Have you been looking for the best treatment approach to use for overcoming chronic neck pain or back pain or headaches?

Today, you’re in luck because I’m about to save you a whole lot of time shopping around.

In this post, I’m going to compare the most popular treatment approaches of Chiropractic and Physical Therapy to help you choose the best approach for all your pain relief needs.

Whether you’re new to Chiropractic and Physical Therapy or are a pro, this guide will tell you everything you need for making the decision that is right for you and your goals. 

Within each approach, I’ll be evaluating:

• Strengths: what are they best at
• Weaknesses: what do they not specialize in
• Expertise: the special training they each have
• And much more! 

Only after a specific section of the Chiropractic and Physical Therapy comparison? Jump around using the links above to find what you need. The real value is in the discussion of each in comparison to the other.

TIP: Read the whole guide to gain a better understanding of how you might benefit from each discipline. 

Ready for the comparative discussion of the most popular treatments for musculoskeletal pain?

Let’s get into it!

Treatment Overview

Before we get into the review, let me give you a bird’s eye view of both Chiropractic and Physical Therapy. 

First, if you’ve had the chance to experience both chiropractic and physical therapy you may have found that they each have their own strengths with little overlap. 

When I first started as a chiropractor there was little collaboration between chiropractic and medicine and physical therapy. And it served me well over the years, as I worked hard to deepen my skills to serve people the best. 

I knew I wanted to be able to help people recover from chronic neck and back problems without easy access to the medical system.

I’ve become an expert in correcting chronic neck pain, headaches, and low back pain from my work in chiropractic for more than 35 years. To be honest I’ve also been motivated to develop the best program for myself. 

Before we dive into my comparative review, if you’re not sure if either chiropractic or physical therapy is what you need right now – or you want an in-depth look at how they work and what you can do with them – this will still serve you as its better to be prepared before you need something than to have to figure it out in the midst of pain. 

Let’s Compare, One Feature at a Time

By the end of this article, you’ll know so much about the relative advantages of both chiropractic and physical therapy that you’ll be ready to make a choice and probably could open your own referral service.

Who has the better record when it comes to pain relief?

This is perhaps the most important and unfortunately there isn’t a clear cut answer without asking more questions.

For most of us suffering with neck or back pain or headaches, the most important feature in a treatment is how well it does in correcting that pain. 

After all that is perhaps the most common motivation of someone seeking either chiropractic or physical therapy care. 

It can be challenging to find the best treatment that has the best impact on correcting your chronic neck pain, back pain, or headaches. 

I’ve written many times before that in order for any treatment to be effective it must be addressing the core deficit or imbalance. So, let’s take a brief look at the deficits and imbalances that both chiropractic and physical therapy address:

• Chiropractic is a Neurological and Mechanical solution to a problem with a fundamental mechanical imbalance. 

The vast majority of neck and back pain (and headaches and sciatica) are caused by long standing mechanical dysfunction in the joints of the pelvis and spine. If the problem is coming from a mechanical problem it makes sense that the most appropriate solution must be mechanical as well. 

If the underlying cause of your headaches or back pain or sciatica is arising due to long standing dysfunction in the joints of the pelvis and spine, then chiropractic is an exceptional choice. 

• Physical Therapy is primarily an exercise based approach to muscular and functional imbalances. If you have neck pain or back pain the physical therapy approach is to prescribe a series of exercises for the area that is affected. 

If you have been terribly inactive for an unrelated reason and as a result you developed neck or back pain, then the physical therapy exercise approach is likely to help. 

Who’s the winner?

You are the winner and come out on top in this category  as long as you are able to get a good idea of the underlying cause of your problems. 

This is especially important if you have tried a number of approaches that have either given you minimal help or have not helped at all.

When you’re looking for chronic pain relief, the last thing you want is to travel down the road of ineffective treatments, wasting more of  your time and money.  

The more you know about the when, how, and why your pain started the better chance you have of identifying a likely cause. 

Almost every instance of neck and back pain is mechanical in nature. If the problem is not too chronic there is a greater chance that either physical therapy or chiropractic can help.

And, the longer you have suffered the more you will benefit from both approaches. But, let’s dive a bit deeper into what is most likely to help you the most. 

Exercise for Chronic Neck or Back Pain

The next feature on the list is one that every one tends to try even before they see a doctor or physical therapist. It’s the rare person who comes into my office that has not been stretching or doing exercises on their own. 

If the exercise had been successful I wouldn’t be seeing them. I’ve found that proper exercise can be extremely helpful when used at the right times. But, I have yet to see someone for whom exercise was all they needed. 

Physical Therapy is great at prescribing exercises. While there are some exceptional physical therapists the majority tend to prescribe the same set of exercises for everyone with the same “condition”, whether that be low back pain or neck pain. 

If you can find a physical therapist who assesses you and prescribes exercises specific to your situation then go with that. Appropriate exercises are not going to hurt you. Even if they don’t fully correct your problem they will help. 

