What is the Difference between a Physical Therapist and Chiropractor?


Have you ever wondered whether you should see a Physical therapist or a Chiropractor for your symptoms? Check out the descriptions below to learn the differences and which type of provider you should see depending on your injury.

Physical Therapist

A physical therapist performs an exam of an individual’s impairment, disability or functional limitation by examining their movement, affected joints and tissue, neuromuscular imbalances and misalignment. They determine a diagnosis and intervention of treatment and set treatment goals.  Physical therapists work to alleviate pain, restore range of motion, regain any function lost, promote and maintain fitness and prevent further injury. The physical therapist may use heat/cold, electric stimulation, ultrasound, soft tissue mobilization, stretching, exercise and other manual techniques to reach treatment goals. There are many different specialties/settings in physical therapy.  Examples of this are outpatient, women’s health, acute care, sub-acute care, sport, and neurological.  An average physical therapy treatment program consists of the patient attending physical therapy 2 times a week for 4 to 6 weeks.  The end goal for a physical therapy treatment program is to decrease the patient’s symptoms and educate the patient on how to prevent their injury/symptoms from recurring through continued exercise.


A chiropractor concentrates on musculoskeletal and systemic disorders through a controlled manipulation of the spine. Some chiropractors perform x-rays of the spine to check for misalignment. Chiropractors look to the physiological and biochemical aspects of the patient’s structural, spinal, musculoskeletal and neurological components. They also may use heat/cold electrical stimulation and ultrasound for pain control. Chiropractors practice in a private practice setting and occasionally you can find them staffed in a hospital setting.  In the state of Maryland, Chiropractors can take an exam to receive physical therapy privileges.  Therefore, you might see a facility advertising chiropractic and physical therapy services together. However, be mindful that most of these facilities only employ chiropractors.  A chiropractic treatment program on average is once a week and then tapers down to once a month for a long period of time.  Chiropractors typically see their patient consistently for sometimes years to continue to assess for misalignment of the spine to manipulate.

If you are wondering what practitioner you should see for your injury, it is always beneficial to see a physical therapist.  I typically educate my patients that you should always see a physical therapist first as we are more conservative than chiropractors.  Physical Therapists are able to increase strength/range of motion of a muscle/joint which in turn naturally corrects misalignment of the spine.  If you have not reached your goals with physical therapy, then try your local chiropractor.

Written by:

Amanda Macht, D.P.T.
Owner/Physical Therapist Harbor Physical Therapy

The Relationship Between Personal Trainers and Physical Therapists

Personal trainers often see people with pre-existing or new injuries. A physical therapist provides rehabilitation for injuries to return you to your current workout routine or sport of choice. The physical therapist will provide education to you and your personal trainer to focus on specific workouts or avoid certain exercises to prevent re-injury. Therefore, it is helpful to have an ongoing relationship with both a personal trainer and physical therapist to decrease the likelihood of injury while working towards your fitness goals.

At Harbor Physical Therapy, we now provide personal training. If you do not already have a personal trainer, please contact us and we can help you to achieve your fitness goals. We will be happy to get you started on a safe exercise program catered to your specific needs.


There are two main types of orthotics: off-the-shelf arch supports and custom orthotics. A person is prescribed an orthotic to help normalize weight distribution with weight bearing. Some people tend to bear more weight through the inside or the outside of their foot. This in turn, can cause back, hip, knee, ankle, or foot pain. Orthotics correct imbalances, improve posture, and help to relieve pain with weight bearing activity.

Off- the- shelf orthotics (or arch supports) can be found in retail stores. They are a less rigid type of shoe insert costing approximately $30.00 to $50.00. Unless you have a severe biomechanical foot problem, initially you will be recommended to purchase an arch support.

Custom Orthotics can be created by a Podiatrist or Physical Therapist. Custom orthotics helps people that require more assistance with their foot posture. An orthotist will take a plaster cast mold of your foot to create an orthotic. This orthotic is usually the most rigid of all the orthotics. It may take several months for your foot to get used to the orthotic. Custom made orthotics are expensive. Some health insurances will cover a portion or all of the expense.

