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 therapy such as stretching muscles, or equipment such as wheelchairs or exercise machines. Some PTs may see a lot of 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 orthopaedic care. Typically, physical therapists are seen by referral and work as part of a patient’s care team.

Physical therapists are required to 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, which requires 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 a number of 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 PracticeAfter earning a bachelor’s degree, it typically takes just over three years of graduate education, training, and credentialing for chiropractors to practice.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 meeting 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, which may include additional 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 in need of care.
• Compile individualized care or recovery plans for each patient, bringing together information provided by their care team and the patient 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 it’s focus.No. While physical therapists commonly work as part of a healthcare team and may recommend certain kinds of medical treatment, they are not able to 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’ schedule. 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 tests 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 prior to 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 are 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 Requirements Continuing 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.
Specializations Chiropractors interested in choosing a specialty can focus on certain 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 separate requirements for certification (also known as diplomate certification) that may differ by state.

Typically, certification requires additional clinical experience and passage of an exam, as well as 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 a certified specialist through the American Board of Physical Therapist Specialities (ABPTS). There are nine specialities available through the ABPTS, including women’s health, oncology, geriatrics, and sports. Certified specialists are required to pass an exam and either 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 of more areas to specialize in, so long as they meet the certification requirements.
Salary (Bureau of Labor Statistics, 2019)
    According to the BLS, chiropractors made a median annual wage of $71,410 ($34.33 per hour).
Here were the wage percentiles:

United States (50,300 chiropractors employed)
• 10th percentile: $34,990
• 25th percentile: $51,890
• 50th percentile (median): $71,410
• 75th percentile: $99,290
• 90th percentile: $149,170
The BLS reported that physical therapists made a median annual wage of $87,930 ($42.27 per hour).

Here were the wage percentiles:

United States (247,700 chiropractors employed)
• 10th percentile: $60,390
• 25th percentile: $72,680
• 50th percentile (median): $87,930
• 75th percentile: $102,530
• 90th percentile: $123,350
Career Outlook (Bureau of Labor Statistics, 2018-2028)
    The BLS expects employment for chiropractors to grow by 7 percent between 2018 and 2028, as more health insurance plans cover chiropractic care and the Baby Boomer generation ages. This will add 3,700 jobs nationally.
The BLS projects demand for PTs will increase by 22 percent by 2028; this is in large part a result of the aging Baby Boomer population in the United States. This will add 54,200 jobs nationally.
Professional Associations and Resources• •
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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