Chiropractic vs Physical Therapy: Which Do You Need?

"Should I see a chiropractor or a physical therapist?" I get this question all the time. The honest answer is that we do different things, and sometimes you need one, sometimes the other, and sometimes both.

The core difference

Here's the simplest way I can explain it:

Chiropractors focus on joints, especially the spine. We find joints that aren't moving correctly and restore proper motion through adjustments. The goal is to fix mechanical problems in how your body moves.

Physical therapists focus on muscles, movement patterns, and rehabilitation. They use exercises, stretches, and hands-on techniques to strengthen weak areas, improve flexibility, and retrain how you move.

There's overlap, and good practitioners in both fields understand that joints and muscles work together. But our training and primary tools are different.

When chiropractic tends to work best

Chiropractic care is often the better first choice when:

• Your pain came on suddenly after a specific movement, sleeping wrong, or minor incident. This often indicates a joint that's stuck or out of position.
• You have restricted range of motion that feels mechanical, like something is blocking movement rather than just tight muscles.
• The pain is in or around your spine including lower back, mid-back, neck, or radiating into arms or legs.
• You've had this problem before and adjustments have helped in the past.
• Headaches that seem connected to neck tension or stiffness.
• You want quick relief and don't have time for weeks of exercises before seeing improvement.

When physical therapy tends to work best

Physical therapy is often the better choice when:

• You're recovering from surgery and need structured rehabilitation.
• You have significant muscle weakness that's contributing to your problem.
• You have a complex injury like a torn rotator cuff, ACL reconstruction, or stroke recovery.
• Your problem is primarily in a peripheral joint like knees, ankles, shoulders, or elbows (though chiropractors treat these too).
• You need hands-on treatment multiple times per week over an extended period, which insurance often covers better for PT.
• Balance and coordination issues related to aging or neurological conditions.

When you might need both

Some situations benefit from a combined approach:

Chronic recurring problems: If your back goes out every few months, a chiropractor can fix the acute episode, but a physical therapist can help you strengthen the supporting muscles so it happens less often.

Auto accidents and significant injuries: Chiropractic can restore joint function while PT addresses the soft tissue damage and rebuilds strength.

Athletes: Regular chiropractic keeps joints moving well while PT addresses sport-specific movement patterns and prevents overuse injuries.

The practical considerations

Beyond the clinical differences, there are some practical factors:

Time commitment: A chiropractic visit is typically 10-15 minutes for a follow-up adjustment. PT sessions usually run 45-60 minutes because they include exercises. If you're short on time, this matters.

Insurance: Physical therapy is often covered better by insurance, especially post-surgery. Chiropractic coverage varies widely. At our practice, we're cash-based at $35 per visit, which is often comparable to PT copays anyway.

Referral requirements: Some insurance plans require a physician referral for PT. Chiropractors are direct-access providers in all 50 states, so you can come in without a referral.

Speed of results: Many people feel improvement after a single chiropractic adjustment. PT is typically a longer process because you're building strength and retraining movement patterns, which takes time.

My honest take

I think both professions do valuable work, and the right choice depends on your specific situation. I've referred plenty of patients to physical therapists when I thought that's what they needed. Good practitioners refer out when appropriate.

If you're not sure which you need, start with whoever you can get into sooner. Both chiropractors and physical therapists can evaluate your situation and tell you if you're in the right place. If you're not, they should point you in the right direction.

And if you've tried one and it's not helping after a few weeks, it's reasonable to try the other. Sometimes what looks like a muscle problem is actually a joint problem, or vice versa. The body is complicated.