Sleeping Positions

Positions you should avoid:

1. Lying on your stomach– This position makes you maintain a position of head rotation. This causes your neck muscles to shorten and can result in pain and stiffness in the morning. Also, sleeping flat on your stomach extends your low back which causes shortening and tightening of the low back muscles.

2. Lying on your side with your arm above your head– This position can create shoulder pain. You can compress the nerves in your shoulder causing your arm to go numb. Also, you are impinging the shoulder joint. This can cause stiffness and soreness at the shoulder joint.

Ideal sleeping positions:

1. Lying on your side with your arms in front of your body and a pillow between your knees– This causes decrease strain on your shoulder and allows your back muscles to remain relaxed. The amount of pillows under your head should be determined by your neck position. Your neck position should be in a slightly flexed position compared to the rest of your body.

2. Lying on your back– In this position, you should make sure you are using the correct amount of pillows as noted above. Also, place pillows under your knees to create a position of decrease strain on your lower back.

Please note if you have current or previous injuries, the position you favor will depend upon making the area of injury as comfortable as possible. If you continue to have difficulty getting comfortable in bed, make an appointment to your local physical therapist. The therapist will determine which position will better suit you based upon your past and current medical history.

Physical Therapist vs. Chiropractor

Many patients are curious about the difference between these two health practitioners.

Chiropractors specialize in manipulating bone structure (such as the spine) to improve the function of the joints and or nervous system.  They are very well known for manipulating the spine to help decrease low back pain.  A lot of patients frequent a chiropractor’s office several times a year for many years to manage their ailments.  A chiropractor has an aggressive approach to treatment.

Physical Therapists specialize in treating injury or dysfunction with exercises, manual techniques, neuromuscular re-education, and postural re-education to improve function throughout life.  A patient will attend a physical therapist 2-3 times a week for on average 6 weeks to improve function/decrease pain and gain education on how to further these gains with independent exercise.  Physical Therapy is a conservative treatment option and one which should be used in the first line of defense against injury.

In my professional opinion, it is in the patient’s best interest to understand the difference between these two disciplines before choosing the treatment option that is appropriate.  With acute injury, one should first go to a physical therapist.  If the patient has tried physical therapy and finds they have not met their goals, then they should look into seeking a chiropractors services.  A chiropractor offers more of an aggressive approach to treatment by using manipulations so a lot of times this is inappropriate for an acute injury, such as a car accident, ankle sprain, sport injury, etc.

If you are unsure what type of discipline best suits you, feel free to contact Harbor Physical Therapy with questions.

Article Response – Wall Street Journal, “Getting Fit Without the Pain”

I recently read the article “Getting Fit Without the Pain” in the Wall Street Journal on September 28, 2010.

This article did a good job of educating America about going to a Physical Therapist not only for an injury, but to begin exercising safely.  As we age, we tend to develop aches and pain along the way.  For some people it is their knee, others their shoulder, etc. Physical Therapists educate patient’s on how to safely begin their exercise goals and which exercises are better suited for them based on their past medical history.  By going to a physical therapist before starting an exercise program, you are less likely to cause injury to yourself while exercising.

As the article states, ” what physical therapists are very good at is identifying barriers to exercise-knee injuries, chronic ankle pain-and building a program around them that creates incremental improvement.  After receiving a fitness program from a physical therapist, many patients will hire a personal trainer to implement it.  But prevention is where many physical therapist say their progession could make the most difference. ”

When going to a physical therapist to begin an exercise program, the therapist will evalute your muscles and joints from head to toe.  Therefore, we can create a program catered to strengthen/stretch the key areas needing improvement.  This in turn will help prevent injury in the future.

Harbor Physical Therapy offers Wellness Evaulations to create an exercise program catered to your needs.   If you are interested in learning more about how you can prevent injury when starting an exercise program.  Please give us a call at 443-524-0442.

Click here for a link to the article.