What patients respond better to chiropractic manipulation versus physical therapy?


In discussions with physicians, we are often asked: “What patients respond better to chiropractic manipulation versus physical therapy?”. This is an excellent question as the emerging healthcare model demands that PCP’s select the most cost-efficient and clinically effective management for every case. Almost all musculoskeletal conditions have a defined “best practice” recipe and different conditions require a toolbox of different specialists.

Some neuromusculoskeletal conditions like a spinal cord injury or post-surgical rehab, are nearly always better managed by a therapist. Other conditions like uncomplicated ankle or knee sprains can typically be managed equivocally by either. But when dealing with mechanical LBP, neck pain, and cervicogenic headache, the research is clear – chiropractic spinal manipulation is the most effective option.

In fact, earlier this year the American College of Physicians published a clinical practice guideline (the ultimate synthesis of research) recommending that for acute or chronic LBP, physicians delay pharmacologic management and consider “spinal manipulation, heat, massage or acupuncture”- with no recommendation for therapy modalities. (1)

Furthermore, a new randomized clinical trial comparing outcomes for neck pain patients treated with manual joint mobilization vs. physical therapy demonstrated that the manual therapy group required significantly fewer treatment sessions (6.1 vs. 10.0 treatments at 52 weeks). (2)

Medical physicians, chiropractors, and physical therapists must work together to provide integrated “best practice” care. This means recognizing each other’s strengths and limitations while choosing the best possible option regardless of personal or professional bias.

Our providers understand who to treat and more importantly who not to treat. We strive to employ best practice management for every patient, every encounter. We are proud to co- manage our patients and will work hard to maintain your trust.


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