Chiropractor vs Physical Therapist

As America’s Baby Boomer generation ages and the scientific understanding of pain and movement evolves, the demand for physical therapists and chiropractors has grown significantly in recent years. 

Physical therapists and chiropractors use non-surgical methods to provide treatment, rehabilitation, or preventive care to those of all ages. Both typically work in an office, clinic, care facility, or home visit setting, where patients can receive one-on-one care. However, the professions differ in treatment philosophy.

Physical therapists use exercises, hands-on therapy, and assistive equipment to provide care. This includes demonstrating exercises or stretching maneuvers for patients to do at home, using hands-on treatment such as stretching muscles, or equipment such as wheelchairs or exercise machines. Some PTs may see many different patients in one day, working with everyone from a patient who has cerebral palsy to a patient recovering from a sports injury. Others may focus on a specific area of practice, such as pediatric or orthopedic care. Typically, physical therapists are seen by referral and work as part of a patient’s care team.

Physical therapists must obtain a Doctor of Physical Therapy (DPT) degree and be licensed to practice physical therapy. Licensing requirements vary by state but universally require passing the National Physical Therapy Examination. Some physical therapists may want to pursue a specialty through the American Board of Physical Therapist Specialities (ABPTS). The ABPTS offers nine specialties, including women’s health, oncology, geriatrics, and sports.

Alternatively, chiropractors focus on the alignment of the musculoskeletal system, particularly the spine, to provide treatment and care. They use spinal adjustments, ultrasound, massage therapy, and more to help patients with musculoskeletal health problems. The field has over 100 methods of treatment, and there is a wealth of chiropractic specialties to work in. 

Chiropractors may choose to specialize in multiple methods or work within a specific area of chiropractic. Similar to physical therapists, chiropractors may see a lot of different patients in one day. However, seeing a chiropractor does not require a referral unless otherwise required by a health insurance plan.

Chiropractors must be licensed to practice chiropractic, requiring obtaining a Doctor of Chiropractic (DC) degree. While states have different licensure requirements, each state requires passage of the National Board of Chiropractic Examiners exam.

Side-by-Side Comparison: Chiropractor vs Physical Therapist (PT)

Below is a side-by-side comparison of chiropractors and physical therapists, including the typical timeline to practice, responsibilities, education, licensure, and professional resources.

ChiropractorsPhysical Therapists (PTs)
EducationChiropractors are not required to have a bachelor’s degree but must have a Doctor of Chiropractic (DC) degree. However, most state licensing boards require chiropractors to have a bachelor’s degree and a DC degree. Many accredited chiropractic schools offer concurrent BS/DC degrees.
Additional certifications in a variety of specialties are also available.
Physical therapists must earn a bachelor’s degree and a Doctor of Physical Therapy degree (DPT). There are many accredited programs that offer concurrent BS/DPT degrees. The American Board of Physical Therapist Specialities (ABPTS) offers additional certifications in nine specialty areas.
Timeline to PracticeIt typically takes over three years of graduate education, training, and credentialing for chiropractors to practice after earning a bachelor’s degree.After earning a bachelor’s degree, PTs generally take three years of graduate education and training to qualify for a license to practice. However, additional residency and fellowship options may extend this timeline to four or five years.
Typical Duties• Review patients’ medical history and meet with them to understand their concerns. This may include a physical examination, such as testing their reflexes or assessing their posture.
• Work with patients to develop a care plan, including other health and lifestyle advice, such as nutrition or sleep patterns.
• Use neuromusculoskeletal therapy to adjust patients’ spine, joints, and more. This may include massage therapy, spinal manipulations or adjustments, or using additional equipment such as braces.
• Monitor patient progress, adjusting care plans as needed or referring patients to a medical provider.
• Go over referrals, notes, and medical history provided by patients’ care teams. This could include information provided by surgeons, primary care physicians, and more.
• Meet with patients to understand their health needs, including having them perform exercises and movements to diagnose areas needing care.
• Compile individualized care or recovery plans for each patient, bringing together information provided by their care team and themselves.
• Work one-on-one with patients to meet their care plan goals. This could include demonstrating exercises or stretching maneuvers, using hands-on therapy, or equipment such as wheelchairs or exercise machines.
• Monitor patient progress and update care plans as needed.
• Provide education and health and wellness information to patients around the care process.
Can They Prescribe Medicines?No. Chiropractors are not licensed medical professionals. However, alternative medicines and hands-on natural healing approaches are the bedrock of this profession, and therefore, prescribing medicine is outside of its focus.No. While physical therapists commonly work as part of a healthcare team and may recommend certain kinds of medical treatment, they cannot prescribe medicine.
Common Practice SettingsChiropractors typically work in a clinic or office setting, although some chiropractors may provide care at a patient’s home or work non-traditional hours to accommodate patients’ schedules.Most physical therapists work in a clinical or office setting. However, PTs may also work in a care facility or home visit setting where patients can receive one-on-one care.
Licensing and CertificationLicensure requirements vary state-by-state. However, all states require passage of the National Board of Chiropractic Examiners exam. This exam includes four parts that test applicants on basic science, clinical science, clinical areas, and practical skills. There are also elective exams offered in acupuncture and physiotherapy.

Licensed chiropractors may choose to receive their diplomate (certification) through one of the specialty boards or councils recognized by the
American Board of Chiropractic Specialities (ABCS).

Requirements differ by state and specialty board or council. However, those looking to obtain their diplomate generally need to complete additional clinical work in the specialty area and potentially pass additional exams.

