Physical Therapy or Chiropractor? Who should I see for my new injury?
Getting injured, especially for the first time, is a terrifying experience. When we
unfortunately suffer a setback, it can be difficult to decide what to do. A quick google
search will tell you to see either a physical therapist or a chiropractor but…what is the
difference?
Both PTs and chiros fall under the same general umbrella of a treatment approach to
relieve pain and improve mobility. The main differences between a PT and a
chiropractor are in the way they achieve these goals.
Physical Therapy
A physical therapist, as defined by the American Physical Therapy Association (APTA), is a healthcare professional who “helps people improve their movement and physical function, manage pain, and other chronic conditions, and recover from and prevent injury and chronic diseases.” Following a thorough evaluation, a physical therapist will use a combination of manual techniques and exercise prescription to strengthen weak muscles, to improve movement patterns, to address balance impairments, and to help decrease the risk of future injuries.
Physical therapists hold doctoral-level degrees (DPT — Doctor of Physical Therapy) and are trained in evidence-based, individualized care. According to the APTA’s 2023 updated clinical practice guidelines, physical therapy is the recommended first-line treatment for many musculoskeletal conditions, including low back pain, neck pain, shoulder impingement, knee osteoarthritis, and post-surgical rehabilitation. PT focuses on long-term outcomes: restoring function, reducing recurrence, and empowering patients with the knowledge and tools to manage their own health.
Chiropractor
A chiropractor, as defined by the World Federation of Chiropractic (WFC), is a “health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system. There is an emphasis on manual treatments including spinal adjustments.” A certified chiropractor traditionally focuses more on joint manipulations and “adjustments” to offer short-term relief.
Chiropractors complete a Doctor of Chiropractic (DC) degree, which includes significant training in spinal anatomy, manual therapy, and musculoskeletal assessment. Chiropractic care is most commonly sought for low back pain, neck pain, and headaches. Research supports chiropractic spinal manipulation as one effective option for acute low back pain, often providing faster short-term relief. However, chiropractic care generally places less emphasis on therapeutic exercise, patient education, and long-term rehabilitation compared to physical therapy.
Which one should I see for my new injury?
There can be many benefits to seeing both physical therapists and chiropractors, and the right choice often depends on your specific goals, the nature of your injury, and how long your symptoms have been present. A chiropractor is a great option for someone looking for short-term symptomatic relief — particularly for acute spinal pain or headaches. A physical therapist is a great option for someone looking to address the root cause of their symptoms, recover from surgery or a complex injury, and become more independent in managing their health over the long run.
A 2022 systematic review published in the Journal of Orthopaedic & Sports Physical Therapy found that exercise-based physical therapy produced superior long-term outcomes for chronic low back pain compared to spinal manipulation alone. For post-surgical recovery, sports injuries, pelvic health conditions, neurological rehabilitation, and vestibular disorders, physical therapy is the gold-standard evidence-based approach.
It is also worth noting that many conditions benefit from a collaborative approach. PT and chiropractic care are not mutually exclusive — in fact, some patients see both providers at different stages of recovery. That said, if you are unsure where to start, the current clinical consensus is to begin with physical therapy for most musculoskeletal complaints, as PTs are trained to identify when referral to another provider is needed. Please reach out to us at Joint Ventures if you have any questions about who you should see for your injury — we would love to help!
Key Differences: Physical Therapy vs. Chiropractic Care
Understanding the practical differences can help you make an informed decision. Physical therapy emphasizes active, patient-driven rehabilitation through therapeutic exercise, movement re-education, manual therapy, dry needling, and modalities like ultrasound or electrical stimulation. PTs treat a wide range of conditions — from orthopedic injuries and sports medicine to pelvic health, vestibular disorders, neurological conditions, and post-surgical rehabilitation.
Chiropractic care centers primarily on passive treatments, particularly spinal manipulation and mobilization. While chiropractors also offer soft tissue work and some lifestyle counseling, the treatment focus tends to be narrower, with a primary emphasis on the spine and nervous system. Sessions are often shorter, and treatment plans may extend over longer periods for maintenance care.
When Physical Therapy Is the Right Choice
Physical therapy is generally the recommended first-line approach for a wide variety of conditions. Consider physical therapy if you are recovering from orthopedic surgery (such as ACL reconstruction, rotator cuff repair, or joint replacement), dealing with a sports injury, experiencing chronic pain that has not responded to other treatments, managing a neurological condition such as stroke or multiple sclerosis, struggling with pelvic floor dysfunction, experiencing dizziness or vertigo (vestibular conditions), or seeking to improve athletic performance and prevent future injuries. PT is also typically required or recommended by insurance as a prerequisite before certain surgical procedures.
Insurance Coverage and Access
Both physical therapy and chiropractic care are typically covered by health insurance, though coverage limits and requirements vary by plan. Most major commercial insurance plans, Medicare, and Medicaid cover physical therapy when it is medically necessary. Chiropractic care coverage has historically been more variable — some plans cover a limited number of chiropractic visits per year, while others require a referral or prior authorization. As of 2024, Medicare Part B covers chiropractic services only for manual manipulation of the spine to correct subluxation, whereas Medicare covers a broader range of physical therapy services. Always verify your benefits with your insurance provider before beginning care.
– Clark Berger, PT, DPT
