The Difference Between Manual Therapy and Chiropractic

Many neck and back patients can benefit from manual therapy to their spine. A common question that arises is “What is the difference between manual therapy and chiropractic care?” While the patient may perceive many similarities, they are rooted in very different philosophies. Most manual therapy is based on Osteopathic theories which focus on proper movement of the joints. Traditional chiropractic training is based off “The Law of the Nerve” which believes that the key to proper healing is through ensuring proper nerve flow. Traditional chiropractors look at perceived alignment problems of the vertebrae and manipulate to correct these positional faults. Manual therapy, on the other hand, assesses movement of each joint in the spine to see if it moves too little or too much. A joint that moves too little needs to be mobilized or manipulated whereas a joint that moves too much requires a stabilization program to strengthen the muscles around it. Physical therapy joint manipulation uses “locking techniques” to isolate a segment that moves too little without manipulating the adjacent segments. The goal of a successful manipulation is not a “pop,” but rather improved movement at the manipulated segment. If a cavitation or “pop” is brought on it should be a single level if the technique is performed correctly.

A great deal of research exists to support the specificity of skilled manual therapy and its use with an exercise program to correct improper movement patterns. If a manipulation is not accompanied by a stretching program the results tend to be temporary and require repeat manipulation. Performing a home exercise program designed by a physical therapist can minimize the chance of recurrence.


Joe Schmersahl, PT, MTC