If you’re someone who’s been to both a chiropractor and a physical therapist, then you may have noticed some tension between the two professions. Some may even say that there is an ongoing rivalry between these two groups of healthcare professionals.
So why exactly do physical therapists hate chiropractors? Is it all just hearsay or is there actually some truth behind it?
“To understand this issue better, we need to first look at the history and differences between chiropractic care and physical therapy.”
In recent years, there has been a growing debate among patients over which form of treatment is best for dealing with chronic pain and musculoskeletal conditions. While both chiropractors and physical therapists share similar goals in helping their patients achieve optimal health, they tend to use different methods and philosophies when treating various issues.
Some believe that physical therapists view chiropractors as having limited knowledge in terms of anatomy and physiology. In contrast, chiropractors may perceive physical therapists as being too reliant on drugs and surgery rather than focusing on holistic approaches such as adjustments and spinal manipulations.
But is this really the whole story? Or are there deeper underlying factors fueling this perceived animosity between these two professions?
“In this blog post, we’ll delve into the shocking truth behind why physical therapists seem to harbor animosity against chiropractors and what can be done to address this divide.”
The Battle for Patients
Physical therapists and chiropractors both serve a similar purpose: to alleviate pain, increase mobility, and improve patients’ overall quality of life. However, the relationship between these two professions has been fraught with tension for years. Some physical therapists view chiropractors as unscrupulous competitors who jeopardize patient safety, while some chiropractors see physical therapists as too cautious and conservative.
While it’s not fair to generalize all physical therapists or chiropractors, there are several reasons why some physical therapists may hate chiropractors:
- Differing opinions on manual therapy: Manual therapy, or hands-on manipulation of the spine and joints, is often employed by both physical therapists and chiropractors. However, the techniques used can vary greatly between the two professions. Physical therapists tend to use milder, gentler techniques such as mobilization and soft tissue work, while chiropractors may employ more forceful adjustments designed to crack the joints and realign the spine. This disparity in approaches can lead to mistrust and skepticism between the two groups.
- Philosophical differences in treatment: While both physical therapists and chiropractors aim to heal the body without surgery or medication, they may have different underlying philosophies about how the body works and what constitutes an effective treatment. For instance, chiropractors generally believe that problems with the musculoskeletal system can affect other areas of health and wellbeing, whereas physical therapists may prioritize rehabilitation and functional improvement over holistic wellness.
- Bitter competition for patients: Both physical therapists and chiropractors rely heavily on patient referrals and word-of-mouth marketing. As a result, there is often intense competition for patients between the two groups. Some physical therapists may feel threatened by the popularity of chiropractic care and may view chiropractors as a threat to their business.
Rise of Complementary and Alternative Medicine
One factor that has contributed to the ongoing battle between physical therapists and chiropractors is the rise of complementary and alternative medicine (CAM). CAM encompasses therapies and practices that fall outside of mainstream conventional medicine, such as acupuncture, homeopathy, and naturopathy. Chiropractic care falls squarely within the realm of CAM, and its growing popularity in recent years may have put some physical therapists on edge.
According to a survey conducted by the National Institutes of Health in 2017, over one-third of Americans use some form of CAM for healthcare purposes. Chiropractic care was among the most commonly used modalities, with an estimated 35 million people visiting a chiropractor each year. This trend shows no signs of slowing down: forecasters predict that the global market for CAM will reach $516 billion by 2026.
“Patients today are much more savvy and they’re looking for something different… looking at nutrition, exercise, lifestyle changes… Chiropractic also fits into that category of really taking control of your own health.” – Ray Foxworth, Executive Vice President of the American Chiropractic Association
While physical therapy is not usually considered part of the CAM umbrella, it shares many philosophical tenets with other complementary disciplines like yoga and massage therapy. Physical therapists often promote holistic wellness and focus on helping patients achieve optimal function rather than simply treating symptoms of injury or disease.
The rise of CAM represents both a challenge and an opportunity for physical therapists and chiropractors alike. While there may be growing competition for patients, there is also increased public attention and acceptance of non-conventional medical approaches. As healthcare continues to evolve, it’s likely that more patients will seek out holistic, integrative care that combines aspects of both physical therapy and chiropractic.
