Physiotherapist or chiropractor: who should I see?

Two regulated professions

In the UK, "physiotherapist" and "chiropractor" are both protected titles. Physiotherapists must be registered with the Health and Care Professions Council (HCPC), and chiropractors with the General Chiropractic Council (GCC). Registration means the clinician has completed an approved qualification, works to professional standards and keeps their skills up to date. You can check any clinician on the HCPC or GCC online register.

Both professions assess and treat problems of the muscles, joints and nerves, such as back and neck pain, headaches linked to the neck, sports injuries and joint stiffness. Neither replaces your GP or hospital care, and both will refer you on if something needs medical investigation.

What physiotherapists do

Physiotherapy is a broad profession. A physiotherapist looks at how your body moves and how your symptoms respond to activity, then builds a plan that usually centres on exercise and a gradual return to the things you want to do. Treatment may include:

• hands-on techniques such as joint mobilisation and soft-tissue work
• a progressive exercise programme you continue at home
• advice on activity, work set-up, sleep and pacing
• dry needling, taping or clinic equipment such as focused shockwave, where appropriate
• rehabilitation after surgery or injury, and planning a return to sport

Some physiotherapists, including one of ours, are also trained in spinal manipulation — a quick, controlled movement applied to a stiff joint — which they may use within a physiotherapy appointment when it suits you.

What chiropractors do

Chiropractors focus on the spine, the joints and the nervous system, and on how joint movement relates to pain and function. A chiropractor will assess you and may use:

• chiropractic adjustments — quick, controlled movements applied to specific joints
• mobilisation and soft-tissue techniques
• exercises and advice to support the hands-on care

Chiropractic care is provided only by a GCC-registered chiropractor. Many people see a chiropractor when they would like hands-on treatment for back or neck pain, but chiropractors also use exercise and advice, and an adjustment is only used when it is appropriate for you.

Where they overlap — and where they differ

There is a lot of common ground. Both will take a full history, examine you, explain what they think is going on and agree a plan with you. Both may use manual therapy, exercise and advice, and both check for warning signs that need medical attention.

The differences are mostly about emphasis:

• Physiotherapy tends to lean towards active rehabilitation: progressive exercise, building strength and capacity, and planning a return to sport or work. It covers a wide range of problems, from tendon pain to recovery after an operation.
• Chiropractic tends to lean towards hands-on care of the spine and joints, including chiropractic adjustments, alongside exercise and advice.

Individual clinicians also differ in their training and interests, so it is more useful to ask "who can assess my problem and explain a sensible plan?" than to think of one profession as the right answer for everyone.

A rough guide to choosing

• If you have a sports injury or a tendon problem, or need rehabilitation after surgery, physiotherapy is often a natural starting point.
• If your main problem is back or neck pain or stiffness and you would like to discuss chiropractic adjustment, the chiropractor may suit you.
• If you are not sure, either is fine — the first appointment is an assessment, and the plan follows from what we find.

At UK Pain Clinic you can book either initial assessment

Our Bloomsbury clinic has HCPC-registered physiotherapists and a GCC-registered chiropractor, Dr Lok Sze Candice Wong (Chiropractor), working side by side. Whichever you book, your first appointment is a full assessment. If your clinician feels another member of the team would suit your problem better, or that a combination of approaches may help, they will explain why and help you arrange it.

If you would rather ask before booking, message us on WhatsApp or WeChat, or give us a call, and we can point you in the right direction. Fees for both initial assessments are on our fees page.

Insurance and referrals

You do not usually need a GP referral to see a physiotherapist or chiropractor privately, although some insurers ask for one. Cover differs between policies — some include physiotherapy but not chiropractic, or the other way round — and your insurer decides what is covered and whether pre-authorisation is needed. If you plan to claim, please check with your insurer and check with us before you book: send us your pre-authorisation by WhatsApp, WeChat or email, and once we have confirmed it we will tell you how to book, usually online.

When to seek urgent help instead

Some symptoms need prompt attention rather than a routine appointment. If your pain followed a fall or accident, or is severe and getting worse, call us for a same-day assessment; we can arrange imaging through our imaging partner. For more severe symptoms, such as a suspected broken bone or a head injury, go straight to A&E. Call 999 for life-threatening signs such as loss of bladder or bowel control, numbness around the groin, chest pain or rapidly worsening weakness.

Whichever clinician you see, outcomes vary from person to person, and your clinician will discuss the likely benefits, risks and alternatives with you before any treatment.