Almost all patients with musculoskeletal pain who decide to see a doctor will usually first go to their primary care physicians. The primary care doctor will often write out a prescription for painkillers, as well as a referral to a physical therapist. While it may seem as though a physical therapist may be the best possible choice of specialist to treat musculoskeletal pain, this is not necessarily true. Physical therapy can provide benefit for certain types of pain, but chiropractic care may actually be a better choice overall to treat musculoskeletal pain. Dr. Nathen Horst believes it is important for patients to understand the difference between chiropractic care and physical therapy.
Physical therapists treat muscle, ligament, tendon, and soft tissue pain and stiffness. This is done with hands-on manipulation. This can be done through passive therapies such as the application of heat or ice on the affected area, massage, myofascial tissue release, and ultrasound. Physical therapy also involves active therapies such as stretching and strengthening muscles, and cardiovascular (aerobic) training.
Patients will generally only go see a physical therapist with a referral from their primary care physician. In other words, patients who experience muscle pain and stiffness will not just go directly to a physical therapist as their first treatment. However, the laws with regards to what is termed direct access to physical therapists are changing, according to the American Physical Therapy Association (APTA). This direct access only applies to those with the degree of doctor of physical therapy (DPT), which is a newly created program to help put physical therapists on par with MDs and doctors of chiropractic (DCs). The DPT is now considered the minimum professional degree required for all new students.
While chiropractic care does involve the muscles, tissues, tendons, and ligaments, there is one important distinction from physical therapy. Chiropractic care is, first and foremost, concerned with the joints of the body. Most physical therapy will not include any joint manipulation, while chiropractic care will focus heavily on the joints and how they move in relation to surrounding muscles, tendons, and ligaments. Chiropractic care will use many of the same passive and active treatments as physical therapy. However, it will also include joint adjustment, mobilization, or immobilization, depending upon the condition being treated.
Patients can see chiropractors without having to first get a referral from their primary care doctor. However, some HMO programs will still want a referral for chiropractic care from the primary care doctor. Patients should check their benefits to determine if they need a referral.
Chiropractic education is geared toward a professional medical degree. A chiropractic curriculum will include classes on physiology, pathology, clinical examination, radiology, laboratory testing, and interpretation and diagnosis.
The main difference between physical therapy and chiropractic care is in terms of scope of practice. While physical therapists can treat conditions involving the muscular structure of the body, chiropractors can treat the entire musculoskeletal system at once. Although many patients may feel that physical therapy will meet their needs, they may actually need the more complete care provided by a chiropractor.