Should I see a chiropractor or physiotherapist is a question I get asked a lot in clinic. There is a lot of confusion, further complicated by the fact that both chiropractors and physiotherapists work with the musculoskeletal system!
First of all, you should know I am a chiropractor, but I will do my best to give a neutral explanation. Second, to answer this question properly, we will need to get into a little bit of basic physiology 😉
So the short and simple answer is, physiotherapists focus on the muscles (via massage and exercises), and chiropractors focus on the nervous system (via boney “adjustments”).
Unfortunately, in the real world, it’s almost never so simple. When somebody is experiencing pain, it’s often BOTH the muscle and the bones that are involved! Nothing in the human body works in isolation, often, both are involved! But this still doesn’t tell you who you should be seeing, a chiropractor or a physiotherapist, does it?
This is where I’m going to have to put my chiropractor hat on and explain a couple of things, as well as ask you a few important questions.
1) What does the muscle attach to?
Answer: the bone
2) What controls the bone AND muscle, and every other function in your body?
Answer: the nervous system
3) What is the language of the nervous system?
Answer: Proprioception (MOVEMENT messages from your JOINTS)
4) What else DIRECTLY affects the bones, muscles and nerves?
Answer: In our society, usually diet, posture, accidents and stress.
5) Did you know that repetitive movements/postures like sitting cause the bones to misalign, and scar tissue to build up in the joint and muscle? Scar tissue also follows ANY injury.
So if you move a bone, you directly stimulate the nervous system, reduce muscle tension and reduce pain. Pain is detected and felt by the nervous system. So you could say the nervous system plays a central role in this argument, and movement of our joints happens to be one of the most powerful stimulators of the nervous system.
Now this is very important, so listen up. There are 2 basic types of movement: i) General movement- like when you exercise and stretch, and ii) Specific movement – between individual joints. This kind of movement is what chiropractors specialise in. You see, when scar tissue is present, no amount of “general movement” can get rid of it! Only a very “specific” joint movement can do this.
So what I’m saying is, movement of the JOINT is critical for proper muscle AND joint function and the KEY TO REDUCING PAIN and scar tissue! Muscle is just the innocent bystander.
5) What is the most powerful way to stimulate the nervous system?
Answer: With gentle, low amplitude, high velocity MOVEMENT of the bone. Chiropractors call this an adjustment (see our FAQ’s)
6) Who specialises with this type of joint movement?
Answer: The chiropractors
7) How do you intend to remove the joint scar tissue (built up over years of poor posture and too much sitting), by working only on the muscle?
9) Did you know chiropractors also have muscle rehabilitation training?
So, in summary, my advice in most situations is to:
1) Start with the chiropractic, simply because at the root of most pain syndromes and muscle imbalances are a joint movement deficiency, and nervous system interference from a build up of scar tissue. This is chiropractic territory and what we specialise in! No amount of massage and stretching can break up scar tissue in the joint. For this you need the chiropractic adjustment.
2) Once movement is restored, and joint scar tissue is reduced, you can start to work on the muscle with a form of remedial massage, as this too will have some scar tissue, but usually not central to the cause of pain. A physio could do this for you, but also a qualified massage therapist. At our practice, we have 3.
3) Muscles do what they’re told and are very rarely the CAUSE of the problem. They are the “innocent bystander.” For the cause, look to the posture and other lifestyle factors and then bony movement/alignment.
4) Once scar tissue from joints and muscles is removed with chiropractic adjustments and some massage, exercise does help hold the bones together better. Either a chiropractor or physiotherapist can give you exercises. Generally speaking, exercises are more of a physiotherapists specialty, however most chiropractors too are quite knowledgeable on the subject.
For any further questions on who you should see, a chiropractor or physiotherapist, don’t hesitate to contact us further, either by email (Contact Us) or call us on 9444 0100