In recent years, many have become more informed on the benefits of undergoing physical therapy to decrease joint pain, improve muscular health, or treat work-related or sports injuries, providing an alternative or complementary solution to medications or more invasive medical treatments like surgery. However, with the presence of many therapy fields, it is difficult to know who to go to when you have an injury or back pain.
When it comes to resolving conditions pertaining to musculoskeletal (muscle and bone) injury and restore normal function and mobility, two disciplines often come to mind – chiropractic care and physiotherapy (also known as physical therapy). Which of these two professionals should patients choose, what are the differences between the two, and which treatment approach works better?
Similarities of Chiropractic and Physiotherapy
First, let’s discuss the similarities between a chiropractor and a physiotherapist in terms of how they treat conditions and decrease pain through their different treatment focus and techniques.
Both chiropractors and physiotherapists have the ultimate goal of reducing or eliminating musculoskeletal pain through non-invasive physical therapy, and to decrease stiffness and improve mobility or ease of movement in patients. Their hands-on approach uses the manipulation of tissues in your body to help your body recover and restore its function, and they may often help treat the same medical conditions such as neck, back, or knee pain.
Both chiropractic care and physiotherapy have a similar workflow. Their typical session starts with conducting a subjective assessment by taking your health history which may encompass pain symptoms, injury history or chronic diseases if any, then performing an objective assessment of your body’s current status such as range of motion and pain pattern, after which they will formulate a suitable intervention and evaluate their treatment approach after. They may also use other treatment modalities, or recommend an interdisciplinary approach with other healthcare professionals to help with your long term recovery.
So what are the differences between a Chiropractor and a Physiotherapist?
According to the World Health Organization’s (WHO) definition, chiropractic is “a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system, and the effects of these disorders on general health”.
Pain relief and correcting the misalignment of the spine is a chiropractor’s main objective, and their treatment emphasis focuses on manual techniques on the body, such as joint adjustments. The basis of a chiropractor’s approach is to restore health through the manipulation of the musculoskeletal system, specifically the spine, so as to alleviate stresses on other parts of the system or the nervous system. This technique is what patients often refer to as “cracking” of the spine or other joints, with the aim of correcting the body structure and hence treat patient symptoms by release pressure and pain.
The treatment process of a chiropractor is deemed more passive, as they believe that after they restore your body back to optimal condition, it will allow your body to work its magic and get better gradually.
The conditions targeted are mainly on musculoskeletal conditions, with some aiming to improve organ health with adjustments on the joints and body structure as well
On the other hand for physiotherapists, WHO’s definition is that they “assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases, and other impairments”.
Physiotherapists use joint mobilization and soft tissue release for pain relief and range restoration, then recommend stretches and exercises to help patients actively maintain their improved status. Their main objective is for pain-free movement and focuses on how patients perform many movements and function as a whole. To help optimize one’s recovery or sports performance, a patient needs to be active and compliant in their treatment journey, strengthening specific muscles and being aware of their posture, all of which will be guided by their physiotherapists.
A physiotherapist’s treatment process is deemed more active. After receiving manual therapy, patients are expected to adapt with prescribed exercises to promote better movements and maintain this newly restored system. With the education and reinforcement of better movement patterns during physiotherapy, our body can then learn to use the correct muscles to move more efficiently and effectively. This will reduce the risk of recurring injuries or return of symptoms and allow us to carry out our daily functions better or perform better at our sports.
On top of musculoskeletal conditions, physiotherapists are also equipped to deal with other conditions like cardiac disease, spinal cord injuries, stroke or even brain injury, depending on their chosen specialization and training.
Is a Chiropractor or Physiotherapist better?
To put it simply, both chiropractors and musculoskeletal physiotherapists focus on injury pain treatment and improve mobility using non-invasive, hands-on techniques. The main difference is that chiropractors use manipulation and joint adjustments, stemming from the spine, to help your body heal itself and focuses on the musculoskeletal and the nervous system, whereas physiotherapists will also prescribe exercises and stretches to help you actively improve your movement by restoring mobility and proper movements.
One is not better than the other, they simply cultivate different treatment methods based on different beliefs of how our body heals, and as with many other therapists of different expertise, they may work together and use their specialized techniques on patients for greater long term treatment outcomes. Other than knowing the difference between the two, it may be useful to find out what condition or techniques your therapist specialize in to make sure he or she is a better fit for your specific need and goals.
Specializations of a Physiotherapist
What many people don’t know about physiotherapy is that there are several medical specialties that a therapist can choose to focus on and hone their skills in. Other than the better known musculoskeletal specialty, other specialties are in sports, cardiopulmonary (heart and lung) like in post-heart surgery, neurological (brain and nervous system) like in post-stroke rehabilitation, and geriatric (senior population). Exercising under careful supervision is crucial to safely rehabilitate after such major health episodes.
For example, your exercise intensity may be limited by poor heart health that may be dangerous if not monitored cautiously. A cardio-pulmonary trained physiotherapist will monitor your parameters while you exert at a challenging but manageable threshold, which means you can improve at a good pace without putting yourself in danger.
You may also be a high-level athlete who needs to learn how to transition from just being pain-free to excelling in your sport. After the initial manual therapy and pain management by a musculoskeletal trained therapist, an exercise physiologist can prescribe a specific exercise routine that allows you to carry forward the initial muscle strengthening gains to sport-specific tasks, also analyzing and evaluating your biomechanics and physiological capability.
Lastly, it is also better for a post-stroke patient to have a neuro-trained physiotherapist that understands that his therapy journey needs to be different from someone else with the same injury, taking into account the cognitive and neuromuscular deficits that may have occurred.
These are scenarios that could be less than optimal if your sessions are not carefully planned and monitored by a skilled therapist or a multidisciplinary team.
Physiotherapy at Rehab Paradigm
In Rehab Paradigm, we have highly skilled and experienced therapists covering these medical fields, who work with like-minded expert partners to co-manage patients. We have an exercise physiologist in our team for advanced training back to function or sports performance, and occupational therapists to help you with gross and fine motor skills and in assessing your daily environment. To value-add our patient’s recovery, we also communicate with multi-disciplinary associates like doctors and dieticians when needed, to ensure a holistic treatment plan, and also use research-backed treatment modalities such as shockwave therapy and dry needling.
We believe that the many treatment approaches, expertise, and modalities, need to be individualized to patients, depending on their goals or the complexity of their condition.