Insurance Coverage and Patient Choice
Another point of contention between physical therapists and chiropractors is insurance coverage – or lack thereof. Depending on the state, insurance companies may cover chiropractic care but not physical therapy, or vice versa. This discrepancy can lead to frustration for both patients and healthcare providers, who may have to jump through hoops in order to get appropriate reimbursement for services rendered.
“When insurance plans are designed and implemented, they should include all forms of treatment that will benefit the patient.” – American Physical Therapy Association Public Policy Agenda
Patient choice also plays a role in this issue. Some patients may be more drawn to one type of treatment than another based on factors like cost, convenience, and perceived effectiveness. For instance, a patient with chronic back pain may choose to see a chiropractor because they believe spinal manipulations offer faster relief than exercises recommended by a physical therapist. Alternatively, a patient recovering from a knee replacement surgery may opt for physical therapy over chiropractic care because they feel it’s more tailored to their specific needs.
The battle for patients between physical therapists and chiropractors is complex and multi-faceted. Both professions play important roles in helping people heal and recover from injury, and there is potential for collaboration and mutual respect moving forward. As always, the best approach is likely to be patient-centered, focusing on what each individual needs and responding to evolving trends in healthcare as they arise.
Differences in Education and Training
The debate between physical therapists and chiropractors goes way back to their differences in education and training. While both professions require advanced knowledge of the human body, there are distinct discrepancies in how they acquire it.
Chiropractic vs Osteopathic Education
Chiropractors undergo extensive training in spinal manipulation techniques, often referred to as adjustments or manipulations, that aim to restore proper alignment and function of the musculoskeletal system. Their educational program typically involves a four-year undergraduate degree followed by another four years in a specialized chiropractic college. During this time, they learn about anatomy, physiology, radiology, pathology, nutrition, diagnosis, and patient management.
Osteopaths, on the other hand, have similar training to medical doctors with an emphasis on musculoskeletal systems and holistic care. Their curriculum requires a four-year undergraduate degree, followed by four years of osteopathic medical school and supervised clinical rotations. They also receive training in manual therapy and joint manipulation but tend to use these techniques less frequently than chiropractors do.
Integrative Medicine Programs
In recent years, more integrative medicine programs have emerged that bridge the gap between these two practices. Integrative medicine is a type of healthcare that takes into account the whole person, including physical, emotional, mental, social, and environmental factors affecting their health. The approach is aimed at treating the root causes of disease rather than just managing symptoms.
Some chiropractors and physical therapists choose to pursue additional certification in integrative medicine to broaden their skillset beyond traditional methods. This allows them to provide patients with a wider range of treatment options such as yoga, acupuncture, meditation, and massage therapy.
Continuing Education Requirements
To maintain their professional license, both physical therapists and chiropractors are required to complete continuing education courses regularly. These courses help them stay up-to-date with the latest advancements in their field and refine their skills.
Physical therapists must meet state-specific requirements regarding their continuing education while also adhering to regulations set forth by the American Physical Therapy Association (APTA). Such coursework includes topics dealing with anatomy, injury prevention, evidence-based practice, and ethics. They must complete a certain number of hours every few years to maintain their Missouri-State licensing.
In contrast, chiropractors need to earn continuing education credits that focus on adjustments and manipulations. This often results in many chiropractors solely attending seminars related to spinal manipulation, which can limit their exposure to alternative approaches such as rehabilitation or exercises.
Scope of Practice Differences
Another reason why physical therapists might not like chiropractors is due to differences in scope of practice and authority. While both professions work with patients suffering from musculoskeletal disorders, they have different prescribing abilities and limitations.
Physical therapists typically work in collaboration with physicians and other healthcare providers, designing and implementing treatment plans that involve exercises, manual therapy, and modalities such as heat or cold applications. In most cases, they cannot prescribe medication or perform surgery without direct supervision from a medical doctor.
On the other hand, chiropractors are seen as primary care physicians capable of diagnosing and treating a wide range of ailments. They can order diagnostic tests, including X-rays and MRI scans, and may recommend dietary supplements, nutraceuticals, or home remedies. However, their ability to prescribe medications is limited, so this is often omitted from their treatment plan.
“There’s often confusion between what chiropractor and physical therapist do because there’s some overlap in conditions they treat, but they come at it from different approaches,” – Dr. Brian Sutton, a sports medicine specialist.
