Chiropractor & Physical Therapists

Chiropractors & physical therapists (or physiotherapists) are professionals who help in the treatment of different injuries or trauma to the body.

A chiropractor is a professional who is engaged in the diagnosis and treatment of mechanical disorders of the musculoskeletal system, whereas a physical therapist (also called physiotherapist) is a medical professional who provides treatment in case of injury, disease or caused due to aging, to assist and restore mobility and function.

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Comparison chart

Chiropractor versus Physical Therapist comparison chart
Chiropractor Physical Therapist
Residency and Internship One-year internship that coincides with clinical courses while in training. NO Residency required, but have the option to complete if accepted and desire to. All curriculums are required to have a minimum of 30 weeks of full time internship. Residencies exist in all specialties, certified by the American Board of Physical Therapy Residency and Fellowship Education.
Practice Private practice clinics, generally. However, some are employed by health systems and hospitals. Generalist practice, neurology related, orthopedic related, and general alignment restoration dealing with the skeletal system. Acute care, Inpatient/Outpatient Neurologic Rehab, General Outpatient, Othopedic, Geriatrics, Pediatrics, Veterans Affairs, Military, Sports Medicine, Women’s & Men’s Health, Wound Care, Work Rehab, Electrophysiology, etc.
Can prescribe medication No. New Mexico recently allowed limited prescription rights to DCs Unless in the Military, PT’s do not prescribe medications. However, all PT’s are tested on pharmacology.
Medical Licensing Exam (MLE) National Board Exam (NBCE). Parts I, II, III IV (practical) and state boards. The National Physical Therapy Exam (NPTE) administered by the Federation of State Boards.
Treatment Techniques Chiropractic adjustment (grade I-V) ranging from soft tissue mobilization to joint adjustment. Electrical Stimulation. Acupuncture, Pain Management All manual therapy techniques including joint manipilation, and all modalities; Neurologic rehabilitation, sports performance, gait training, muscle coordination & performance, wound care, tissue mobilization, massage, cardiovascular rehab, etc.
Years of medical school 4-5 undergraduate years (Bachelor’s required / state dependent), 5 Chiropractic school, 1 year residency, minimum 10 years Doctor of Physical Therapy = 3 academic years. All accredited Physical Therapy programs require a Bachelor’s Degree. As of January 2012, only 5 Master’s programs remain, which are typically 2 years in length. There are 213 programs in the US.
Status DC stands for Doctor of Chiropractic. They are not medical doctors, however for insurance purposes, some states consider chiropractors health care providers, some do not. A PT (Physical Therapist) is also not a medical doctor and cannot prescribe medication. PTs are also considered specialty practitioners by the insurance industry.

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Top 5 Things Chiropractors Won’t Tell You

1. Chiropractic theory and practice are not based on the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community.

Most chiropractors believe that spinal problems, which they call “subluxations,” cause ill health and that fixing them by “adjusting” the spine will promote and restore health. The extent of this belief varies from chiropractor to chiropractor. Some believe that subluxations are the primary cause of ill health; others consider them an underlying cause. Only a small percentage (including me) reject these notions and align their beliefs and practices with those of the science-based medical community. The ramifications and consequences of subluxation theory will be discussed in detail throughout this book.


2. Many chiropractors promise too much.

The most common forms of treatment administered by chiropractors are spinal manipulation and passive physiotherapy measures such as heat, ultrasound, massage, and electrical muscle stimulation. These modalities can be useful in managing certain problems of muscles and bones, but they have little, if any, use against the vast majority of diseases. But chiropractors who believe that “subluxations” cause ill health claim that spinal adjustments promote general health and enable patients to recover from a wide range of diseases. The illustrations below reflect these beliefs. The one to the left is part of a poster that promotes the notion that periodic spinal “adjustments” are a cornerstone of good health. The other is a patient handout that improperly relates “subluxations” to a wide range of ailments that spinal adjustments supposedly can help. Some charts of this type have listed more than 100 diseases and conditions, including allergies, appendicitis, anemia, crossed eyes, deafness, gallbladder problems, hernias, and pneumonia.

A 2008 survey found that exaggeration is common among chiropractic Web sites. The researchers looked at the Web sites of 200 chiropractors and 9 chiropractic associations in Australia, Canada, New Zealand, the United Kingdom, and the United States. Each site was examined for claims suggesting that chiropractic treatment was appropriate for asthma, colic, ear infection/earache/otitis media, neck pain, whiplash, headache/migraine, and lower back pain. The study found that 95% of the surveyed sites made unsubstantiated claims for at least one of these conditions and 38% made unsubstantiated claims for all of them.1 False promises can have dire consequences to the unsuspecting.


