It’s almost second nature for therapists to become defensive when a client claims ‘Isn’t PT the same as chiropractic?’ But the reality is that these professions are both involved in the treatment of pain and injury. The difference is in their education, philosophy, and clinical expertise as they strive to help a client achieve recovery and pain-relief. More often than not, people resort to a tagline for description of medical professions. Chiropractors are all about spinal manipulation and keep you coming back for maintenance. Physical Therapists are all about exercise and emphasize independence and return to function. Yet this does little to truly differentiate the principles and methods employed by Chiropractors and Physical Therapists, since both professions share some similarities in the treatment methods employed. Hopefully, this comparison chart will give some clarification to what is the difference between these two healing professions.
Comparison chart
| Chiropractor | Physical Therapist | |
|---|---|---|
| Residency and Internship | One-year internship that coincides with clinical courses while in training. NO Residency required, but have the option to complete if accepted and desire to. | All curriculums are required to have a minimum of 30 weeks of full time internship. Residencies exist in all specialties, certified by: American Board of Physical Therapy Residency and Fellowship Education |
| Practice | Private practice clinics, generally. However, some are employed by health systems and hospitals. Generalist practice, neurology related, orthopedic related, and general alignment restoration dealing with the skeletal system. | Acute care, Inpatient/Outpatient Neurologic Rehab, General Outpatient, Orthopedic, Geriatrics, Pediatrics, Veterans Affairs, Military, Sports Medicine, Women’s & Men’s Health, Wound Care, Work Rehab, Electrophysiology, etc. |
| Prescribes medication | No. New Mexico recently allowed limited prescription rights to DCs | Unless in the Military, PT’s do not prescribe medications. However, all PT’s are tested on pharmacology. |
| Medical Licensing Exam | National Board Exam (NBCE). Parts I, II, III IV (practical) and state boards. | The National Physical Therapy Exam (NPTE) administered by the Federation of State Boards. |
| Years of medical school | 3-4 undergraduate years (Bachelor’s required / state dependent), 2-4 Chiropractic school, 1 year residency, minimum 6-7 years | Doctor of Physical Therapy = 3 academic years. All accredited Physical Therapy programs require a Bachelor’s Degree. (total education time 7yrs). There are 213 PT programs in the US. |
| Treatment Techniques | Chiropractic adjustment (grade I-V) ranging from soft tissue mobilization to joint adjustment. Use of therapeutic modalities and exercise is a common adjunct to spinal manipulation and massage. | All manual therapy techniques including joint manipulation, soft-tissue mobilization. All therapeutic modalities, neurologic rehabilitation, sports performance, gait training, muscle coordination & performance, wound care, , massage, cardiovascular rehab, etc. |
| Status | DC stands for Doctor of Chiropractic. They are not medical doctors, however for insurance purposes some states consider chiropractors health care providers. | DPT stands for Doctor of Physical Therapy. They are not medical doctors and cannot prescribe medication. PTs are also considered specialty practitioners by the insurance industry. |
| General Expertise | DCs have evidence to support their expertise in the adjustment of the spine. Their knowledge extends into the scope of Physical Therapy and general Medicine as well as radiology and neurology. | PT’s have evidence to support their expertise in human movement and restoration of all movement related dysfunctions. Their knowledge extends into the scope of Chiropractic and general Medicine. |
| Surgery | Minor surgery in some states. DCs are non-pharmacologic and non-surgical clinicians who are experts at conservative treatments within their scope of practice. However, do perform MUA in surgical setting. | Wound Care: A PT is limited to debridement of tissue and does not perform surgery. PT’s are movement scientists and non-pharmacologic, non-surgical experts who use conservative treatments within their scope of practice. |
| Specialties | Orthopedics, Pediatrics, General Rehab, Internal Disorders, Radiology, Neurology, Nutrition, Occupational Health, Sports Med, Forensic Sciences. | Orthopedics (Generalist Practice), Sports Medicine (Generalist & Sports related), Pediatrics, Geriatrics, Women’s Health, Neurology (SCI, TBI, MS, ALS, CP, Parkinson’s, etc), Cardiovascular & Pulmonary (COPD, CHF, etc), Clinical Electrophysiology. |
| Diagnosis | DCs diagnose joint subluxation complexes, and most medical conditions, depending on state law. Treatment of many acute non spinal or traumatic conditions may require referral of the patient to the correct specialty practitioner. | PT’s diagnose movement, musculoskeletal, and functional related conditions within their scope of practice. Like DC’s, they do not diagnose medical conditions, but have the education and training to recognize and refer to the correct practitioner. |
| Differences between formal education | 5,200 instructional hours. 3-4 years of undergraduate required for admission into DC school. Programs may vary. Not required to have a Bachelor’s degree prior to admission. Total time in school = 6-8 years depending on undergraduate course work. | > 3,500 instructional hours. The Mayo Clinic’s DPT program has about 5,000 instructional hours, thus programs do vary. All PT’s have a Bachelor’s degree prior to obtaining their clinical doctorate. Total time in school = 7 years with undergrad. |
| For more information | Chiropractors are organized by the American Chiropractic Association (ACA). www.acatoday.org. All information above was taken from this website. | Physical Therapists are organized by the American Physical Therapy Association (APTA). www.apta.org. All information above was taken from this website and various program websites, such as the Mayo Clinic’s. |
| Board Certification | National exam, Chiropractic Board at the State level and Diplomat specialty boards. | Federation of State Boards of Physical Therapy (FSBPT) for all US states. Commission on Accreditation in Physical Therapy Education (CAPTE), division of the US Department of Education, accredits the academic programs. |
Thanks, Keith! This is very helpful!
Very helpful, exactly what I needed to know!
Thank you! Very helpful!
Years of Medical School note: BS is not required for Chiropractic school, GPA 2.5 (C+)average. PT requires BS to apply to PT school (minimal 3.0 GPA). Physical Therapist do Manipulation (WA,Arkansas have some limitations). Most research that has been on manipulation and producing practice guidelines on when manipulation is needed has been done by DPT in the research side of the training (Research that is not required by Chiropractic school).
Very helpful side-by-side, especially in helping to distinguish the overlap between PTs and DCs.
Hello,
Great post! Thanks you so much for the share. It is indeed a helpful one. I am looking forward of reading more article with the similar topic as this one. Good luck and More Power.
Thank you Keith… this is awesome. I was torn between visiting my chiropractor and physical therapy, after a recent THR.
My chiropractor felt that he could assist me in returning to normal range of motion, but, after your article and speaking with the Nurse Mgr. for the insurance company… they too are recommending PT.
Glad you found this information useful. Best wishes for a quick recovery
Very helpful information. Now I can have a good conversation with people who think chiropractors are the way to get you back to being fit. I know I have had Keith get me back to being pain free through manipulation, dry needling and red cord. First time I went for a shoulder injury and the next time sciatica ! Keith, you are the best!!! Thanks for this helpful
Information !!
Thank you, indeed very helpful info.
I just wonder why alot of insurances will pay for PT but not for Chiro. ????