Note that available specialties may vary by state. Some states do not permit certain chiropractic specialties, so chiropractors interested in a specialty area should check state licensing requirements before pursuing a diplomate.
Each state requires passage of the National Physical Therapy Examination, regardless of individual licensing requirements. This exam is administered by the Federation of State Boards of Physical Therapy (FSBPT). Some states may require additional exams, such as a jurisprudence exam that tests knowledge of state laws and regulations. Those ready to apply for licensure should check the individual requirements for the state they want to practice physical therapy in.

The American Board of Physical Therapist Specialities (ABPTS) is the primary professional board that manages specialist certification for physical therapists. The ABPTS offers nine specialties:

• Cardiovascular & Pulmonary
• Clinical Electrophysiology
• Oncology
• Women’s Health
• Geriatrics
• Neurology
• Orthopaedics
• Pediatrics
• Sports

Physical therapists looking to get certified in a specialty area required to 1) Pass an exam and either complete 2,000 hours of clinical work in the specialist area they are interested in; or 2) Successfully complete a clinical residency program in that specialist area.
Continuing Education RequirementsContinuing education requirements and subjects vary by state. For example, California requires 24 hours of continuing education a year, while Iowa requires 60 hours over two years.

States condition license renewal on meeting these continuing education requirements.

Physical therapists should check with their state licensing board for continuing education requirements. Many states will only renew a license to practice physical therapy if continuing education requirements are met. Physical therapists may take continuing education courses on new state laws, best practices, or recent trends.
SpecializationsChiropractors interested in choosing a specialty can focus on specific patient populations, such as sports or neurology. Chiropractors looking to choose a specialty will need to pursue additional credentials in addition to licensure requirements.

The American Board of Chiropractic Specialities (ABCS) coordinates specialty councils and boards accredited by the American Chiropractic Association (ABA). Each board and council represents a different specialty and has additional requirements for certification (also known as diplomate certification) that may differ by state.

Typically, certification requires additional clinical experience and passage of an exam and annual continuing education requirements to stay up-to-date on current trends and best practices.
Physical therapists interested in specializing may choose to complete a clinical residency program after they receive licensure. These typically yearlong programs provide the opportunity to gain experience and specialized training.

Additional fellowships are also available for those who wish to gain a deeper understanding of specific specialty areas.

Licensed physical therapists may choose to become certified specialists through the American Board of Physical Therapist Specialities (ABPTS). There are nine specialties available through the ABPTS, including women’s health, oncology, geriatrics, and sports. Certified specialists must pass an exam, and complete 2,000 hours of clinical work in the specialist area they are interested in or successfully complete a clinical residency program in that specialty area. Physical therapists may choose one or more areas to specialize in, so long as they meet the certification requirements.
Career Outlook (Bureau of Labor Statistics, 2019-2029)
    The BLS (2020) expects employment for chiropractors to grow by 4 percent between 2019 and 2029, as more health insurance plans cover chiropractic care and the Baby Boomer generation ages. This will add 2,300 jobs nationally.
The BLS (2020) projects demand for PTs will increase by 18 percent by 2029; this is primarily a result of the aging Baby Boomer population in the United States. This will add 47,000 jobs nationally.
Professional Associations and ResourcesCommission on Accreditation in Physical Therapy Education (CAPTE)
Physical Therapist Centralized Application Service (PTCAS)
American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE)
Federation of State Boards of Physical Therapy (FSBPT)
American Board of Physical Therapy Specialists (ABPTS) 
American Physical Therapy Association (APTA)

Salary Data Chiropractor vs Physical Therapist

Becoming a chiropractor or physical therapist requires 6-7 years of undergraduate and graduate-level education, so it’s not surprising that they earn similar salaries. Here’s a breakdown of the average annual salaries and the wage percentiles for chiropractors and physical therapists. All data comes from the BLS Occupational Employment and Wage Statistics from May 2020.

How Much Do Chiropractors Make?

In May 2020, the BLS shows chiropractors earned average annual salaries of $83,830 or $40.30 per hour. Here are the wage percentiles for the same year:

United States (34,760 chiropractors employed, not including self-employed workers)

  • 10th percentile: $35,390
  • 25th percentile: $53,070
  • 50th percentile (median): $70,720
  • 75th percentile: $98,050
  • 90th percentile: $137,950

States with the highest average annual salaries for chiropractors in May 2020 are as follows: 

  • Washington: $125,860 
  • Missouri: $106,870
  • Oklahoma: $105,170
  • New Jersey: $103,120
  • Connecticut: $102,290

How Much Do Physical Therapists Make?

In May 2020, the BLS reports that the average annual salary for physical therapists is $91,680 or $44.08 per hour. The wage percentiles for the same year are as follows: 

United States (220,870 physical therapists employed, not included self-employed workers)

  • 10th percentile: $63,530
  • 25th percentile: $75,360
  • 50th percentile (median): $91,010
  • 75th percentile: $106,060
  • 90th percentile: $126,780

The states that pay the highest annual salaries for physical therapists in May 2020 are: 

  • Nevada: $108,580
  • California: $104,500
  • Alaska: $101,190
  • New Jersey: $100,740
  • Connecticut: $100,580
Bree Nicolello

Bree Nicolello


Bree is an urban planner and freelance writer based in Seattle, WA. She has worked on land use and housing policy issues throughout the Pacific Northwest. She previously led Run Oregon Run, a nonprofit dedicated to helping Oregonians run for office and apply to boards and commissions. When not writing, she is lovingly tending to her cast iron pans.

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