Short answer: both are registered health professions, both treat back pain, and for most people the clinician and the plan matter more than the title. Ask what they think is going on, what the plan is, and how you will both know it is working.
What they have in common
Physiotherapists and chiropractors are both registered with AHPRA, the national regulator, through their own boards. Both can see you without a referral for private appointments, and most private health extras policies cover both, with limits and rebates that vary by fund and level of cover. Check your own policy.
Both treat back and neck pain, which is why people ask the question in the first place.
Where they tend to differ
Chiropractic is best known for hands-on spinal treatment, including manipulation. Physiotherapy is a broader profession. It covers sport and orthopaedic injuries, post-surgical rehab and many other areas, and in musculoskeletal care it usually leans on exercise, education and a graded return to activity, sometimes with hands-on treatment alongside.
These are general tendencies. Individual clinicians vary a lot within both professions, and some blend the two. A good clinician of either kind will tell you what they think is going on and what they are and are not sure about.
What the guidelines say about back pain
Guidelines for low back pain generally put education and staying active first. Exercise is a core part of care, and hands-on treatment can be added for some people as part of a package. Rest on its own and scans for most ordinary back pain are not the answer. Whatever you choose, a plan that only ever involves passive treatment is worth questioning.
Questions worth asking any clinician
- What do you think is going on, and how sure are you?
- What does the plan look like, and roughly how many visits?
- What will I be doing between visits?
- How will I know it is working, and what happens if it is not?
- Would you send me elsewhere if this is not your area?
I wrote more about how to choose a physio if you are comparing clinics.
When to seek emergency help first
Seek emergency medical help, before seeing any clinician, for loss of bladder or bowel control, numbness around the groin or inner thighs, leg weakness that is getting worse, back pain with fever or feeling very unwell, or pain after a significant fall or accident. Constant pain at night that does not change with position should be checked by a doctor promptly.
How I work
I am a physiotherapist. My approach is to work out why the problem keeps coming back, then rebuild the strength and capacity around it. I use hands-on treatment where it helps. Education and exercise are a large part of my ongoing work, because the research supports them as core to long-term recovery from back pain. If I think you need a scan, a doctor or a different kind of care, I will say so and refer you on.
I see back pain and sciatica at my clinic in Hampstead Gardens, Adelaide. Initial appointment $150 (45 minutes), HICAPS on site, no referral needed for private appointments. Fees and claiming are on the services and FAQ pages.