The problem with exercises is when they are inappropriately prescribed. Often the muscle tension in the neck or lower back is actually the body’s way of compensating or bracing for the injury. When you remove this bracing you can destabilize the area and cause an increase in pain. 

Who’s the winner?

Highly skilled physical therapists (of which there are few) come out ahead with prescribing exercises because that is their bread and butter. This is what they do and they better do it well.

That said, we’ve already discussed why exercise is seldom the best first line treatment with chronic neck or back pain. 

Passive Modalities

Passive modalities like electrical muscle stimulation, ice, heat, ultrasound are often used by both chiropractors and physical therapists. But, just because they use them doesn’t mean they have much benefit. 

The reality is that these modalities do very, very, very little to help with the correction of the problem. 

Then why are they used? Good question!

One reason is that they have been used for decades and some things in healthcare are resistant to dying.

Another reason is that they give you the perception of more being done than is actually done, to help justify fees.

And, another reason is that the practice can bill a higher fee to insurance. 

BUT, none of that changes the fact that whether you use passive modalities or not, it will not impact whether or not you get well. 

Who’s the winner?

You come out ahead because now you have the power to negotiate what works and what doesn’t work.  And, if  you come across a PT or a Chiropractor who insists on using these largely useless procedures you can cross them off your list and find another practitioner. 

Massage or Soft Tissue Therapy

When we are discussing chronic issues like neck pain, headaches, arm pain and numbness, back pain, sciatica, etc. there is always some degree of muscle tightness, tension, or spasm. The big challenge is identifying whether the muscle “spasm” is causing the problem or is it the result of the problem?

The vast majority of patients that come to see me at Life Chiropractic in Grass Valley have seen a massage therapist, use a massage gun, or both.  

When I ask whether it helped the answer is invariably either no or that it offered brief relief. 

So, where does massage or other forms of soft tissue therapy fit in?

My biggest concern initially is that the muscle tightness might be the body’s attempt to brace or stabilize the painful area. If we remove that stability it can cause the problem to get worse. 

What I suggest to my patients is that we do a couple of things before they see a massage therapist:

• Identify the core imbalance causing their problem
• Return their pelvis and spine to balance
• Start the process of correcting spinal misalignments and motion

This way I feel confident we aren’t removing the body’s defenses or stability since we’ve restored balance and stability before the soft tissue therapy. 

With our lifestyle soft tissue therapy is an exceptional way to offset the physical stresses of modern life in conjunction with chiropractic care. 

Who’s the winner?

You are the winner! There are a number of great ways to help address chronic neck and back pain and stay out of pain. 

The key is knowing when to use each approach. As I’ve noted muscle tension is rarely if ever the cause by itself. It is almost always the result of the body’s attempt to compensate for some other imbalance.

Which Treatment is a Better Value: Chiropractic or Physical Therapy?

All the features in the world mean very little if you can’t afford them.

There are a lot of considerations around value or price. Health insurance covers less and less with higher and higher deductibles and copayments. 

Since I have no idea what your insurance might be let’s assume you are paying out of pocket for your care:

• Physical Therapy office visits are likely to cost $150-$250 per visit with much of that coming from rather worthless modalities like ultrasound, e-stim, heat, ice.
• Physical Therapy visits in most clinics are actually conducted by a Physical Therapy Aide and not the physical therapist. 
• Corrective Chiropractic care office visits are likely to cost between $45 and $75 per visit.
• Chiropractic adjustments are always delivered by a licensed Doctor of Chiropractic.

The real value is found in the change that the service delivers. If you get out of pain in a reasonable time then there is great value in the service.  If the service has minimal impact on your condition then obviously there is less value. 

But you get more bang for your buck if you find a treatment that can help you reduce or eliminate your pain and keep it that way with minimal ongoing effort. 

Both chiropractic and physical therapy are great values in addition to the fact that there is minimal downside. Medical procedures come with a wide range of risks and the research demonstrates they have poorer outcomes. 

Which Treatment is better: 

Chiropractic or Physical Therapy?

By this point, you may already know that given my decades as a practicing chiropractor from reading between the lines. It’s true! I believe that there is nothing as natural and impactful as corrective chiropractic.

Do I utilize exercises? 

Yes, but only once we’ve returned the body to balance. Otherwise we are reinforcing the imbalances. 

Do I use passive modalities?

Why would I? They don’t work.

What about massage and soft tissue therapy?

Yes, after balance has been achieved. Many times it is no longer necessary but when it is, the impact is far greater after balance has been achieved. 

There are physical therapists that function much like corrective chiropractors. If you can find one, use them. And, there are chiropractors that are nothing more than glorified physical therapists, using ice and heat and ultrasound and e-stim. Stay away from them. 

However, if you can get a referral and ask some detailed questions, you will find better skilled practitioners.

If you are in Nevada County you can schedule a visit with Life Chiropractic in Grass Valley here:  Schedule Here