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FAQ What is the difference between physio and chiro?

This is a guest blog by Alex Bar, a health coordinator from Backs in Action, a centre in North America with both physios and chiros. He is also an aspiring health writer and host to a wellness website called Tips4Wellness. We asked Alex to write the answer to this FAQ in order to get an unbiased response, however, there is some input from us as well as a South African chiropractor in order to get the local information right. Here are Alex’s thoughts…



Today we are looking at two different therapeutic areas and in the beginning we will emphasize that there is no right or wrong practitioner. While they both work in slightly different ways, they treat many similar conditions and focus on patients through a hands-on approach.

The short answer

Both, chiropratic and physiotherapy, can be used to address conditions such as low back pain, neck pain, frozen shoulder, headaches (certain types), tennis elbow, knee pain, hip pain, ankle injuries and many more. Regardless of the title, it is important to find the individual practitioner that suits you.

Chiropractors are all about spinal manipulation and you will be required to come back for maintenance sporadically. Physical therapists are all about exercise and emphasize independence and return to function.

Chiropractors focus on aligning the neuromusculoskeletal system while physiotherapists focus on overall biomechanics, reducing pain and improving mobility through movement correction and exercise plans. They may also prescribe assistive devices, such as walkers or SIJ belts.

But let us take a closer look…

What is Physiotherapy?

Physiotherapy helps with improving the quality of life by supporting tissue repair, reducing stiffness and pain and increasing mobility. Physiotherapists aim for joints and muscles to work to their full potential. They often provide exercise programs to improve mobility, and also use massage, stretching and electrotherapy modalities. Physiotherapists traditionally use mobilization techniques such as Maitland, Mulligan and McKenzie.

difference between physio and chiro physio massage

People are often referred to physio for a treatment of back pain, neck pain, shoulder pain, sports injuries, movement problems resulting from a stroke, multiple sclerosis (MS) or Parkinson’s disease, rehabilitation after a heart attack, chronic obstructive pulmonary disease (COPD) and cystic fibrosis. Paediatric physiotherapists help with gross motor developmental delays.

Physiotherapists more often put the healing in your hands by suggesting exercises to improve your mobility and posture.

difference between physio and chiro physio exercise

Some of the treatments and techniques that physiotherapists use:

  • Exercises to strengthen weak areas
  • Laser therapy to speed up healing
  • Electrical stimulation to help muscles contract that cannot do so effectively on their own
  • Joint mobilisation (gentle gliding) techniques
  • Joint manipulation
  • Physiotherapy Instrument Mobilisation (PIM)
  • Minimal Energy Techniques (METs)
  • Muscle stretching
  • Neurodynamics
  • Massage and myofascial release
  • Fascial therapy
  • Taping – kinesio, dynamic and rigid.
  • Acupuncture and Dry Needling


All accredited Physiotherapists have completed a Bachelor’s Degree in Physiotherapy, completed a year of a community service and are registered with the Health Professions Council of South Africa (HPCSA). It is optional to be a member of the South African Society of Physiotheapists (SASP).

Special interests and scope of practice.

Orthopedics, Sports Medicine, Pediatrics, Geriatrics, Women’s Health, Neurology, Cardiovascular & Pulmonary, Medico-legal, Occupational health.

Physio therapists work in Private practice, Private hospitals, Public hospitals, Care homes and Frailcare units in South Africa. Some may even do home visits where patients are unable to travel.

In South Africa, physiotherapists are first line practioners that can diagnose and do not need a referral from the GP. Physiotherapists can send their patients to have x-rays and untrasounds to assist in diagnosis.

What is Chiropractic therapy?

Chiropractors are known as spinal health professionals, with focus on techniques of adjustment (sometimes they ‘move’ areas that are not moving properly) to help create bio-mechanical correction. They treat problems related to the nervous system, musculoskeletal system, and the impact that those problems can have on your overall health. Chiropractors traditionally use manipulation techniques.

difference between physio and chiro spine

Chiropractic care is traditionally known for being more spinal manipulation than the exercise and rehabilitation techniques of physiotherapy, however, this has changed in the last 2 decades, particularly in South Africa.

People are often referred to chiropractors with injuries to the back and neck as well as sports injuries, such as tennis elbow. Chiro can also help babies suffering from colic. Chiropractors focus on getting your spine aligned for the rest of the body to move easier and to reduce pain elsewhere.

Some of the treatments and techniques that chiropractors use:

  • Manual therapy
  • Manipulative therapy
  • Corrective exercises
  • Integrated spine care
  • Activator techniques
  • Soft tissue massage
  • Dry needling
  • Kinesiotaping
  • Flexion distraction
  • Thompson, or drop table, technique
  • Diversified technique
  • Gonstead technique


All accredited chiropractors in South Africa have completed a Masters degree in Chiropractic (6 years) and have to be registered with the Allied Healthcare Professions Council of South Africa (AHPCSA). It is optional to be a member of the Chiropractic Association of South Africa (CASA).

Specialities and scope of practice.

Orthopedics, Pediatrics, General Rehab, Occupational Health, Sports Medicine.

Most chiropractors work in private practice in South Africa. Chiropractors do not work in hospitals or acute care units. Chiropractors are primary care practitioners, can take x-rays and send for blood tests to assist in diagnosis.

difference between physio and chiro xrays

A final thought on the difference between physio and chiro.

Both, physiotherapy and chiropractic professionals, specialize in the musculoskeletal system with goals of improving the overall health and well-being of their patients. The main difference is that chiropractors traditionally use manipulation, while physiotherapists will more commonly use mobilization techniques.

In conclusion, no matter if you are looking for a physio or chiro, the chosen therapist should listen to you, understand your concerns, and should have knowledge and experience of treating injuries similar to yours.

The examination will always be a first step on the way to healing and your practitioner will recommend the best treatment for the condition.

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