The differences in education and training greatly impact how chiropractors and physical therapists treat their patients. While each profession has its unique approach to musculoskeletal health care, both can be beneficial if used appropriately. Integrative medicine programs that combine elements of both disciplines are becoming more popular as healthcare shifts towards a more holistic approach. Ultimately, what is most important is the patient’s well-being justifying who should visit first; physical therapist or chiropractor? It depends on your condition and preference for treatment.
Disagreement on Treatment Techniques
Physical therapists and chiropractors both aim to help individuals recover from injuries and improve their overall health. However, there is often a disagreement between the two professions when it comes to treatment techniques.
Manual Therapy vs Instrument-Assisted Techniques
Physical therapists tend to rely on manual therapy techniques such as massage, stretching, and joint mobilization to alleviate pain and stiffness in patients. On the other hand, chiropractors commonly use instrument-assisted techniques like spinal decompression and electrical muscle stimulation to treat similar conditions.
“We want our patients’ recovery to be long-lasting, so we emphasize proper body mechanics, posture recognition and correction, and total-body fitness as part of any patient-specific plan of care.” -American Physical Therapy Association (APTA)
The APTA emphasizes the importance of treating the whole person and incorporating preventative measures into a patient’s care plan. They argue that traditional manual therapy techniques are more effective in achieving this goal than relying solely on instruments.
Spinal Manipulation vs Mobilization
Another area where physical therapists and chiropractors differ is the approach to spinal manipulation. Chiropractors generally perform high-velocity thrusts to adjust the spine, while physical therapists use less forceful mobilization techniques to gradually restore range of motion and reduce pain.
“The difference is simple: PTs do not ‘crack backs,’ but instead provide independent exercises that help each patient build strength and flexibility over time” -Joseph Brence, DPT
DPT Joseph Brence states that physical therapy prioritizes individualized exercise programs rather than quick adjustments, which can sometimes worsen underlying issues or pose risks for certain patients.
Soft Tissue Techniques
Both physical therapists and chiropractors use soft tissue techniques like myofascial release to address muscle tension and reduce pain. However, there is a difference in the level of intensity used when administering these techniques.
“Very aggressive soft tissue techniques could be detrimental or even lead to delays in recovery if our interventions create additional inflammation” -Philip Grossman, DC
Chiropractor Philip Grossman suggests that overly aggressive soft tissue work can worsen inflammation and potentially harm patients. He argues that conservative treatment options yield better results than forceful methods.
It’s clear that physical therapists and chiropractors have different approaches to treating patients. While their end goals may be similar, their recommended techniques vary greatly. It’s important for individuals seeking treatment to research both professions and choose a method that aligns with their personal values and health needs.
Controversies Surrounding Spinal Manipulation
Stroke Risk and Cervical Manipulation
One of the main controversies surrounding chiropractic care is the risk of stroke associated with cervical manipulation, also known as neck cracking. The concern stems from several case reports linking the two, although the exact causation remains unclear.
A 2014 study published in the Journal of Stroke and Cerebrovascular Diseases analyzed Medicare data and found that patients who saw a chiropractor for neck pain had a slightly higher risk of stroke compared to those who saw a primary care physician. However, the overall risk was still low, with only one additional stroke per 1 million manipulations.
Despite the small risk, some physical therapists remain wary of cervical manipulation and prefer alternative treatments for neck pain such as exercise therapy or massage.
“The risks are small but real, while the benefits of spinal manipulation simply don’t exist.” -Steven Novella, neurologist at Yale University School of Medicine
Effectiveness in Treating Low Back Pain
Chiropractors often tout their ability to effectively treat low back pain through spinal adjustment. While some studies have shown positive results, others suggest that chiropractic care may not be any more effective than other conservative treatments.
A 2017 study published in JAMA Network Open analyzed data from over 750 patients with low back pain and found no significant difference between spinal manipulation and usual medical care in terms of pain, function, and medication use.
Physical therapists argue that they can achieve similar results through evidence-based interventions such as manual therapy, exercise, and patient education without necessarily manipulating the spine.
