Physical Therapist or Chiropractor?This is a very common question and to those who are unaware of the difference, it can seem confusing. Chiropractors focus on the holistic aspect, which is to say that they look at the entire body when a person is having pain, is injured, or has some other issue. They are experts in the entire musculoskeletal system and know that muscles, tendons, joints, nerves, and the spine are all interconnected. Many injuries involve more than just one tissue or one area. For example, a sprained back has injured muscles that will need time to heal and should undergo physical rehabilitation to strengthen the muscles once they have improved. The muscles could also have pulled the spine out of alignment, causing low back pain or shoulder pain as well. This would require the chiropractor to perform adjustments so the vertebra would be aligned once more. It is not uncommon for physical therapy and chiropractic care to work together, since they go hand in hand when it comes to healing, aligning, and strengthening the body. Does physical therapy actually work? When you work together with your therapist, it absolutely does!
It Is What It Is Until It Isn’tWe want to help clear up some of the confusion while offering some insights into what physical therapy entails and what it does not.
- Physical Therapists Work in a Variety of Settings You might only think of physical therapy as something that is done in an outpatient clinic or in a certain portion of a hospital, but therapists work in a wide variety of settings, including nursing homes, neurorehabilitation centers, cancer centers, home health agencies, chiropractors, schools, private practice, even in hospital emergency rooms.
- You Need a License to do Physical Therapy It’s interesting to note that an APTA survey in 2016 found that only about 42 percent of people polled knew that physical therapy needed to be performed by a licensed physical therapist. Almost as many people thought that any health care professional could perform PT.
- You Don’t Need a Doctor’s Referral All 50 states now allow patients to seek treatment either from a chiropractor or a physical therapist without a referral from a physician. Can a chiropractor refer to physical therapy? Yes, they can, but it isn’t really necessary. If your chiropractor doesn’t have one on staff, you can go to see one without a referral, but chances are that your chiropractor has an excellent recommendation for an outstanding PT in your area.
- Is No Pain No Gain True? This is a tricky question. Is physical therapy painful? Sometimes, yes, it is. An old joke says that PT actually stands for “pain and torture.” While it’s true that sometimes, rehabilitation exercises can hurt because the muscles are injured and weak, the fact is that by doing PT, pain will slowly subside, something that probably won’t happen if you don’t follow the therapist’s directions.
- It’s Not Just for Post-Operatives When it comes to things like knee replacements or back surgery, physical therapy is always prescribed, so it’s no wonder that most people think of PT as being something one only needs after surgery. However, PT is also terrific for helping people avoid surgery to begin with! In fact, for many musculoskeletal problems, some studies have found that PT exercises are more effective than surgery for certain conditions.
- Prevention Beats Rehabilitation The old saying that an ounce of prevention is worth a pound of cure is certainly true when it comes to PT. You don’t have to wait until after surgery, you don’t even have to wait until the pain is so unbearable that you can’t deal with it. When you seek help from your chiropractor and start receiving physical rehabilitation early, you can keep minor pain from becoming a major problem.
- They Can Help with Vertigo Positional vertigo, when you feel dizzy moving into certain positions or when tilting your head to one side or the other, is very common. Most people never consider seeing their chiropractor or physical rehabilitation therapist for this issue, but they can truly help, often times in just one or two visits.
- Physical Rehabilitation Isn’t Magic Your physical rehabilitation therapist cannot wave a magic wand and make all your pain and problems disappear, you need to do at least some of the work and your body should do the rest. Physical therapy works best when you follow the treatment plan set up by your chiropractor and therapist.
- They Don’t Do Spa Massage If your physical rehab therapist advises you that they are going to massage a muscle, don’t expect a Zen experience. To reduce tightness in an area that you are working on, your rehab therapist will genuinely work that one (or set of) muscles to loosen it so you can work it more actively. If the therapist or chiropractor feels that a chiropractic massage would be helpful, they will send you for one, but don’t expect a candle and an orange oil massage from your rehabilitation therapist.
- They Don’t Offer Medical Advice You shouldn’t ask your rehabilitation therapist whether you should take a certain medicine or herbal supplement, you shouldn’t ask them if they could “look at something” for you that isn’t related to physical therapy (a skin rash for example). They will certainly suggest that you see the appropriate health care professional, but don’t expect them to make health care decisions for you or to give you a diagnosis on anything other than your therapy.
- Yes, They Expect You to Do More at Home Very much in the same way that your teacher expected you to do reading or homework, your therapist will expect you to do exercises or other therapies (soaking in a hot bath, for example) once you go home. Yes, they very much expect you to do this. When you don’t do your end of the treatment plan, your therapist becomes frustrated and you are left wondering why your PT didn’t seem to work as well or as quickly as expected. Be a partner and do your share.
- They Aren’t a Personal Trainer When it comes to getting fit and improving your overall physical condition, personal trainers are valuable parts of a fitness or sports team. Your physical therapist is NOT your personal trainer. While they might try to motivate you with words of positive encouragement, they sometimes need to push you to work a bit harder. Like your chiropractor, your rehabilitation therapist has spent years of schooling and worked hard to earn and keep their professional license to practice. Don’t expect them to be your personal trainer. If you are seeking advice regarding modifying workouts to suit your injury or to enable you to exercise because of a health condition, you can speak to your chiropractor about that issue.
Tips for Talking to Your TherapistNo one likes an awkward silence, especially when you are huffing and puffing or groaning while trying to perform certain exercises. Chances are that you will have some time to chat with your rehab therapist and we bet you find lots to talk about. However, there are a few things that should probably not mention or say to your physical therapist, such as:
- Your job is easy, all you do is order people to do stuff (absolutely not true)
- This exercise is really easy (if you want to work a lot harder, try this line just once)
- On the pain scale, this exercise is like 12! (You would be in the emergency room if this were true. Don’t exaggerate)
- When do I get a rub down? (If necessary, your therapist will provide a specific massage, not a rub down, which sounds more like a scene from Rocky)
- This isn’t (or you aren’t) helping me (try to be specific, such as “This doesn’t appear to be effective, am I doing something wrong?”)
- Don’t bring up religion
- Never discuss politics
- I can’t do this (you can)
- I’m ready to go home now (they will find one more thing for you to do)
- Never lose count! They make you start over!
- Don’t lie about pain levels or whether you did your homework (they will know)
About the Author
Dr. Brent Wells, D.C. founded Better Health Chiropractic & Physical Rehab and has been a chiropractor for over 20 years. His practice has treated thousands of patients from different health problems using services designed to help give long-lasting relief.
Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe, Organic Facts, and Thrive Global. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.