There is no question that there are a record number of patients going to see specialists for treating problems with the musculoskeletal system.
According to an article published in the July 2011 issue of Physical Therapy, the official journal for the American Physical Therapy Association (APTA), 9 million adults spent a total of $13.5 billion for 88 million outpatient physical therapy visits just in 2007.1 Furthermore, an estimated average of $130 was spent per visit for 2007, with an average number of 9.6 visits for that year. In comparison, more than 20 million adults and children sought out chiropractic or osteopathic care, according to the 2007 National Health Survey (NHS).2 The survey also found that Americans spent $3.9 billion on out-of-pocket expenses in that same year.
With all of this money being spent on both physical therapy and chiropractic care, many patients may be confused about the difference between the two disciplines. On the surface, it may seem as though both are concerned with the musculoskeletal system, but there may not be much contrast beyond that. However, while the two disciplines do overlap in many regards, there are some important differences.
According to the APTA, physical therapy is concerned with diagnosing and treating any type of movement impairment or disorder. As part of this, physical therapists will use passive and active stretching, ice, heat, massage, resistance training, and home exercises for patients. Physical therapy may be undertaken in order to regain lost mobility after an illness or injury, as part of a regular care routine (such as for athletes), or to prevent further movement impairment.3
Physical therapists can work in a variety of settings, ranging from hospitals, to fitness clubs, to nursing homes. In most cases, their services are covered by insurance or Medicare. However, physical therapy usually requires a referral from a primary care physician.3
Perhaps the biggest difference between physical therapy and chiropractic is in terms of how each approaches treating movement disorders. While physical therapists and chiropractors are both concerned with the muscles, tendons, joints, and ligaments, chiropractors are also concerned with how misalignments of the spine may affect the entire body. Specifically, chiropractic works to correct sublaxations, which may impede proper nerve signals and lead to a whole host of other medical issues.4 Furthermore, while both physical therapists and chiropractors may use their hands to manipulate parts of the musculoskeletal system, chiropractic is unique in terms of its use of adjusting instruments in order to correct for sublaxations.
Although some chiropractors may work in a hospital or group practice setting under a primary care physician, many DCs have their own individual practices, so they do not require a referral. While some insurance plans do pay for a limited number of chiropractic visits, there are several that do not. Therefore, chiropractic care is often an out-of-pocket expense for patients.4
1 Chevan J, Machlin SR, Yu WW, Zodet MW. Determinants of utilization and expenditures for episodes of ambulatory physical therapy among adults. Physical Therapy. 2011:91(7);1018–1029.
2 National Center for Complementary and Integrative Health. “Chiropractic: An Introduction.” National Institutes of Health, U.S. Department of Health & Human Services. https://nccih.nih.gov/health/chiropractic/introduction.htm#hed3. Published November 2007. Updated February 2012. Accessed February 2015.
3 American Physical Therapy Association. “Role of a Physical Therapist.” APTA.org. http://www.apta.org/PTCareers/RoleofaPT/. Updated February 2015. Accessed February 2015.
4 American Chiropractic Association. “Frequently Asked Questions.” ACAToday.org. http://www.acatoday.org/level3_css.cfm?T1ID=13&T2ID=61&T3ID=152. Accessed February 2015.