3. Our education is vastly inferior to that of medical doctors.

I rarely encountered sick patients in my school clinic. Most of my “patients” were friends, students, and an occasional person who presented to the student clinic for inexpensive chiropractic care. Most had nothing really wrong with them. In order to graduate, chiropractic college students are required to treat a minimum number of people. To reach their number, some resort to paying people (including prostitutes) to visit them at the college’s clinic.2

Students also encounter a very narrow range of conditions, most related to aches and pains. Real medical education involves contact with thousands of patients with a wide variety of problems, including many severe enough to require hospitalization. Most chiropractic students see patients during two clinical years in chiropractic college. Medical students also average two clinical years, but they see many more patients and nearly all medical doctors have an additional three to five years of specialty training before they enter practice.

Chiropractic’s minimum educational standards are quite low. In 2007, chiropractic students were required to evaluate and manage only 15 patients in order to graduate. Chiropractic’s accreditation agency ordered this number to increase to 35 by the fall of 2011. However, only 10 of the 35 must be live patients (eight of whom are not students or their family members)! For the remaining cases, students are permitted to “assist, observe, or participate in live, paper-based, computer-based, distance learning, or other reasonable alternative.”3 In contrast, medical students see thousands of patients.

Former National Council Against Health Fraud President William T. Jarvis, Ph.D., has noted that chiropractic school prepares its students to practice “conversational medicine”—where they glibly use medical words but lack the knowledge or experience to deal appropriately with the vast majority of health problems.4 Dr. Stephen Barrett reported a fascinating example of this which occurred when he visited a chiropractor for research purposes. When Barrett mentioned that he was recovering from an attack of vertigo (dizziness), the chiropractor quickly rattled off a textbook-like list of all the possible causes. But instead of obtaining a proper history and conducting tests to pinpoint a diagnosis, he x-rayed Dr. Barrett’s neck and recommended a one-year course of manipulations to make his neck more curved. The medical diagnosis, which had been appropriately made elsewhere, was a viral infection that cleared up spontaneously in about ten days.5


4. Our legitimate scope is actually very narrow.

Appropriate chiropractic treatment is relevant only to a narrow range of ailments, nearly all related to musculoskeletal problems. But some chiropractors assert that they can influence the course of nearly everything. Some even offer adjustments to farm animals and family pets.


5. Very little of what chiropractors do has been studied.

Although chiropractic has been around since 1895,  little of what we do meets the scientific standard through solid research. Chiropractic apologists try to sound scientific to counter their detractors, but very little research actually supports what chiropractors do.


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Chiropractic Adjustment Questions

Chiropractic Adjustment Questions
How much does it cost to go to a chiropractor?
After the first visit, chiropractic treatments usually cost between $40 and $60 per visit. Most chiropractors charge $100 for the first visit depending on the extent of your assessment. If you are trying chiropractic for the first time, ask about fees when you book your first appointment.
What is a chiropractic adjustment?
The common goal of most chiropractic techniques is to restore or to enhance joint function, with the general goals of resolving joint inflammation and reducing pain. Some approaches use some force (spinal manipulation), while others are more gentle (spinal mobilization).
What is a Chiropractor?
Chiropractic is a form of alternative medicine that focuses on diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine, under the belief that these disorders affect general health via the nervous system.
Is a chiropractor a licensed physician?
Doctor of Chiropractic (DC) – Chiropractors diagnose and treat back and neck pain and are considered by definition primary care physicians as they are often the first doctor a patient will visit when experiencing back pain.

If you haven’t visited a chiropractor before, you might be missing out. Millions of people around the world have experienced the incredible benefits of chiropractic care.

One of the best things about chiropractic care is it’s a drug-free and surgery-free path to healing naturally.

People have reported chiropractic benefits help to improve:

  • Back pain
  • Headaches
  • Ear infections
  • Neck pain
  • Arthritis and joint pain
  • Scoliosis
  • Asthma
  • Blood pressure
  • Healthy pregnancy
  • Organ function
  • Surgery prevention

There are a lot of misconceptions about chiropractic practices and how chiropractors are trained. In fact, did you know many chiropractic programs also incorporate an entire year of PhD-level advanced nutrition training?

However, most of the benefits of seeing a chiropractor come from getting a chiropractic adjustment. Let’s talk about the philosophy, history and evidence-based research of chiropractic care.

Chiropractic Adjustment Basics

Chiropractic Adjustment Basics

Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment.

Spinal adjustments were among many chiropractic techniques invented in the 19th century by Daniel David Palmer, a “magnetic healer”. Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care. There is no good scientific evidence that spinal adjustment is effective against disease.

