Im also amazed at how a patient with a sore neck/shoulder ,say following as a direct result of an activity they have recently undertaken. Can get their neck cracked then have their lower back manipulated by the Chiro even though theyve never had a days soreness from their back. Then the Chiro keeps’em coming for the "wellness" for their back. Even when its totally unjustified.
    Also minimal exercises or home remedies(although iceis the 100% choice) so basically just total dependence on the Chiro.
    Thats why they go for daily "adjustments".

    What is an adjustment anyway, Oh yes thats right its a way to push that slipped disc back into place or put that spine with "functional" scoliosis straight again.
    Click ,click with the activator.
    What a load of garbage.
    Totally,Totally unethical.

    The patients get hooked in and although theyre aware somethings not quite right they keep going ,sucked in by the charm of the snake oil salesperson.
    I suppose all the supplements the Chiros sell are a good money earner too. Useless for the patients but another car, rental property or shares or holiday for the Chiro.

    Im only describing what patients have said to me and the patients conditions I have treated following a visit or 26 to the Chiro.

    I have never had the same or any negative feedback from patients who have seen PTs. Why would this be?

  • Thanks very much for sharing, you offer an interesting perspective. Chiropractors and Physical Therapists are similar as they work towards normalizing the function of the physical body. Physical Therapists work towards joints of the body characterized as mobilization, not manipulation and have not received any proper training in the manipulation of the joints. On the other hand Chiropractors, though, receive extensive training in both joint manipulation.

    • Brent

      that is not true Jack, although it may vary from country to country or state to state what physios are allowed to do. In many places physiotherapists can and do take extensive post graduate training in joint manipulation to the point they can manipulate anything that a chiropractor can. The chiros learn it in school. The physios learn it as another tool in the tool belt at the post graduate level.

      • OZbloke34

        They do? They don’t here in Australia, every Physio I have been to say they are not taught manipulation.

        • Brent

          that’s funny because I know a number of physios here that have gone to Australia to do a specific Masters of manipulation course for physios. Most of the physios that come here from Australia have strong backgrounds in manual therapy, but as I say it is typically post-graduate training more than it is part of the physio curriculum. Curtain and U of Queensland both have good physio programs from what I understand

          • OZbloke34

            Aye as I mentioned, every Physio I have been to has not been taught it. It may be be taught afterwards…. and after a quick google search I can see one for example being taught at Newcastle University. It is a 9 month course. Hardly anywhere near a profession that gets taught it for a period of 5 years.

            Also here in Australia Physiotherapy normally has finished in a 3 year bachelor degree and a one year masters degree. Chiropractic is min 5 years. So I’d even go on to say that Chiropractic straight off the bat is more highly trained? The proof is in the length of time required to finish. It does vary I guess country to country, but that is the case here.

            Also as your article says you are more integrated into the medical system. There is a reason for that, here Chiropractic was asked if they wished to join and have prescribing rights (advanced courses required) , the main association declined. As they focus on a 100% natural approach.

            Now I’m not saying the above is a fantastic idea, as I think anti-inflammatory drugs in some extreme cases can be used and work well with other treatments, but that was the end decision main by the main body of Chiropractic in Australia.

            So at the end of the day it defines the profession, go to a GP for drug prescriptions and / or go to the Chiropractor for a more natural treatment.

            Most GP’s I know work with Chiro’s and vis versa here now anyway. Seems to be only the older generation stuck in their ways that are still giving Chiro’s a bad name for no reason, I think that will be gone after the older generation have gone.

            PS just FYI, the best Chiropractor I have ever been to have trained and practices Chiropractic adjustments and physiotherapy exercises. I think this is a fantastic way of doing things as Chiropractic adjustments seem to have instant relief as opposed to PT, but followed by exercises, exactly what PT does is the best of both worlds.

            I’ve been to Chiro’s before and asked why they don’t give exercises, same answer every time. We used to but 9/10 people would just come back and not have done anything, too busy, etc etc (which lets face it is most people) so want an instant fix no matter how much you education them.

            If a patient asks and is enthusiastic about actually wanting to fix themselves long term (different type of person) they ask and you educate. I think this is where the bad stigma comes out of Chiropractic because they don’t do it every time because, lets be honest, if 9/10 people never do what you give them, you are spending anywhere from 10 – 15 min per patient wasting your time when you could be helping someone else.

  • felix

    I injured my middle finger since sep this year when i was sparring with another person. I did the xray and the bone is fine. Should I go for chiropractic or physiological?

  • Great post! Glad to see this discussion being held. Thanks for all the thoughts!

