Chiropractor or Physical Therapist: Which Should You See First?

Chiropractors and physical therapists can sound like rival camps, as if calling one means turning down the other. For back or neck pain with no warning signs, either one is a sensible first call. Both are licensed, both examine you before they treat you, both use hands-on care and exercise, and both send you elsewhere when what they find calls for a different kind of care. What decides it is the kind of care you want to start with and how soon you can begin.

At Omni, the practical difference is access. You can see one of our chiropractic physicians at any of our five Connecticut offices with no referral. Physical therapy and aquatic therapy are at our Wallingford office and always require a physician's referral.

Rule out an emergency first: back pain with loss of bladder or bowel control or numbness in the groin, buttocks or inner thighs means the emergency room right away (opens in a new tab), and sudden numbness or weakness on one side of the body (opens in a new tab) means calling 911. A few more warning signs, including the ones that mean calling your doctor, are further down.

What chiropractic care centers on

Chiropractic is a licensed health care profession whose treatment typically involves manual therapy, often including spinal manipulation (opens in a new tab). The manipulation itself is usually a quick, gentle thrust by hand, meant to improve how a joint moves. Before treating you, a chiropractor takes your history, examines you and arrives at a working diagnosis. Care can also include exercise and nutrition advice. To practice in the U.S., a chiropractor needs a Doctor of Chiropractic degree, a passing score on a national board exam and a state license.

The American Chiropractic Association describes chiropractors as especially well known for caring for back pain, neck pain and headaches. At Omni, licensed chiropractic physicians treat low back pain and neck pain, but that isn't all they treat. They also see patients for headaches, whiplash, sciatica, spinal stenosis, sports injuries, and sprains, strains and other muscle, joint and nerve problems. You'll find them at all five offices: East Haven, Meriden, Milford, Wallingford (Tuesdays and Thursdays) and West Haven.

Care can be a hands-on adjustment or the ProAdjuster SRT, which every Omni office offers as a gentle, low-force, instrument-assisted adjustment. It's computer-guided and done while you sit in a chair, with no twisting or popping, so it's worth asking about if a manual adjustment makes you uneasy.

What physical therapy centers on

A physical therapist's care is built around movement: hands-on treatment, patient education and prescribed exercise. Physical therapists are licensed health care providers who evaluate, diagnose and manage health conditions and movement problems (opens in a new tab). Everyone who has graduated as a physical therapist in the U.S. since 2016 has earned a Doctor of Physical Therapy degree. At Omni, physical and aquatic therapy start with a physician's referral.

For low back pain, the evaluation covers your health history, your symptoms, how well you move and what you ask of your body at work, at home and in sports or leisure (opens in a new tab). Treatment may include manual therapy, strengthening and flexibility exercises, training in how to lift, bend and sit, and a program you can keep up on your own. After a recent back injury, timing matters: starting stretching and strengthening exercises too soon can make the pain worse, and a physical therapist can tell you when to begin (opens in a new tab) and how to do them.

At Omni, physical therapy is currently based at our Wallingford office. Our physical therapists help you move and function again after an injury, surgery or illness. That includes back and neck pain, rotator cuff, knee and ankle injuries, sports, work and auto injuries, and balance problems. A plan of care can draw on heat, cold, electrical stimulation, joint mobilization, exercise, massage, aquatic therapy and patient education.

The same team delivers aquatic therapy in our warm-water pool at 8 Research Parkway in Wallingford. It's one option when pain or weight-bearing limits make exercise on land hard to start, since buoyancy takes load off sore joints and the warm water helps muscles relax.

Where the two professions overlap

The line between them is blurrier than the names suggest. Spinal manipulation is done mostly by chiropractors, but osteopathic physicians and physical therapists use it too. Chiropractors, for their part, give advice on exercise and daily habits.

If spinal manipulation is part of your care, you might feel some temporary soreness, stiffness or a headache afterward, which usually goes away within 24 hours (opens in a new tab). Serious problems are very rare. Tell whoever treats you about your health conditions and the medications you take.

One more thing takes some pressure off the choice: both kinds of care are among the recommended first steps. The American College of Physicians' guideline for low back pain (opens in a new tab) lists heat, massage, acupuncture and spinal manipulation among the non-drug options for recent low back pain and puts exercise among the first choices for chronic low back pain.

When to call 911 or your doctor instead

Call 911 if neck or back pain comes with chest pain or shortness of breath (opens in a new tab), follows an injury to the neck or spine (opens in a new tab), or comes with a fever, a headache and a neck so stiff you can't touch your chin to your chest (opens in a new tab).

Contact your doctor if your pain started with a hard fall or blow, comes with a fever you can't explain, or is back pain that has lasted longer than four weeks (opens in a new tab). Our post on where to go for sudden low back pain lists the rest of the signs.

Matching your first call to your situation

When chiropractic and physical therapy could both help, the choice usually comes down to a few practical questions: whether you have a referral, how soon you want to begin, and what kind of care you'd like first.

If you'd like to start soon and don't have a referral, chiropractic is the direct way in at Omni. All five offices offer it, and same day appointments are available. If your physician has already referred you to physical therapy, start there, at our Wallingford office.

Then there's what you'd like the first visits to center on. Chiropractic care typically leads with hands-on treatment such as an adjustment. Physical therapy puts prescribed exercise and coaching on how you move first, with hands-on care alongside. If the pool sounds like the easier place to begin, ask your physician whether aquatic therapy fits, since it needs the same referral as physical therapy.

You don't have to get the choice right on your own. If you're not sure where to start, tell us what's going on when you call, and we'll match you with the right provider and office. Starting with one doesn't close off the other, either: our chiropractic physicians work with our physical therapists and can refer you in house to them.

Booking your first visit at Omni

For chiropractic care, call (203) 562-8600 to book at whichever of our five offices is easiest for you to reach. Our staff will verify your plan's requirements before your first visit.

For physical or aquatic therapy, the referral comes first. If you don't have one yet, ask your physician, then call our Wallingford office at (203) 294-1998 and our staff will take care of the rest.

Our FAQ page covers insurance, what to bring and office hours, and our contact page lists the phone number for every office.