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What’s the Difference Between a Physical Therapist and a Chiropractor?

While both practitioners seek to address pain and promote healing in their patients, the jobs do vary.

September 1, 2021

physical therapist working on womans shoulder
physical therapist working on womans shoulder
catherine gregory

Written and Reported by
Catherine Ryan Gregory
Contributing Writer

Do you want to help people not only feel better—heal an injury or relieve chronic pain, for example—but also promote their overall wellness? Both chiropractors and physical therapists work to address immediate physical pain and look at the body holistically.

Each job, however, follows a different path toward that goal. Which job interests you?

Physical therapy emphasizes functional health. A practitioner may focus on restoring movement needed to work, such as reaching or even sitting, for example, or they may help a person get back to enjoying a sport or playing with grandchildren after an injury.

Chiropractic restores overall health and helps people regain movement by realigning the musculoskeletal system, especially the spine.

Physical therapy focuses on restoring functional health, while chiropractic focuses on restoring overall health.

Roles and Responsibilities

There is plenty of crossover between physical therapy and chiropractic, says Andrea Mursu, DC, a chiropractor in Chicago. “We chiropractors do some physical therapy, and physical therapists do some adjustment and mobilization. The difference is each job’s primary focus.”

Both chiropractic and physical therapy focus on helping patients not only feel better but get to a healthier state—in other words, “overall wellness,” says Greg Gillum, DPT, a physical therapist in Wenatchee, Washington. People often try chiropractic or physical therapy after other approaches don’t work.

Physical therapists often treat sports or work injuries, post-operative challenges, and even the effects of a stroke. Patients are generally referred to physical therapy for a specific issue—like restoring core strength after pregnancy or increasing mobility after ankle surgery—and are limited to treating that concern because of insurance coverage.

Chiropractors, on the other hand, “treat the whole body versus one region,” Mursu says. Chiropractors often help people with back pain and can also alleviate issues that don’t seem related to the spine, such as headache and insomnia. Why?

“We don’t just align the spine and take pain away,” Mursu explains. “We’re releasing pressure on the nervous system so the body can heal itself and function at its best.”

What Do Chiropractors and Physical Therapists Do All Day?

While both physical therapists and chiropractors help patients feel better, their day-to-day differs.

Physical Therapists’ Daily Duties:


“Physical therapists have a lot of hands-on time, meaning manual work, tissue massage, joint mobilizations, and more,” explains Gillum. They are trained to work on the body from head to toe—literally.

A physical therapist starts working with a new client by doing a “movement screen” to see how a patient moves—if the patient can’t fully extend an arm or turn their head to one side, for example. A physical therapist will not only work on the site of injury or discomfort but “look upstream” to sleuth out what caused the limitation.

So if a patient has numbness and tingling in their fingers, a physical therapist might discover that the pinched nerve in their shoulder is actually caused by too-tight neck muscles.  “We look at how to get that location healthy again and why it happened so we can fix that as well,” Gillum says. “Then patients don’t have to continue seeing us forever.”  

Physical therapists and patients work together as a team. They may brainstorm ways to incorporate stretching into an office job or exercise in a way that feels doable while recovering from surgery. They also test out strategies during a session, where they can get real-time feedback. For example, if an exercise is causing more pain, not less, they can adjust in the moment and try something new.

Another duty: Physical therapists emphasize educating patients on how to continue healing and maintain progress at home. “For an hour, patients have my undivided attention, but there are 23 other hours in the day,” Gillum says. “We often educate patients to engrain patterns of movement, stretch out a part of the body, or exercise they can do at home.”

Physical therapists:

  • Look for the root cause of pain
  • Work as a team with their patients
  • Educate patients about how to maintain progress at home

Chiropractors’ Daily Duties:


Chiropractors also begin work with a new patient by doing evaluations, not only of how they move but also a full survey of health habits—their sleep, diet, exercise, and other factors that affect “whole body wellness,” Mursu says.

Chiropractors then mobilize the spine and make adjustments that realign the musculoskeletal system. This may include what’s called high-velocity, low-amplitude adjustments (the small and quick adjustments that target one joint at a time) or more gradual adjustments, along with stretching, heat or cold therapy, or other treatments.

Chiropractors who own their own practice or work as contractors also spend a lot of time running their small business. “I manage employees, pay bills, network, and more to run my business,” Mursu says. “I wear a lot of other hats in addition to helping patients.”

