The difference between a chiropractor and a physiotherapist

What’s the difference between a chiropractor and a physiotherapist is a question that is often asked. There is a lot of confusion between an osteopath, physiotherapist and chiropractor in terms of what each health professional does, what differentiates one from the other and which type of treatment may be most beneficial for specific individual situations. Generally speaking, if someone has a tooth problem they see a dentist, a heart problem a cardiologist and yet if you have a back problem who do you see? Should you go see a chiropractor or a physiotherapist or an osteopath?

The stereotypical physiotherapist

When considering the way an osteopath, a chiropractor and a physiotherapist approach treatment, there is a lot of variation in how all three practice, but then there is also a lot of variation within the physiotherapy profession itself regarding the practice methods. Stereotypically, the overall belief around what’s the difference between a chiropractor and a physiotherapist is that the use of soft tissue techniques is generally associated with a physiotherapist, whereas chiropractors prefer to treat primarily with spinal adjustments and an osteopath stands somewhere as they have a more holistic approach to treatment.

But stereotypes are exactly and only that – stereotypes. All three professions find this generalization to be offensive. Chiropractors are trained to use soft tissue techniques just as physiotherapists are trained in chiropractic adjustments (i.e. spinal manipulation), and no osteopath wishes to be pigeonholed in between the other two professions.

There are no two same physiotherapists

What this generalization fails to address is that every individual patient and every individual complaint they have needs to be treated as such. And just as no two physiotherapists are the same, no two physiotherapy sessions carried out by one practitioner are likely to be the same despite patients potentially having very similar health complaints. All three professions are in the business of musculoskeletal care and skillfully assess, diagnose and treat with the intention to relieve and prevent as appropriate mechanical disorders of the musculoskeletal system. Each practitioner carries similar yet slightly different skill sets with them and takes these skill sets into every patient session they manage. Using to the best of their ability their knowledge and experience to provide what they believe will be the most appropriate, safe and beneficial treatment approach possible for that patient’s individual situation. The treatments used will vary at times slightly and other times greatly from one physiotherapist to the next and one profession to the other.

Is a physiotherapist’s place to comment on what a chiropractor or osteopath does or doesn’t do?

It is not up to us to comment on what chiropractors or osteopaths may or may not do, just as it isn’t our place to generalize and comment on what other treatment modalities and techniques another physiotherapist may use. Each individual practitioner has their own style of practice that works for them, methods that over the years they may have found achieves them the best results. 

Conversely, countless times we have had patients questioning if we were chiropractors because we included some manipulation techniques similar to what they had previously experienced during a chiropractic consultation. Typically, we simply reply “no, we are physiotherapists who use manipulative techniques when we feel they are warranted and likely to be beneficial” which almost always leads to them asking the obvious question “what’s the difference between a chiropractor and a physiotherapist?” There is no straightforward answer to that question, or at least not one that we are aware of.

The myth of physiotherapists only treating locally

Some chiropractors and osteopaths consider that physiotherapists tend to focus exclusively on treating the local area of injury only, providing treatment at the site of the patient’s complaint or injury disregarding the rest of the body’s potential relevance. We believe this is not the case, as any complaint seen by a physiotherapist should receive a full assessment, examining all related areas and the biomechanics of how the body moves to determine what the injury in order to ascertain why the injury occurred, what needs to be done to settle the health complaint and what strategies should be implemented to correct and prevent any recurrence.

Physiotherapists are trained to look at potential causative factors for any complaint such as any appropriate sporting or activity technique, including active and stationary postures, neuromuscular control, etc. Physiotherapists are also trained to address these areas to prevent the recurrence of the injury or prevent an injury from occurring in the first instance. Any physiotherapy treatment session will take into consideration the assessment findings, their clinical reasoning and how the physiotherapist has prioritized their assessment findings. As a result, the treatment session may include the application of treatment to local and referral areas and any causative factors deemed relevant.

Physiotherapists encourage patient independence and self-management

A large part of a physiotherapy treatment approach is focused on getting the patient actively involved in their treatment. Physiotherapists should encourage the patient to become independent, emphasizing patient self-empowerment over their health complaints. Patient understanding of their issue and any appropriate self-management strategies towards both managing the complaint and preventing recurrence are an important part of a physiotherapist’s mindset. From a business point of view, it doesn’t make a lot of sense, but physiotherapists are schooled to want to get you better, as such you don’t have to keep coming back week after week, or month after month. Although practice styles may vary between individual physiotherapists, the big focus is typically always on achieving self-management and patient independence. This way, in the future, the patient won’t have to always rely on the therapist for relief and pain or injury management.

Physiotherapy is closely linked to a wider medical community

Physiotherapists place a huge emphasis on evidence-based practice and are more closely associated with the rest of the medical community as a whole than chiropractors or osteopaths. When selecting your practitioner or your chosen provider of musculoskeletal therapy it is best to talk to that specific health professional and see if you are comfortable with them and their treatment approach. It is only normal patients will have preferences and beliefs that lean them towards one approach over another. Through personal experience or exposure, patients may have found that particular conditions they are experiencing respond more favourably to one method of approach than another. Not everyone will respond to the same approach regardless of the conditions being fundamentally similar, so what works for one may not work for another.

We would suggest if you are not “responding” to the current treatment approach and are not offered a clear understanding of why this is the case that you should change your therapist. If you still want to know “what’s the difference between a chiropractor and a physiotherapist”, the truth is that we all treat similar conditions and though our methods do vary quite a lot from one profession to another, methods also vary just the same within the profession between practitioners of the same field. 

What is important to remember is you needn’t fear we may be insulted if you change your therapist. It is a patient’s right to have total control over the selection of their chosen health professional and their approach to treatment. We are sure that we are not speaking for ourselves alone when we say that all we want is for you to achieve the goals you had in mind when you approached us for help.