Physical therapy can be traced back to the ancient Egyptians, Greeks, and Romans. By 500 BCE, Greek physician Herodicus had begun prescribing exercise to treat pain and disease. Later, Roman physician Galen purportedly used gymnastics to rehabilitate wounded soldiers.
By comparison, chiropractic – which comes from the Greek words cheir, meaning hand, and praktos, meaning done -- might seem to be the new kid on the block. The profession didn’t take shape in the United States until the late 19th and early 20th centuries; Daniel David Palmer administered the first chiropractic mobilization/manipulation in 1895. But some form of hands-on healing can be traced back to ancient times.
The long co-existence of physical therapy and chiropractic has been informed and sometimes made rather uneasy by the two professions’ occupation of some of the same territory on the healthcare landscape and their treatment of some of the same ailments with occasionally similar approaches. For prospective patients, this overlap can be confusing. Physical therapy is wholly non-invasive. So is chiropractic. Physical therapy is drug-free. So is chiropractic. Physical therapy can help patients avoid surgery. So can chiropractic. And both use some of the same methods, such as heat therapy and electrical stimulation. So, how exactly are these two licensed professions different? Which one can best help you, given your unique circumstances and condition?
It may surprise you to learn there are at least as many meaningful differences as similarities between physical therapy and chiro.
Physical therapy is more comprehensive
There are a handful of simple but significant distinctions between physical therapy and chiropractic. In contrast to chiropractors, who often require repeated maintenance visits, physical therapists strive to work themselves out of a job by
- empowering patients by showing them how to move and prescribing them customized home-exercise programs designed to help them heal and stay healed;
- training patients to care for themselves and, with graded exercise programs, help their brains sense the body’s problem areas without responding with danger messages;
- mobilizing as well as manipulating patients to effect healing through activity as well as hands-on treatments such as massage; and
- rehabilitating and retraining patients. Comprehensive rehabilitation is a major facet of physical therapy. A physical therapist may help a stroke patient or someone with a new prosthetic limb relearn how to walk, for example, or help someone recovering from surgery regain strength – things that are outside the scope of chiropractic.
A fifth difference between physical therapy and chiropractic is how you pay for treatment. Chiropractic is more often cash-based while PT, which often comes with a doctor’s referral, is more likely covered by insurance.
For all these reasons and more, many experts see physical therapy as more comprehensive than chiropractic. While chiropractors specialize in effecting quick and temporary relief from sciatica, headaches, sports and car-accident injuries, physical therapists specialize in facilitating recovery and improving mobility through methods that are slower but ultimately effect more sustainable progress by making patients active players in their own recovery.
And, just as you do with chiropractors, you have direct access to physical therapists, which is to say you can visit a physical therapist first after being injured without a physician’s prescription or referral – although doctors often prescribe physical therapy and physical therapists often treat patients in their hospital rooms.
How New York defines physical therapy
Physical therapists are experts in movement. We focus on the whole body and multiple systems – the nervous, musculoskeletal, cardiovascular, and vestibular. We help people improve their overall mobility, balance, and functional safety, instead of addressing joint misalignments only.
New York state law defines physical therapy as “the evaluation, treatment or prevention of disability, injury, disease, or other condition of health using physical, chemical, and mechanical means including … heat, cold, light, air, water, sound, electricity, massage, mobilization, and therapeutic exercise with or without assistive devices, and the performance of tests and measurements to assess pathophysiological, patho-mechanical, and developmental deficits of human systems to determine treatment and assist in diagnosis and prognosis.”
What can’t a physical therapist do? “[use] roentgen rays or radium or … electricity for surgical purposes such as cauterization...”
New York defines chiropractic as “...detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations [spinal misalignment] … for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column.”
The law goes on to state what a chiropractor cannot do:
“...use radio-therapy, fluoroscopy, or any form of ionizing radiation except x-ray which shall be used for the detection of structural imbalance, distortion, or subluxations...”
Physical Therapists and chiropractors have similar levels of education and must pass board exams to be licensed.