  • ethan

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565606/

    Seems there is a bit of threat perceived, and certainly a hostile response on the part of some chiropractors, at the level of legislation, even…IMO, it smells of getting stuck in the Concorde fallacy

  • john c

    chiros are so shit… scammers.. never go to them

  • Sabine

    Hi Brent,
    Thanx so much for your website. I am currently struggling with tailor bunions and cannot find any shoes anymore that are wide enough to accommodate my bunions (especially on my right foot). I have a pair of Vivo barefoot shoes – unfortunately also not wide enough. I want to avoid surgery and orthotics don’t work for me anyways. I really would like to learn to walk properly and use the right posture and hope that that will resolve the bunions. I live in London, UK. You don’t happen to know anyone here that you can recommend to me? And…you also don’t happen to know a shoe brand that will go a good bit wider than the vivo barefoot shoes? Thank you. Sabine

  • Lyn L

    I have been exposed to a lot of chiropractors, for what i have experienced, most of the patients that i have treated came from chiro where they inflict a more serious injury after they have been manipulated. So physio becomes the treatment of choice after they have been injured, so now, the chiropractors incorporated modalities in their treatment, just to say that the did not crack the px’s back for less than 5 minutes, sometimes the only treatment of choice would be the modalities and no manipulation occurs. Recently there was an incident in my clinic where a patient walks in and looked for a physio, the chiro in our clinic took him in his office and after an hour he book an appointment with him, i later found out that he said to his patient that physiotherapist do not treat ligaments, they only treat muscle problems, despite the patient’s request to be transfered to physio, he keeps on adding lame excuse to keep this patient. This chiro never did hands on to this patient, i am afraid that he already burn the patient by using 1MHZ, 1.5w/cm2 100% 7mins on the patient’s carpal joint.

  • Chiropractor Halifax

    This is a great article.

  • For me both of them are best because we find it worth when we actually need it… it is my personal experience that Physio Therapy clinic provided the exercises and encouragement to help us strengthen the back muscles. And Chiropractors are also usefull for us.

  • sean

    It seems like Physiotherapists have a broader scope of knowledge and understanding. If I understand this article correctly It seems like most the time, for most people, physiotherapy may be a good starting point. For people with chronic pain, or persistent problems, though, a good chiropractor might supplement physiotherapy well. http://www.claytonheightsphysio.com/en

    • OZbloke34

      Aye really depends, for my neck pain and back / shoulder pain both helped, although Chiropractic was quicker too most of the time. Needless to say I had to find a GOOD Chiro (which seems to be hard, but then again some people say the same about Physios and GP’s / MD’s)

      • Brent

        thats right its not that one entity is good and the other is bad….there may be good and bad ones of each profession. They are two professions that have an overlapping scope of practice and you are best to do some home work on who you are going o see to determine if they are the best fit for you. In my opinion a good physio or chiro will define themselves more by what they learn after school than during.

        • OZbloke34

          Aye exactly, as mentioned above (in my other comment) the be Chiropractor I’ve been to practices both. He strongly believes Chiro is best for some things, Osteo for some others and follows up with PT long term life modification to keep things in place he has just rectified. He will never see anyone more than twice for the same issue and has about a 6 week wait to get in to see him. Will be exactly like that myself when I graduate.

          Myself and my partner actually plan to become dual qualified, as you mentioned I do believe Chiropractic as the best at what they do, manipulation, but I do believe PT to have a better reputation, (purely from MD’s vilifying the profession before they were sued for it) plus both get taught so much of the same course structure (Anatomy and Physiology, Biology, Chemistry, Biochem etc etc) apart from one has a specialist side course added on for Physio and one for Chiropractic.

          And in addition the above you throw in everyone is different (like you have said in the past even in the same profession) and you have major differences between the two.

          Anyways the end result I wish is for the best for my patients and that is all. As any health professional (I hope) would. Some are in it for the money and you can tell this as a patient so just be aware and move on. It is not the profession it is the individual.

    • Heather

      if you get a physiotherapist who has been certified in manipulation which is a very intensive postgraduate training, you will be swimming! If you can find one who also taken some craniosacral training, it would be even better.

      • OZbloke34

        Heather, here (not sure about there) again the training is no where near that of Chiropractic. Manipulation is taught for 9 months (as opposed to 5 years in Chiropractic) for an after course for PT.

        Craniosacral training I’ve found comes in 4 levels. At each level min 80 hours each level. Still no where near the level.

        I’m not biased (as I’ve stated above in other comments I strongly believe both professions have their places and are best when both are practised) but the after courses provided for manipulation are no where near the same standard as Chiropractic is.

        It actually reminds me of Germany where they learn manipulation on a weekend, each weekend for 2 years and can practice manipulation. These are the types of people that have damaged most people in manipulation unfortunately.

  • I had a good chuckle from the picture of Batman and Robin. Thanks for that. I would have to say for any business there are always the good ones and bad ones. I like to assume people are good though, but it is smart to do your research before picking a service. You may save yourself a lot of trouble in the future.

