Talk to anyone with a bad back or other aches and pains, and you’ll probably find they’ve been recommended both physiotherapy treatment and chiropractic treatment, depending on who they’ve spoken to.

Most people assume the answer is either/or, and many people who have visited chiropractors swear by the ‘good’ feeling they end up with after their treatment.

But do chiropractors actually fix a spinal problem for the long term, or does it only provide short term ‘feel good’ relief?

The perceived ‘battle’ between physios and chiros is an age old one, and asks that very question - but is there a basis for it?

Physiotherapist and owner of Evoker Physiotherapy, Adam Monteith says while he believes most health professionals get into their industry for virtuous reasons, the issue with chiropractors is in their training.

“I don't believe chiropractors have undertaken enough study to thoroughly assess and examine the patient,” says Mr Monteith.

“I don't feel that chiropractors are able to generate a specific and accurate diagnosis based on a patient’s subjective and objective presentation. I simply don't believe they've had the training to get to that point, and that is not the fault of the individual chiropractor, but more a fault of the profession itself.

“If the chiropractic profession does not provide sufficient training to their students, how can we expect a chiropractor to effectively operate as a first contact health professional? If you are not able to accurately diagnose, how can you
know if a patient is progressing in an appropriate manner, or when to refer for investigations or when to refer up the medical chain?”

“Contrast this to my two year post graduate masters in Manipulative Physiotherapy at Sydney University where 95 per cent of the time was spent perfecting our assessment and diagnostic process ( on top of a five year double degree in
Physiotherapy and Exercise Science).

“If you nail the diagnosis, you enable the most efficient treatment process for the patient. If you do not know precisely what you are dealing with, how can you possibly best help the patient?”

Mr Monteith says the lack of required education has enabled chiropractors to become more efficient at the expense of property assessment. 

“And they get to the one thing that they're good at – ‘the crack’ – too soon. They will do this in 10 minutes and move on to the next bed.

“I've heard chiropractors refer to their own profession as “rack ‘em and crack ‘em”. That to me is not good health care.”

In the physiotherapy world, there are certainly contraindications to manipulating or cracking a segment, the spine in particular, says Mr Monteith.

“I believe that you need to go through a very thorough subjective and objective examination before determining whether a manipulation is actually going to form a successful part of the treatment plan.

And so, we make more analytical and critical decisions on whether to manipulate a region or not.”

While Mr Monteith is trainedI to manipulate the neck, he says he chooses not to.

“In my opinion, the risks of cervical manipulation far outweigh the benefits. Ultimately, for physios, manipulation becomes a very small part of our treatment practice, and it generally enters at the later stages of our treatment plan. Again,
manipulation or ‘the crack’ does not generate a long term fix alone.”

While Mr Monteith reinforces his belief that chiropractors enter their profession for the right reasons, he also believes they lack long-term treatment planning and progression, particularly when it comes to exercise and strength prescription, and return to sport modelling.

“There are some good chiros out there, and they're starting to call themselves ‘sports chiros’  - perhaps trying to distance themselves from the profession - and I do believe that they are attempting to merge closer to our physiotherapy profession.”