Chiropractor vs physical therapist

Chiropractors and physical therapists overlap most in outpatient musculoskeletal care. On the topics we have reviewed, both professions generally include joint mobilization, soft tissue work, therapeutic exercise, taping and several modalities, and both can be seen without a referral. Where they differ is in breadth: chiropractic visits center on musculoskeletal and especially spinal problems, while physical therapists also work in hospitals, homes, schools and nursing homes with people from newborns to the end of life.

Spinal manipulation is the sharpest dividing line. Every chiropractic act we read, including Florida's and Washington's, names adjustment or manipulation of the spine as the defining chiropractic procedure. The physical therapy model act includes spinal manipulation too, but state law splits: Washington removes it from physical therapy unless the therapist holds a separate endorsement, and Florida's physical therapy act says it does not authorize specific chiropractic spinal manipulation.

Imaging follows a similar pattern. Chiropractic acts generally authorize diagnostic X-ray, as Florida's and Minnesota's do, while a physical therapist's authority to order imaging depends on the state: APTA reports that most states are silent and a short list expressly allow it, sometimes only for X-rays and with added qualifications, as in Wisconsin.

Neither profession prescribes medication. The practical result is that patients with the same back or neck problem may be seen by either, and the techniques used can be similar, while the legal name for a technique, and which acts it is listed in, can decide which profession may perform it in a given state.