  • Thanks so much for this post! I’ve been really curious about this for a while now. Keep up the great work on this blog!

  • Deepti

    Thanks Brent for pointing out notable difference between Physio and Chiro. I am suffering from neck stiffness and lower back (disc protusion) not that worse but over exertion/sitting for long hrs restricts me from doing daily chores or exercise. There was Road show conducted by Chiropractic clinic, though I went for scan, I had no idea how the treatment like Subluxation or spine adjustment is done. I haven’t started with any Chiro session and this article is really well in time to make my decision. On further note, wanted to confirm if Pilates/Yoga or swimming which one can help me in long run. Thanks again

  • Peter

    Hi Brent,
    First off – thank you for this article. Despite some of the polarizing comments made in this thread, I believe this is an objective – and a fairly accurate – account of the situation as is possible given your bias.

    I am currently a chiropractor practicing in norther rural BC and after about 3 years in practice, I am starting to consider physio school (Brent – in that regard do you have an opinion on University of Queensland’s program?). My reasons are thus:

    1. The chiropractic profession is slowly fracturing into 2 groups – the evidence based practitioners that use sound judgement, rehabilitation, and multiple treatment methods – and the ‘old school’ practitioners who still cling to a somewhat archaic belief that the chiropractic adjustment can heal anything under the sun. I share nothing in common with this latter group and in my opinion, they are hindering the efforts of other leaders in the field to forge inroads with the rest of the medical community.

    2. As a chiropractor, I feel that I will largely be limited to private practice for most of my career – or potentially a teaching/academic position. On the other hand, physio’s have easier access into hospital settings, sports teams, government consultancy positions etc. In short, I feel that I’d have more opportunities as a physio as compared to a chiro. That being said, although I make a very respectable living in private practice, I put value on having more options for my career down the road.

    3. Having been in practice, what really spurred me into considering physio – is that I often found myself disagreeing on an ideological and professional level with my colleagues. While I don’t want to get into it extensively here, I don’t find that a number of beliefs that my peers instill into their patients are founded on even common sense – let alone evidence. That being said, I would also like to point out that only a select group of chiropractors practice this way. And for that matter – as you mentioned Brent – there are equally physios who don’t actually do anything to help their patients and are more interested in cycling them through the clinic to maximize earnings.

    4. At least in the area that I’m in (blue collar) – public perception of chiropractic is that we ONLY deal with the spine and nothing else. It is only after 2 years and success with previous patients that I now get referrals for ACL post surgical rehab and the like. I could be mistaken but conversely, I don’t think that physio’s are pegged as people who ONLY deal with sports injuries. Personally, I like the variety and challenge of extra spinal complaints.

    All in all – the chiropractic profession has the potential to be great. And in time you earn great money and job satisfaction is high. On the other hand, the profession is still far from integrating itself into the larger medical community (in North America anyway – it’s a vastly different story in Switzerland where chiropractors and medical doctors share similar schooling and cultural authority) because of a group of bad apples.

    That’s my 2 cents.

    Thanks 🙂

    • Brent

      thanks Peter that is very thoughtful response. I have some friends and associates that went to University of Queensland and had great things to say about the physio school there. Best of luck with your career choice. I’m sure you can be successful either path you choose, but I agree physio may open more doors for you particularly into the medical community.

  • Fahad

    Very interesting dialogue… Hope somebody could guide me as well. I am currently taking my mother to a chiropractor in Pakistan to treat Carpel Tunnel Syndrome. The chiropractor says it’s due to nerve compression in spine. X-ray report shows spondylotic changes observed in the form of decreased disc height between C3-C4, c4-C5,C5-C6 and C6-C7 level along with end plate sclerosis with mildly decreased vertebral body height more marked at C5 and C6 level. Note is made of anterior as well as posterior osteophytosis present at C3-C5 levels.
    This chiropractor claims experience of a 10 years and mentions some degrees written as MPPS, BSPT, MRP(Neuro), MSc (Ortho Rehab), Dip Sports medicine (IOC), Australian trained Chiropractor and Physiotherapist and also member of Canadian memorial college of Chiropractor…
    Can some one advise, if I am approaching correct person for treatment.
    Many thanks again.

    • OZbloke34

      Not going to comment on the Chiropractor as I’m not qualified, but it may be possible if he thinks so.

      I was in IT for a long time and developed similar (if not exactly the same symptoms as carpal tunnel) look up exercises for carpal tunnel, see if it improves. If not look deeper and try other things. Save surgery for a last measure.