Chiropractors:

  • Evaluate patients’ movements and health habits
  • Adjust patients’ spines to realign the musculoskeletal system
  • Often run their own practices

Where Can I Work?

Both practitioners have flexibility in where they work. Physical therapists can be found in a wide range of workplaces. “The nice thing about my profession is that we can work in a hospital, retirement facility, rehab facility, a private office,” Gillum says.

Chiropractors can work in someone else’s or their own practice or in an integrative facility, an office with a variety of practitioners offering a range of care from acupuncture to primary care.

It’s more common for chiropractors to open their own practice and work as a sole proprietor or small business owner. Physical therapists are more likely than chiropractors to work in hospital settings.

Do Physical Therapists and Chiropractors Ever Work Together?

It’s no surprise that you’re reading about the differences between chiropractors and physical therapists: Many people are unsure of the boundaries between the two fields.

“It’s really common for people to come in and have no idea what they signed up for,” Mursu, the chiropractor, says. “Even my husband, when we first started dating, thought I was a physical therapist!”

The two professions’ common focus on helping patients means they sometimes work together. In some integrative care centers, a patient might see a chiropractor and a physical therapist for the same concern.

The two also refer patients to one another. “My goal is to help people live better lives. If I’m not getting results, I need to find someone who can,” Mursu says.

Networking can build relationships between providers, enabling them to refer back and forth to one another. This strategy can help both practitioners to build their practice and help their patients heal.

Differences at a Glance: Physical Therapist or Chiropractor?

Job Duties

Physical Therapist

Physical therapists provide hands-on stretching and mobilization, and they teach patients exercises to continue healing outside of appointments.

Chiropractor

Specifics vary depending on state regulations, but chiropractors focus on mobilizing and adjusting the spine to restore balance to the musculoskeletal system.

Philosophy

Physical Therapist

Physical therapists translate a deep understanding of anatomy and physiology to restore a patient’s ability to move, work, and enjoy recreational activities

Chiropractor

The chiropractic philosophy teaches that misalignment of the spine and musculoskeletal system can cause pain and illness.

Education

Physical Therapist

A Doctor of Physical Therapy (DPT) typically takes three years to complete.

Chiropractor

A doctor of chiropractic (DC) typically takes four years to complete.

Licensure

Physical Therapist

After earning a DPT and passing the National Physical Therapy exams, physical therapists must become licensed in the state in which they practice.

Chiropractor

In addition to earning a DC and passing the National Board of Chiropractic Examiners exams, chiropractors must become licensed by the state in which they practice. 

Where They Work

Physical Therapist

Private practice, in another physical therapists’ private practice, hospitals, assisted care facilities, integrative health centers

Chiropractor

Private practice, in another chiropractor’s private practice, integrative health centers

Median Salary

Physical Therapist

Median salary $91,010 annually (U.S. Bureau of Labor Statistics, 2020)

Chiropractor

Median salary $70,720 annually (U.S. Bureau of Labor Statistics, 2020)

What Degree Do I Need?

Both chiropractors and physical therapists need advanced degrees. A doctorate in chiropractic studies takes a little longer, however, than a doctorate in physical therapy.

Physical Therapist

Degree Needed: Doctor of physical therapy (DPT) from an accredited school

How Long it Takes: Three years

Certifications: Physical therapists can earn advanced certifications in nine specialties, including geriatrics and sports.

What Else You Should Know: You must pass the National Physical Therapy Exams (NPTE) and become licensed in the state where you practice. Most states require additional qualifications, such as education on local laws and regulations or a criminal background check.

Chiropractor

Degree Needed: Doctor of chiropractic (DC) from an accredited school

How Long it Takes: Four years

Certifications: You can earn optional certifications after becoming licensed, called diplomates, in subjects such as acupuncture and veterinary chiropractic.

What Else You Should Know: You must pass the National Board of Chiropractic Examiners (NBCE) tests and become licensed in the state where you practice. Most states have additional requirements, such as exams or interviews.

Licensing and Certification 

Both chiropractors and physical therapists must be licensed by the board of the state in which they practice. States determine licensing independently from the national boards for each profession.

