Should I see a Chiropractor or Physiotherapist?

Which one is best for Chronic Back Pain?

The best answer is probably, ‘it depends.’ 

Both professions tend to focus on using different types of physical treatment to restore normal function to the neuro-musculoskeletal system. 

This generally results in relieving or reducing pain and other symptoms associated with the dysfunction.

PT or DC for Back Pain?

It depends on a lot of things, but primarily starting with what is causing the back pain. Diagnosis always precedes treatment and getting the right diagnosis is generally necessary to get the next steps right.

A chiropractor will evaluate you – typically with a very thorough examination, order any necessary labwork, x-rays, and advanced imaging. 

I’m unsure about PTs. It may depend on state as far as what they can do in the way of diagnosis and testing.  

I’m also not sure about seeing the PT first – whether they have direct access to patients or require a referral from a Chiropractor or an MD. It may depend on the state (?) in the US.

A PT could tell you more than I can about this.

Treatment options for Back Pain…

Chiropractic is not really a treatment, it's a profession. The same could be said of PT. 

What I mean is that the treatment varies depending upon the problem and even the professional or doctor. 

Chiropractic treatment often involves spinal manipulation, but might involve any number of other physical treatments ranging from various passive therapies (electrical stimulation, ultrasound, infrared, …), types of decompression, acupuncture (some DCs use this), to stretching, rehabiliation exercises, etc. 

Spinal adjustments or manipulations are done by most Chiropractors because it has been a successful treatment for the majority of their patients. There are many reasons why the treatment works to improve ranges of motion, reduce pain, and cause some local and supra-segmmental neurological changes. The science isn't really important here. I'll save it for additional blog posts.

Many Chiropractors will also look at lifestyle modifications and ergonomics to help people better recover.

Individual variance within the professions…

There are some great PTs and some great Chiropractors. 

Not every PT is the same and not every Chiropractor is the same. In each profession, the individual practitioner may be better at certain types of problems. 

Another important variable is you, the patient.

Different people may be better suited for one type of treatment or another – even with the same diagnosis.

I do have a bias towards starting with a Chiropractor. Here is one reason why…

I often see chronic pain patients that have seen numerous other doctors, specialists, and PTs without success. Thousands of people that didn't respond to other care, came in, and got better… 

Having said that, they are only seeing me because they still have a problem. I don't generally see the successful treatments. 

I would guess the same thing happens in PT, MD, and Orthopedist offices. 

They're generally not hearing about all the Chiropractic successes. They're seeing the patients that didn't fully recover – or they wouldn't be there. 

This creates a bias against other types of care if the Professional doesn't give this fact consideration.

You don't have to be forever married to one type of treatment for Back Pain.

If you don't respond well to the treatment in a reasonable amount of time, then the Chiropractor should change the treatment. 

If he or she (the Chiropractor) can't help you, then they should refer you out whether it's to a PT, an MD, or an Orthopedist.

The same should be true of the other professionals that are there to help you. Unfortunately, this isn't always the case.

I would not recommend going to an orthopedic surgeon first. It’s really not even possible, you’ll need a referral from an MD or a Chiropractor generally. 

Orthopedists have a very important role in treating certain types of back pain, but it's not a starting point as others have recommended in their comments.

If you start with a Chiropractor, you're less likely to end up taking various prescription medications and are less likely to end up having surgery. 

The Chiropractor can do all the diagnostic tests and exam necessary to find out what's wrong (the diagnosis). Chiropractors can generally offer good treatment options for Back Pain that are often very effective. 

If you don't respond, a good Chiropractor will refer you to another appropriate professional. This is why it's where I would start with Back Pain – whether it's acute or chronic, with a Chiropractor.

Here are a couple of posts that might be helpful…

www.hagebuschchiropractic.com/chiropractic-effective-for-chronic-neck-pain-and-back-pain/

www.hagebuschchiropractic.com/a-little-known-way-to-quickly-improve-most-pain/