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

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 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.

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?

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.

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.

Here are median salaries, including the national median and by state for both paths:

Pay depends on where you practice, the type of setting in which you work, and other factors. For example, Nevada, California, Connecticut, Delaware, and New Jersey are home to the highest median salaries for physical therapists.

On average, physical therapists are paid more than chiropractors. Pay varies in this field, too. Connecticut, New Jersey, Nevada, Massachusetts, and New York are the top-paying states for chiropractors.

Chiropractors earn an annual median wage of $75,000, compared to $95,620 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 21% by 2030—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: 21% vs 11% respectively, according to the BLS.

Chiropractic is growing at a more modest 11%, which is still above average for jobs in the U.S. “We haven’t made huge strides” in attracting more people to the chiropractic field of study, Mursu says. “We’re not doing enough to spread the word of what chiropractic techniques can do.”

Which Job is Right for You?

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.”