Should You See a Chiropractor or a Physical Therapist for Neck and Back Pain?
Physical therapists often hear: “I’ve been seeing a chiropractor for a while. Should I keep going?” This question usually comes from clients with lingering neck or low back pain that hasn't fully resolved.
Both chiropractors and physical therapists have been around for a long time, but what's the difference when it comes to treating neck and back pain?
Training and Treatment Approaches
Physical therapists undergo extensive training to evaluate, treat, and rehabilitate various conditions. In fact, in an outpatient orthopedic clinic, over 40% of a PT’s caseload involves low back pain, closely followed by neck pain.
Chiropractors, while also extensively trained, focus more on spinal adjustments and passive therapies. This isn’t necessarily wrong, but it often treats the symptoms without addressing the root cause for long-term relief. Typically, chiropractic care involves adjustments, a couple of basic exercises, and follow-up visits until symptoms improve or patients tire of the routine.
Physical therapists, on the other hand, use many similar manual techniques (called mobilizations) but are more conservative in their application. Research shows that adjustments alone have limited long-term effects, making a structured rehabilitation program essential.
So, What’s the Real Difference?
An honest chiropractor will admit that adjustments temporarily relieve pain by breaking the pain-spasm-pain cycle. Similarly, a physical therapist will tell you that adjustments have their place but must be paired with a solid rehab program.
While chiropractic programs include some rehab training, physical therapists generally have more extensive education in exercise prescription. PTs fine-tune their skills during clinical experiences, where exercise becomes their "bread and butter." By contrast, manipulations are the chiropractor’s main tool.
That said, there are chiropractors who excel at prescribing effective rehab programs, just as there are physical therapists with great manual therapy skills. The key difference is that PTs are typically more focused on long-term solutions through exercise and rehabilitation.
Why Choose One Over the Other?
If a chiropractor excels at adjustments and a PT at exercise prescription, why pick one? Recent health research shows that belief in a therapy's effectiveness plays a huge role in recovery. If you believe chiropractic care will work for you, it probably will. If you have more confidence in physical therapy, the same applies.
The truth is, Western medicine has moved past the idea of professionals working in silos. What's most important is the patient in front of us, not our profession’s pride or profit margins.
Whether it’s a physical therapist treating acute low back pain or a chiropractor addressing cervical radiculopathy, what matters most is that the patient trusts their provider. Collaboration between chiropractors and PTs can further enhance outcomes for patients who want to benefit from both forms of care.
The Power of Exercise in Pain Relief
Exercise is proven to benefit all types of pain and dysfunction, especially neck and low back pain, which are the two main reasons people seek chiropractic care. Clinical practice guidelines consistently show high levels of evidence supporting exercise as the most effective treatment. Manual therapies, like adjustments, show only moderate quality evidence in comparison.
It’s important to note that these findings don’t just apply to chiropractic techniques but to any manual therapy, whether performed by a massage therapist, PT, or alternative practitioner. Across the board, exercise and education remain the most powerful tools for recovery.
The ALTR Performance Approach
At ALTR Performance & Physical Therapy, we’re confident in our manual therapy skills, but even more so in our exercise prescriptions and education. However, we won’t perform cervical manipulations due to the risks involved. Thoracic and lumbar mobilizations will be used when appropriate, but not everyone needs them.
We don’t discourage you from seeing a chiropractor or any other healthcare professional. In fact, we believe physical therapy is ideally positioned in modern healthcare as a primary care provider for musculoskeletal issues. If you do see another provider, we encourage collaboration to ensure you get the best results possible.
So, What Should You Do?
If you’re experiencing neck, back, or joint pain, get it checked out! If you trust a physical therapist, start there. If you prefer a chiropractor, that’s a fine starting point too. Chances are, both approaches could help, and they should be working together, not in competition.
At ALTR Performance, we keep an open door to chiropractors, massage therapists, and other alternative practitioners willing to collaborate for the benefit of our shared clients. After all, if we’re not doing this for you, then who are we doing it for?
Book a free 15-minute consultation today and learn how physical therapy can complement other treatments to get you back to your best self.