“There’s absolutely no evidence that having your back cracked does anything useful.” -Edzard Ernst, Emeritus Professor of Complementary Medicine at the University of Exeter
While chiropractic care has its supporters and success stories, it remains a controversial practice in the eyes of some physical therapists. The risk of stroke associated with cervical manipulation and questioning of its effectiveness for low back pain are just two examples of ongoing debates surrounding the field. Ultimately, patients should weigh all available treatment options and consult with their healthcare provider before deciding on a course of action.
Legal and Professional Issues
Licensure and Scope of Practice Laws
One reason why physical therapists may dislike chiropractors is due to licensure and scope of practice laws. Physical therapists must undergo extensive education and training in order to become licensed healthcare professionals. They are bound by strict regulations that dictate the types of treatments they can provide, as well as their scope of practice.
Chiropractors, however, have different requirements for licensure and scope of practice. While their education and training may be similar or even more intensive than that required for physical therapy, many states allow chiropractors greater leeway in the types of treatments they can provide. This can lead to concerns about patient safety, particularly if a chiropractor offers treatment that falls outside of their area of expertise.
Misrepresentation of Credentials and Training
Another issue that may contribute to tensions between physical therapists and chiropractors is misrepresentation of credentials and training. Unfortunately, there have been cases where individuals have misrepresented themselves as licensed physical therapists or chiropractors when they do not have the appropriate credentials.
This can be dangerous for patients who trust that they are receiving care from a qualified professional. It can also reflect poorly on the entire profession, leading to mistrust and dissatisfaction among patients and other healthcare providers.
Insurance Fraud and Overutilization of Services
Finally, insurance fraud and overutilization of services can create animosity between physical therapists and chiropractors. Both professions rely heavily on insurance reimbursement to support their practices, but there have been cases where practitioners from either field have engaged in unethical practices such as billing for services that were never provided or providing unnecessary treatments simply to receive payment.
The result of this behavior can be increased scrutiny and suspicion from insurance companies and regulators, as well as a breach of trust between healthcare providers and their patients.
“Healthcare fraud not only robs us of taxpayer money, but it can also have deadly consequences. When unscrupulous doctors make false claims for fake pills or procedures, sick people are put at risk.” -Charles Grassley
Tensions between physical therapists and chiropractors may be fueled by legal and professional issues such as licensure and scope of practice laws, misrepresentation of credentials and training, as well as insurance fraud and overutilization of services. It is important for practitioners in both fields to maintain ethical standards and work together towards the common goal of providing effective and safe care for their patients.
Frequently Asked Questions
Is there a professional rivalry between physical therapists and chiropractors?
There is often a perceived rivalry between physical therapists and chiropractors, but it varies depending on the individuals involved. Some professionals may view each other as competition, while others may see the benefits of collaboration. However, both professions share a common goal of improving patient health and should work together whenever possible.
What are the differences in approach between physical therapy and chiropractic care?
Physical therapy focuses on restoring movement and function through exercises, manual therapy, and modalities. Chiropractic care emphasizes the manipulation of the spine and joints to alleviate pain and improve body alignment. Both approaches can be effective for treating musculoskeletal conditions, but they have different philosophies and techniques. Physical therapists may also address other areas, such as balance, gait, and endurance, while chiropractors primarily focus on spinal health.
Do physical therapists see chiropractors as a threat to their profession?
Some physical therapists may view chiropractors as a threat, particularly if they believe chiropractors are encroaching on their scope of practice. However, this is not a universal view, and many physical therapists recognize the value of chiropractic care for certain conditions. It’s important for professionals to respect each other’s expertise and work collaboratively when appropriate.
Are there any instances where physical therapists and chiropractors work together?
Yes, physical therapists and chiropractors can work together in a variety of settings, such as sports medicine clinics, rehabilitation centers, and integrative healthcare practices. They may refer patients to each other or collaborate on treatment plans to provide comprehensive care. By combining their strengths, they can improve patient outcomes and promote a more holistic approach to healthcare.
What can be done to improve the relationship between physical therapists and chiropractors?
Communication and education are key to improving the relationship between physical therapists and chiropractors. Professionals should seek to understand each other’s perspectives, share knowledge, and collaborate on patient care. They can also advocate for a more integrated approach to healthcare that recognizes the value of both professions. By working together, they can enhance the quality of care for patients and promote a more cohesive healthcare system.