Chiro, physio or massage?

Chiropractic, physiotherapy or massage…what is right for me?


By Dr. Laina Shulman

I am asked this question a great deal and will answer it keeping in mind that there are many unique scopes of practice within each of these professions. I will answer it as a chiropractor who has spent 19 years in practice working with and referring to many types of health practitioners including physiotherapists and massage therapists. The goal is always maximum healing for the patient.

Years of education:

Chiropractors: a minimum of 7 years after high school
Physiotherapist: a minimum of 5 years after high school
Massage therapist: a minimum of 2 years after high school

Chiropractic is the largest natural health profession in the world. Their extensive knowledge of healing and diagnosis provides them with the title doctor.

The foundation of the professions:

Chiropractors ensure that the spine and nerve system are functioning optimally and focus on eliminating the underlying cause of health concerns. When areas of the spine are out of alignment, they interfere with the proper functioning of the nerves, leading to pain and many different symptoms. These symptoms are the body’s way of letting us know it is under stress. Chiropractors remove this stress through gentle chiropractic adjustments allowing the body to heal without the use of drugs and surgery.

Physiotherapists deal with the integrity, strength and flexibility of the ligaments and muscles surrounding joints. Physiotherapists work within the medical model of health and are often referred to by medical doctors. They frequently use modalities such as ultrasound and strengthening/stretching techniques for the soft tissues.

Massage therapists focus on the amount of tension in the muscles and fascia of the body. Massages can be used for relaxation purposes of to decrease muscle tension and improve lymphatic drainage.

How they work together (in our office):

For every new patient a case history, thorough exam and possible Xrays are done on the first visit. The doctor then takes the time to ensure that the patient understands the cause of their symptoms and the recommended course of action. If the doctor determines that he/she is not a chiropractic case they are referred to the appropriate health practitioner that day. If it is determined that it is a chiropractic case the doctor will recommend the appropriate course of care.

In some cases, as chiropractic care proceeds we determine that working with other health practitioners would help symptoms resolve most quickly. For example: When the spine is out of alignment the body naturally tightens the surrounding muscles. This is the body’s own defense mechanism designed to keep the area stable. This is why some patients report that no matter how much they stretch or massage muscles tighten up again very quickly. The muscles have been protecting an underlying issue in the spine.

As the spine is realigned the surrounding muscles naturally begin to relax. Patients are given supportive stretches for maximum results. In some cases the long term “muscle- memory” continues to tense the muscles. In this case we work in conjunction with a massage therapist in order to ensure that muscle tension is eliminated, ensuring that the body holds its adjustments, and healing occurs as quickly as possible. Patients then feel long term relief from their massages as the muscles are no longer “guarding”.

In the same way, if ligament or other soft tissue strains, sprains or imbalances hinder maximum recovery we refer a patient for physiotherapy in order to augment healing.

As chiropractors it is our role to ensure that the nerves are functioning optimally. If a nerve is being pinched, the area of the body it controls (organ, muscle or joint) cannot heal until the nerve pressure is released. The nerves coordinate and control the healing of the body.

It is our office policy to communicate with the health professionals we refer to on a regular basis and ensure that we are all working together towards clear objectives… the patient’s healing.


Your body will whisper to you. If you don’t listen it will speak louder and eventually it will scream. Listen to the wisdom of your body.

Dr. Laina Shulman