Physical Therapist vs. Chiropractor: Which Should You See?
How the training, methods and evidence compare
Updated October 20263 minute read
Both are licensed, doctoral-level providers who treat back and neck pain. Chiropractors center care on spinal manipulation. Physical therapists center care on exercise and movement and treat a wider range of problems, including joint injuries and post-surgical rehab. For low back pain, guidelines support both exercise and manipulation.
RightPT is a physical therapy marketplace, so weigh this comparison with that in mind. We've kept it to what the sources at the end of the page say.
How do physical therapists and chiropractors differ?
| Physical therapist | Chiropractor | |
|---|---|---|
| Degree | Doctor of Physical Therapy (DPT), typically 3 years | Doctor of Chiropractic (DC), typically 4 years |
| License | Required in every state | Required in every state |
| Main method | Exercise, movement retraining, hands-on therapy | Spinal and joint manipulation (adjustments) |
| Commonly seen for | Back and neck pain, joint and sports injuries, post-surgical rehab, balance, pelvic health | Low back pain, neck pain, headaches |
| Between visits | A home exercise program is central | Mostly in-office adjustments; many also give exercise and lifestyle advice |
What does each one do?
Chiropractors assess and treat the spine and musculoskeletal system, mainly through manipulation. Many also use heat or ice, exercise advice and lifestyle counseling.
Physical therapists evaluate how you move, then use exercise, stretching, hands-on therapy and education to reduce pain and restore function. Their scope is wider: knees, shoulders and hips, recovery after surgery, neurological conditions, and more.
What does the evidence say for back and neck pain?
- Low back pain. The American College of Physicians recommends non-drug treatment first. Its guideline lists spinal manipulation among the options for both acute and chronic low back pain, and exercise among the first-line options for chronic low back pain. The physical therapy guideline for low back pain recommends exercise, with manual therapy and education alongside it.
- How much manipulation helps. The National Center for Complementary and Integrative Health describes the benefit for acute low back pain as a modest improvement in pain and function. For chronic low back pain, results are similar to other recommended treatments.
- Neck pain. Manipulation may help, but the evidence is more limited and of lower quality.
In short, both approaches have support for low back pain, and neither is a cure-all.
Which fits your problem?
A physical therapist is usually the better fit if:
- The problem is a knee, shoulder, hip, ankle, or other joint
- You're recovering from surgery or a sports injury
- The pain keeps returning and you want to build strength to prevent it
- Pain travels down an arm or leg
- You want a plan you can carry on yourself
A chiropractor may suit you if:
- You have a recent, uncomplicated low back flare-up
- Manipulation has helped you before
- You want short-term relief while you stay active
What should I ask either provider?
- What do you think is causing this?
- How many visits do you expect, and what will it cost in total?
- What will I do between visits?
- When will we reassess if I'm not improving?
Be cautious of any provider who recommends frequent visits with no end date, asks you to prepay for a long package before an evaluation, or insists on imaging without a specific reason.
When should I see a physician first?
Loss of bladder or bowel control, numbness in the groin, leg weakness that is getting worse, back pain with fever or unexplained weight loss, or pain after a serious fall or accident needs prompt medical attention before either option.
If physical therapy sounds like the right fit, see how to choose a physical therapist.
Frequently asked questions
Sources (6)
- Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017. — PubMed
- Spinal Manipulation: What You Need To Know. National Center for Complementary and Integrative Health. — NCCIH
- George SZ, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021. — PubMed
- Chiropractic. MedlinePlus, National Library of Medicine. — MedlinePlus
- Chiropractors. Occupational Outlook Handbook, U.S. Bureau of Labor Statistics. — U.S. Bureau of Labor Statistics
- Physical Therapists. Occupational Outlook Handbook, U.S. Bureau of Labor Statistics. — U.S. Bureau of Labor Statistics
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.