Chiropractic Licensing

Chiropractors apply for a license through the state licensing board. A license is required in all 50 states plus Washington, D.C., Puerto Rico, and the U.S. Virgin Islands. Requirements for licensure vary from state to state. Don’t be surprised if you are asked to pass a state-specific exam that covers local regulations, submit a criminal background check or fingerprints, or pass the NBCE physiotherapy exam.

Physical Therapist Licensing

The licensing process is similar for physical therapists. State licensing boards for all states, Washington, D.C., and U.S. territories offer licensure after applicants satisfy all the local requirements, in addition to earning a DPT and passing national exams. Requirements can include taking a class on local regulations, undergoing a background check, and passing a local jurisprudence exam.

Some states have reciprocity with others. That means that both chiropractors and physical therapists who are licensed in one state can be licensed in another state that observes reciprocity.

What Can I Earn? 

Money may not make the world go round, but it probably factors into the career you choose. It certainly played a part in Gillum’s path. The physical therapist first worked as a personal trainer, which satisfied his love of helping people and supporting their wellness goals. “I quickly realized there was a financial ceiling with that job, and physical therapy was a logical step forward,” he adds.

Physical therapists make a median salary of $91,010 in the U.S. Pay depends on where you practice, the type of setting in which you work, and other factors. For example, Nevada, California, and Alaska are home to the highest median salaries for physical therapists.

On average, physical therapists are paid more than chiropractors. Chiropractors earn a median salary of $70,720 annually. Pay varies in this field, too. Washington, Missouri, and Oklahoma are the top-paying states for chiropractors.

Physical TherapistsChiropractors
Median Salary$91,010$70,720
Bottom 10%$63,530$35,390
Top 10%$126,780$137,950
Projected Job Growth18.2%4.5%

Chiropractors earn an annual median wage of $70,720, compared to $91,010 for physical therapists, according to the BLS.

Chiropractors who are self-employed have the potential to out-earn their peers who work in someone else’s practice. That said, they also have to cover more expenses, from rent and utilities to equipment and employees.

It’s intuitive that years on the job factor into what you’ll earn as a chiropractor or physical therapist. You can also increase your pay in other ways. Earning a certification, specializing in a niche, marketing, and referral relationships can all help you build up your business and increase prices.

What’s the Career Outlook?

Demand for physical therapists is booming, says the Bureau of Labor Statistics. They estimate that the field will grow by 18% by 2029—a rate that outpaces other professions. Aging baby boomers, more people embracing an active lifestyle, and mobility issues associated with diabetes and obesity contribute to the higher need for PTs. Those trends won’t stop anytime soon, which translates into job security for this field.

Demand for physical therapists outpaces that for chiropractors: 18% vs 4% respectively, according to the BLS.

Chiropractic is growing at a more modest 4%, which is average for jobs in the U.S. “We haven’t made huge strides” in attracting more people to chiropractic, Mursu says. “We’re not doing enough to spread the word of what chiropractic can do.”

Both chiropractors and physical therapists need “a passion to want to help other people,” Gillum says. They both also thrive on learning new things and problem-solving, especially when they see a patient with stubborn symptoms. They both appreciate that every day is different: new patients, new challenges, new solutions.

“There’s definitely a physical aspect of my job. I’m up moving around and active every day,” Gillum says. Physical therapists might get down on the ground to demonstrate an exercise or use their hands to rotate a patient’s stiff joint. Someone who feels energized by moving all day may prefer the physical therapy path.

Chiropractors benefit from an “entrepreneurial spirit,” Mursu says. “Most chiropractors have an endgame to own their own practice. I like that I’m my own boss.” An interest or background in business or entrepreneurship can be a terrific foundation for chiropractors who aim to strike out on their own. Chiropractic has more opportunities for people driven to grow a business from the ground up.

Both physical therapists and chiropractors enjoy helping and healing others.

And while both fields draw from people who studied sciences like anatomy and physiology in school, Gillum emphasizes that these healing professions need people of all backgrounds. Some of his classmates in physical therapy school held a bachelor’s degree in business; others were going back to school to start a new career.

The bottom line: Both chiropractic and physical therapy are extremely rewarding healing professions. As Gillum says, “I feel a lot of gratification and like helping people get back to the things they need to do and the things they enjoy doing.”


greg gillium

With professional insight from:
Greg Gillum, DPT, FAFS
Physical Therapist

andrea mursu

Andrea Mursu, DC
Chiropractor