Introduction
Physical therapists (PTs) and chiropractors are two types of health professionals that help people with musculoskeletal issues. Both professions focus on a holistic approach to treatment, but it is no secret that many PTs do not like chiropractors. This article will explore why physical therapists do not like chiropractors and uncover the underlying reasons behind the tension between the two professions.
Key Differences in Education and Training
Physical therapists and chiropractors both receive specialized training, but the programs differ in many ways.
Overview of Physical Therapist training
Physical therapy involves a doctorate-level degree that focuses on the diagnosis, management, and prevention of movement disorders. The program includes extensive training in anatomy, pharmacology, pathology, and neuroscience, as well as hands-on clinical practice. PTs are licensed by the state and must complete continuing education courses to maintain their license.
Overview of Chiropractor training
Chiropractic medicine involves a doctorate-level degree that focuses on the diagnosis and treatment of musculoskeletal issues. The program is typically shorter than PT schooling and contains fewer hours of coursework in anatomy, neuroscience, and pathology. In contrast, chiropractic programs include more training in spinal manipulation techniques. Chiropractors are licensed by the state and must also complete continuing education courses.
Differences in training and education
The difference in training and education can cause professional tension. Chiropractors are known for their focus on spinal manipulation, which some PTs view as overly aggressive or unnecessary. Chiropractic education may not equip chiropractors with the same depth of knowledge that PTs have, particularly in fields like pharmacology and disorders of the nervous system.
How differences in training/education create professional tension
These differences in training and education can cause PTs and chiropractors to clash. Physical therapists may view chiropractic manipulation as too risky and unproven, while chiropractors may see physical therapy as too focused on exercises and not addressing underlying spinal issues. These differing views can lead to limited collaboration and even conflict between the two professions.
Different Techniques and Approaches
PTs and chiropractors take different approaches to treating musculoskeletal problems, which can further exacerbate tensions.
Explanation of different approaches
Physical therapy emphasizes a wide range of interventions, including exercise, education, and modalities such as heat, ice, and electrical stimulation. Chiropractic care, on the other hand, is best known for its use of spinal manipulations, also known as chiropractic adjustments. These adjustments involve applying pressure to the spine and other joints to relieve pain and promote healing.
Specific examples of where these methods conflict
One example where methods conflict is in the treatment of low back pain. Physical therapists often use exercises and modalities to manage pain and improve function, while chiropractors may recommend frequent adjustments to the spine. Another example is in the treatment of neck pain. Chiropractors may manipulate the neck to achieve relief, while PTs may use exercises and manual therapy techniques like mobilization.
How conflicting methods exacerbate the tension
Conflicting methods can lead to challenges in patient care. For example, if a patient sees a chiropractor frequently for spinal manipulation, he or she may be hesitant to comply with a physical therapist’s exercise or stretching program.
Perspectives from PTs and Chiropractors
Understanding perspectives from both professions can provide insight into the root causes of tension.
Interviews with PTs and Chiropractors
Many PTs and chiropractors express frustration with the other profession. PTs may feel chiropractors are too aggressive in treating patients and may not have the same depth of knowledge in anatomy and physiology. In contrast, chiropractors may view physical therapy as not treating the underlying issue and void of hands-on treatment.
Presentation of both sides
While there are differences in perspective, many PTs and chiropractors agree that the professions can collaborate to provide better care to patients. The challenge is bridging the gap, which some believe requires both professions to better understand each other’s training and techniques.
Key arguments against chiropractic care
Some physical therapists criticize chiropractic care for its lack of scientific evidence and potential risks of spinal manipulation. Other PTs contend that chiropractors should refer patients with complex conditions to physical therapy for more comprehensive care. PTs have been subjected to criticisms as well, particularly those who overprescribe certain therapies or allow their patients to become overly dependent on passive modalities rather than active treatments.
Efficacy of Chiropractic Care
Chiropractic care’s efficacy to treat musculoskeletal issues is debated in both the PT and chiropractic communities.
Overview of research
While some studies show that chiropractic care is effective for treating certain conditions, such as low back pain, research is not unanimous. Many PTs believe that physical therapy is better equipped to provide comprehensive care and that evidence-based practice should be the gold standard for all musculoskeletal treatments.
Pros and cons of chiropractic care
Chiropractic care may provide short-term relief of certain musculoskeletal issues, but it is not a one-size-fits-all solution. There is a risk of adverse effects from spinal manipulation and, at times, the need for referral for advanced imaging or diagnostic testing. For some patients, active rehabilitative exercises may be more appropriate. Other patients may need a combination of chiropractic care and physical therapy.
Perspective from physical therapy
PTs hold a holistic perspective of treatment and prioritize evidence-based practice. While PTs believe that chiropractic care may have a place in musculoskeletal treatment, they prefer a comprehensive, active approach to care that includes exercise, education, and hands-on treatment.
Historical Overview
The history behind the professional tension between PTs and chiropractors is multifaceted.
Explanation of history
Chiropractic care emerged in the late 1800s, whereas physical therapy came onto the scene about 40 years later. Since then, both professions have gone through significant changes, which have driven a wedge between the two fields.
Contribution to current tension
Dominance battles exist within healthcare professions, and differences in training and techniques between PTs and chiropractors have caused open conflict. The patient-centered focus has been replaced with a lamentable mindset about which profession is most qualified to treat a patient’s condition.
Alternative Approaches
Despite the differences between PT and chiropractic care, there is evidence to suggest alternative approaches are a successful solution.
Explanation of alternative approaches
Alternative approaches involve collaboration between PT and chiropractic care. Practitioners may refer patients to the other profession as needed to provide more comprehensive care, or they may work together to create a comprehensive care plan that incorporates both techniques.
Benefits of collaboration
Collaboration can lead to improved patient outcomes, better communication between practitioners, and a more holistic approach to treatment. Both professions have gone through significant changes, which have driven a wedge between the two fields. Patients who benefit from an integrative approach to care may be less likely to get caught up in the divisiveness.
Bridging the gap between PT and Chiropractic care
For true progress to be made, we need both professions to come together as equals to share their knowledge and skills in an open and collaborative manner.
Conclusion
Physical therapists and chiropractors have different training, techniques, and perspectives, which can lead to tension in the field of musculoskeletal care. A lack of understanding between the two professions has led to challenges in patient care and a critical waste of valuable healthcare resources. While there is still work to be done, it is time for both PTs and chiropractors to bridge the gap and collaborate for better care.
Final Thoughts
Patients require an integrative approach to achieve the best possible outcomes. Physical therapists and chiropractors need to work together as a team to reduce professional tension, making use of their respective training, and techniques to eliminate excessive dependence on opioids or having patients feel forced to select one type of musculoskeletal care over the other. Patients can be very empowered by having access to the best of both options.
