Physiotherapist or Chiropractor?

One of the questions that we are often asked is “Should I visit a Physiotherapist or a Chiropractor when I have a suspected back problem or issue”?

We are a group of Chartered Physiotherapists and our simple answer, with our justification below, is that you should always visit a Physiotherapist for any suspected back issues.

Physiotherapy is supported by the NHS and recognised by the HealthCare Professions Council (HCPC) 

The NHS, which we all love, is a world class Health Organisation and Physiotherapy is clinically recognised within the NHS as a respected medical professionPhysiotherapy training is at degree level and provides the Physiotherapist with extensive clinical knowledge and skills. Physiotherapists are the experts in body movement and rehabilitation, and they provide expert assessment, diagnosis and treatment across many aspects of healthcare. 

Physiotherapists use a variety of scientific and evidence-based skills to make sure that your problem is fully understood and addressed through treatment. Physiotherapists at Physio-Flex use a combination of hands-on treatments and rehabilitation techniques and exercises to get you better but ALSO to make sure you STAY better. 

Physiotherapists are awarded a licence to work by the HCPC which is an organisation which protects the public by only awarding licenses to professionals based on knowledge, competence and commitment to professionalism. Physiotherapists must show evidence of continually updating our skills and knowledge to the HCPC every 2 years in order to continue to work. That means we MUST stay up-to-date with the BEST type of treatments for you. 

In general, you can’t get Chiropractor treatment on the NHS in Scotland because it is considered a type of complementary and alternative medicine (CAM) 

Should I see a Physiotherapist or Chiropractor for my back pain?  

Physiotherapists can help with many problems in the body, so it is often confusing to understand what they can do to help you with your back pain! (please also read article – What is a Physiotherapist? ) 

Chiropractors however are clear in their message – they are the people who ‘fix’ backs aren’t they? But are they? 

People commonly report to us that they have been told by a Chiropractor that they have a ‘Slipped Disc’ which was ‘put back in’ by the Chiropractor. In reality, our body is far more complex than that, and there is no such thing as a ‘slipped disc’ which can be manipulated back in to place.   

A slipped disc is actually a prolapsed disc which means that the central portion of the disc has escaped from the outside structure of the disc, similar to how jam would escape from the middle of a jammy doughnut if you press the front too often. How can this be pushed back in? Simply: It can’t. 

In truth, a sore back, is more likely to be a joint, soft tissue, or muscle issue – the number of actual prolapsed discs is very low (less than 5%). Mechanical (general) back pain accounts for 94% of back pain and is normally caused by placing stresses and strains on your back from poor posture, altered movement patterns, reduced fitness, and incorrect bending and lifting motions. 

The ‘click’ we feel when joints are manipulated by Physiotherapists or Chiropractors is in fact a noise the joint makes when air is ‘popped’ within the joint. In the same way that people who crack their knuckles can do. What this does is temporarily relieve the stiffness within the joint and increase lubrication of the capsule. It can certainly make you feel less pain and improve movement, but the effect is always temporary.  

Physiotherapists at Physio-Flex are able to ‘crack’ (manipulate) your back but we will also always assess why you have a back issue, get to the root cause and give treatment and advice accordingly. We will treat YOUR back issues, with individual treatment, using hands-on techniques for your joints, muscles and ligaments and provide advice perhaps on posture or lifestyle changes, and a strengthening or rehabilitation programme designed to make sure the changes last! 

What is key about Physiotherapy is that the actual issue is diagnosed and treated fully– that is what a Physiotherapist is trained to do. 

Do you need re-aligned? 

 Many people visit a Chiropractor to be told – “Your body needs re-aligned” and that is the explanation given by the Chiropractor for the cause of the symptoms.  In truth, we are all out of alignment, the majority of people have one leg shorter than the other and most of us have one side of our body more developed. 

Many people report that they need to return to the Chiropractor for regular treatment, to get re-aligned regularly, over a long period of time or else their condition will worsen. It is now worth the question – does this type of treatment fix the issue or just gives some temporary symptom relief regularly?  

So, why are you ‘out of alignment’? 

Perhaps you fell when you were young and maybe changed the way you walked for a short time which developed one muscle more than the other? You played football so developed a kicking leg! You are right or lefthanded? Our bodies develop over time because of what we DO on a daily basis and what we have DONE through our lives. 

It is possible to alter the way our bodies are positioned, but not because you have been ‘cracked’ or ‘re-aligned’. It is a combination of handson treatments for your joints and soft tissues and hard work from you to re-educate your body in the correct ways to move and to stretch or strengthen the correct muscles to hold you in a ‘new’ position. 

How do you know the treatment will work? 

The most uptodate evidence for treating back pain states the manual therapy (handson treatments to your joints, muscles and ligaments) combined with appropriate exercise and movement is the best way to relieve your symptoms and improve your long-term recovery from back pain. This is brilliant news as that is exactly what a Physiotherapist is trained to do! 

Unfortunately, clients have attended Physio-Flex following Chiropractor treatments with a fear of movement as they feel their bodies will ‘pop’ out as soon as they bend over. How do you then put on your socks without worrying? Clients feel weak in their bodies and become inactive and change how they move and function due to fear! This inactivity is what actually makes people’s symptoms WORSE over time! Not because you are out of alignment! 

Treatment, using manipulation only, whether from a Physiotherapist or Chiropractor, can certainly help with pain, alter the stiffness of our joints or the way our muscles pull our bodies ‘out of alignment’. Our bodies, however, will revert to their ‘comfortable position’ and the pain may return, unless you make the changes needed after treatment by strengthening muscles and making changes to your posture and lifestyle. This is the beauty of Physiotherapy treatment – we treat the pain AND the underlying ISSUE and don’t have a pre-determined diagnosis. We then treat your issue with the correct procedure and give you help and advice on all the things you need to do to stay better. 

Physiotherapist or Chiropractor? It is completely your choice! 

We can’t guarantee full recovery for all problems as this is just not possible for chronic conditions. Our job, in that situation, is to help you to understand and manage your condition to maximise your function, recovery and pain management.
What we do care about is the way we treat you.
We care about you and the service we provide you.
If you are NOT happy with our service or approach then please let us know. We would love the opportunity to immediately rectify it. We all make mistakes but we believe in making as few as possible, and when we do, we look to make things right.

At any point if you are still unhappy with our service we will immediately refund your treatment fee.

Caroline Bennett
On Behalf of PhysioFlex (West Lothian) Ltd