      • Fahad

        Many thanks Ozbloke for your kind comments… We shall save surgery as a last resort only…..We are continuing with Chiro+Physio treatment (since the doc mentions he is trained in both and technically i am not aware what his degrees mention)….there is some relief but not complete in last 14 sessions….the numbness in fingers can still be felt though pain in wrist is quite relieved ….according to doc, this shall take some time to normalize fingers completely since they are more sensitive part….so he has given some rest for couple of days and given some exercises to practice …I shall keep updating to get more education on the subject….thanks again.

  • wow.. that is outstanding toys i think.. really nice to share.

  • I really like psychotherapists because they work on strengthening your muscles, rather than just aligning your bones. No doubt that both are helpful and necessary, but if I had to choose to go to one, I would have to visit a psychotherapist. I think they do a great job, and whenever I leave the office, I feel rejuvenated, and ready to take on the world.

  • Well! I would say each human being is different in his own, So go for that which suits your body and you will get the best solution. As a Chiropractor, I would go for us!

  • Getting treatment from a physiotherapist is a great option for anyone looking to improve their overall health. I started seeing one as a from of rehab after I was injured but now I go all the time even though I’m healthy. They can teach you and help you a lot on the road to prevention.

  • My son really likes playing sports, but he has been complaining of various aches and pains lately. I want to take him in to get checked out, but I didn’t know which type of facility I should take him to. I really like what you said about how physiotherapist have a broad scope of knowledge. I also like how you said they could help teach him core stability. This is a really important part of playing sports, so I think it will help out my son moving forward. Thank you for sharing.

  • Frank Kerry

    At the end of the day, chiropractors are doctors! Physical therapists have a masters degree. Who would you trust more? The more educated practitioner?

    • Scott

      No they’re not! Why would you think Chiropractors are doctors? They don’t have a medical degree at all.

      • The term ‘doctor’ is misleading. Chiropractors are not doctors in the sense that most people think a doctor is. They have a “Doctorate in Chiropractic” given to them by a privately run chiropractor college, which is not in the same ballpark as the degree a medical physician will receive. Physiotherapy degrees are typically from fully established universities and their programs are usually affiliated with the medical programs and now in the States most are also called a “Doctorate of Physiotherapy” so people may confusingly call physios doctors too. It is a bad and misleading use of language. Do not assume a chiropractor is more educated than a physio because they call themselves doctors….they might be very educated, but Frank’s premise is faulty.

        • Sportzwolf

          In Canada Chiropractors are one of 5 professions who are recognized as doctors in their ability to diagnose, this was granted by the government. Although they are not medical doctors, neither are vets or dentists but they are still considered doctors. Doctor of Physio is a PhD, which is different. There are many privately run Medical schools and there are Chiropractic Schools that are integrated within universities (programs are the same or very similar to private) so I am not sure what point you are trying to make. As a Chiropractor I have worked with many Physios and I have nothing but respect for the profession, I have learned a lot from them. Like any profession there are good and bad and you have to figure out what works for you and who you work better with.

          • I have respect for Chiropractors and I work with them regularly. The only point I am trying to make is that using the word doctor to represent a physician, a dentist, a vet, a chiropractor and a scientist can be confusing for people. Its not a good use of language, but it is the reality of what we have. I just try to help people understand the differences and try to be critical thinkers. This type of dialogue is helpful, if people read through the discussion.. Again I don’t have anything against chiros….I just get asked what I think about them regularly so I started this post years ago and it continues to get traction in random spurts every few months. Thanks for taking part.

  • Sajid Mahmood

    I recently have L5S1 surgery, surgery went okay. My inner calf muscle is completely flattened. now after surgery, should I got for chrio or physio?

    • After surgery you typically want to treat your spine conservatively and
      start more with exercises and rehab which typically fall more into the
      physio realm, but some chiros I’m sure could help you too. I would pick physio, but find someone your trust to help guide your rehab. Your inner calf muscle is innervated by the S2 nerve which may have been affected in your surgery. It will likely come back, but talk to your physio and surgeon about it

  • saurabh

    Hi Brent, would you recommend a chiro or a physio to correct posture related issues / injury. I had upper back / lower neck pain which got a lot better after seeing a physio when i was at Stanford university. I have relocated since to chicago feel i should see a specialist once to check my progress. thanks!

  • Vina Keaveney

    I think this post sums up the key differences very well. For me, I see a chiropractor for their ability to correct nervous system dysfunction through spinal manipulation. Helping the brain communicate better with the body and vice versa. They do not just work on the physical through mobilisation techniques. Chiropractic adjustments have also been shown to alter brain function within the prefrontal cortex. https://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=11&cad=rja&uact=8&ved=0ahUKEwjgidrM6vvWAhWIBBoKHTpWA3kQFghpMAo&url=https%3A%2F%2Fblogs.palmer.edu%2Faskpalmer%2F2016%2F05%2F17%2Fphysical-therapist-versus-doctor-of-chiropractic%2F&usg=AOvVaw0r9jIpTJ15978FPe332SUB

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