‘Everything a chiropractor can do and more’
This chart outlines some of the key differences between physical therapy and chiropractic.
| Physical Therapy | Chiropractic |
| Focus: bones, muscles, ligaments, tendons, joints | Focus: spine, joints, neck, nerves, and extremities |
| Goals: promote optimal functioning and pain- free movement | Goals: alleviate pain, promote healing through proper alignment in spine, neck, joints |
| Methods: stretching, strengthening, exercising to improve muscular imbalance, reduce pain, and increase range-of-motion; hands-on manipulation to reduce pain, promote healing, increase range-of-motion | Methods: spinal manipulation to promote natural healing of the body, reduce pain, increase range-of-motion |
| Settings: work in a variety of healthcare facilities and other places | Settings: often rely on the use of a specific table or tools to perform manipulations |
| Patient involvement: may devise a plan of care involving exercises to do at home | Patient involvement: may create a plan of care incorporating nutrition, sleep, lifestyle |
| Conditions treated: help patients recover from bone breaks, surgery, stroke, and various other conditions | Conditions treated: a variety; most effective with conditions relating to the neck, spine, and joints; less effective with broken bones |
| Visits: 30-60 minutes multiple times a week, decreasing as symptoms improve | Visits: 30 minutes or less weekly, bi-weekly, or monthly, depending on patient’s needs |
According to the website guidedoc.com, physical therapy "covers more aspects of the human body.”
“Physiotherapy is a comprehensive treatment that helps patients regain the abilities they had prior to injury. Physiotherapy may also reduce the amount of pain you’re in from various conditions that cause chronic pain. On the other hand, chiropractic care focuses on the nervous system, skeletal system, and the muscles in the body that enable movement. Unlike physiotherapy, chiropractic therapy is also centered around the spine, regardless of whether or not the patient has a back injury.... Physiotherapy ... focuses on a wide range of problems, from sports-related injuries to weakness caused by strokes.”
The website goes on to say, "Therapists who practice physiotherapy are trained to do many of the same things chiropractic therapists can do, including manipulating the spine and releasing painfully tight muscles.
“Since physiotherapy encompasses everything chiropractic therapy covers, you usually don’t need to go to a chiropractor. ... “[A] therapist who practices physiotherapy can do everything a chiropractor can and more.”
Who can benefit from physical therapy?
As licensed experts of movement, physical therapists use a number of techniques to help restore quality of life and quality of movement. The primary aim of physical therapy is to prevent injury, restore mobility and strength, and optimize daily performance.
Physical therapists can treat patients of any age, from newborn to end of life, though they may choose to specialize in a certain age group. Often, patients who seek physical therapy are recovering from injury or surgery or suffering from a medical condition or disease. However, some choose to work with a physical therapist to improve normal daily functioning, optimize movement for athletic performance, or prevent future injury.
Physical therapy is an effective treatment for back and neck pain, too. And it helps with vestibular disorders of the inner ear that affect balance and eye movement.
Bottom line: Physical therapy can improve quality of life and help patients recover from a wide array of conditions including:
- Autoimmune disorders such as diabetes, fibromyalgia, and rheumatoid arthritis
- Neurological conditions such as Alzheimer’s, MS, and Parkinson’s, and TBI’s
- Orthopedic conditions such as scoliosis, carpal tunnel syndrome, hip replacement rehab, and sciatica
- Acute or chronic injury such as sprains, fractures, concussions, and repetitive use injuries
- Back and neck pain, which responds well to manual therapy and individualized exercise programs designed to ease pain and stiffness, improve strength, increase range-of-motion, avert future pain and injuries; and expedite healing.
Supporting your recovery at Advanced Care Physical Therapy
At Advanced Care Physical Therapy we pride ourselves on our ability to support our patients with best-in-class, individualized care that works closely with their doctors and insurance providers to make the road to recovery as smooth as possible. Our team understands what it takes to help get you better and we strive to support you every step of the way. Our services range from cupping, Kinesio taping, Graston technique, aquatic therapy, cold laser therapy, pediatric care, sports rehabilitation, and more. Whether you’re recovering from an injury and working to improve your range of motion, we would love to help you optimize your recovery. Call us at 716-282-2888 or visit us online to set up an appointment with our expert staff today.