Defined as unique to chiropractic

The International Chiropractor’s Association (ICA) states that the “chiropractic spinal adjustment is unique and singular to the chiropractic profession”, and that it “is characterized by a specific thrust applied to the vertebra utilizing parts of the vertebra and contiguous structures as levers to directionally correct articular malposition. Adjustment shall be differentiated from spinal manipulation in that the adjustment can only be applied to a vertebral malposition with the express intent to improve or correct the subluxation, whereas any joint, subluxated or not, may be manipulated to mobilize the joint or to put the joint through its range of motion… Chiropractic is a specialized field in the healing arts, and by prior rights, the spinal adjustment is distinct and singular to the chiropractic profession.” One author claims that this concept is now repudiated by mainstream chiropractic. The definition of this procedure describes the use of a load (force) to specific body tissues with therapeutic intent. This ‘load’ is traditionally supplied by hand, and can vary in its velocity, amplitude, duration, frequency, and body location and is usually abbreviated HVLA (high velocity low amplitude) thrust.


Adjustment methods

As the chiropractic profession grew, individual practitioners and institutions proposed and developed various proprietary techniques and methods. While many of these techniques did not endure, hundreds of different approaches remain in chiropractic practice today. Not all of them involve HVLA thrust manipulation. Most cite case studies, anecdotal evidence, and patient testimonials as evidence for effectiveness. These techniques include:

  • Toggle Drop – this is when the chiropractor, using crossed hands, presses down firmly on a particular area of the spine. Then, with a quick and precise thrust, the chiropractor adjusts the spine. This is done to improve mobility in the vertebral joints.
  • Lumbar Roll (aka side posture) – the chiropractor positions the patient on his or her side, then applies a quick and precise manipulative thrust to the misaligned vertebra, returning it to its proper position.
  • Release Work – the chiropractor applies gentle pressure using his or her fingertips to separate the vertebrae.
  • Table adjustments – The patient lies on a special table with sections that drop down. The chiropractor applies a quick thrust at the same time the section drops. The dropping of the table allows for a lighter adjustment without the twisting positions that can accompany other techniques.
  • Instrument adjustments – often the gentlest methods of adjusting the spine. The patient lies on the table face down while the chiropractor uses a spring-loaded activator instrument to perform the adjustment. This technique is often used to perform adjustments on animals as well.
  • Manipulation under anesthesia (MUA) – this is performed by a chiropractor certified in this technique in a hospital outpatient setting when the patient is unresponsive to traditional adjustments.

Chiropractic Adjustment

A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain.18

A chiropractic adjustment refers to a chiropractor applying manipulation to the vertebrae that have abnormal movement patterns or fail to function normally.

The objective of this chiropractic treatment is to reduce the subluxation, with the goals of increasing range of motion, reducing nerve irritability and improving function.

Chiropractic Adjustment Description

A chiropractic adjustment typically involves:

  • A high velocity, short lever arm thrust applied to a vertebra
  • An accompanying, audible release of gas (joint cavitation) that is caused by the release of oxygen, nitrogen, and carbon dioxide, which releases joint pressure (cavitation)19
  • A relieving sensation most of the time, although minor discomfort has been reported (that usually lasts for a short time duration) if the surrounding muscles are in spasm or the patient tenses up during this chiropractic care.

Chiropractic Adjustment Techniques

There are many different manipulative techniques that can be utilized in chiropractic, and there is a certain skill level and “art” involved with high velocity, low amplitude adjustment or manipulation. It is perhaps more important for the chiropractor to determine when not to apply the adjustment.

Chiropractic Adjustment Side Effects

The most common reaction to a chiropractic adjustment is aching or soreness in the spinal joints or muscles. If this aching or soreness occurs, it is usually within the first few hours post-treatment and does not last longer than 24 hours after the chiropractic adjustment. Application of an ice pack often reduces the symptoms relatively quickly.

Common Forms of Chiropractic Therapy

Some physiological therapeutic measures that are often utilized in chiropractic care include:

  • Heat and cold. Chiropractors may alternate between heat and ice therapy to help patients treat back pain. Ice packs may be used to numb the back for a 10 to 15 minute period and then switched with a heating pad, heat wrap or hot water bottle to restore blood flow to the area and promote faster healing.
  • Exercise. Chiropractors may provide patients with instructions for an exercise program focusing on stretching and strengthening the back. For more information, see Exercise and Chiropractic Therapy.
  • Massage. Chiropractors may massage the soft tissues to improve circulation, reduce swelling and inflammation associated with the back pain, and encourage quicker healing. See Massage Therapy for Lower Back Pain.
  • Dietary management. Many chiropractors will provide patients with tips on how an improved diet may help with their back pain, and some may recommend dietary supplements after spinal manipulation.

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