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Guide
Chiropractor vs physical therapist vs osteopath
How chiropractors, physical therapists and osteopathic physicians (DOs) differ in training, licensing and what they can do – from official sources.
The short answer
All three are licensed in every state and can use hands-on techniques. Chiropractors (DC) center their work on spinal manipulation. Physical therapists (DPT) focus on exercise and movement. Osteopathic physicians (DO) are fully licensed medical doctors who can prescribe drugs and perform surgery.
Side by side
| Chiropractor | Physical therapist | Osteopathic physician | |
|---|---|---|---|
| Degree | Doctor of Chiropractic (DC) | Doctor of Physical Therapy (DPT) | Doctor of Osteopathic Medicine (DO) |
| Typical program | About 4 years, after at least 3 years of college | Typically 3 years | Medical school, then 3 to 9 years of internship and residency |
| Program accreditor | Council on Chiropractic Education (CCE) | CAPTE | COCA (American Osteopathic Association) |
| National exam | NBCE exams | A qualifying licensing exam | COMLEX-USA (3 levels) |
| State license | Required in every state | Required in every state | Required in every state |
| Prescribe drugs and do surgery | No – BLS describes chiropractic as nonsurgical and drug-free | No | Yes, in all 50 states (AACOM) |
| Manual therapy | Spinal manipulation is central to the work | Exercise, movement and hands-on therapy | Trained in osteopathic manipulative treatment (OMT) |
Chiropractor (DC)
Chiropractors earn a Doctor of Chiropractic degree from an accredited chiropractic college – usually 4 years, after at least 3 years of undergraduate study. Programs are accredited by the Council on Chiropractic Education, which the US Secretary of Education recognizes. To practice, chiropractors pass the National Board of Chiropractic Examiners exams and need a license from their state. Sources: BLS; NCCIH; CCE; NBCE.
Physical therapist (PT)
Physical therapists earn a Doctor of Physical Therapy degree; programs typically last 3 years. Entry-level programs are accredited by CAPTE, the only agency the US Department of Education recognizes for this. Every state requires physical therapists to be licensed, which includes passing a qualifying exam. Sources: BLS; CAPTE.
Osteopathic physician (DO)
Physicians hold either an MD or a DO degree; both can use drugs and surgery, and DOs place extra emphasis on the musculoskeletal system, prevention and whole-person care. After medical school, physicians spend 3 to 9 years in internship and residency. DO students also train in osteopathic manipulative treatment (OMT) and take the three-level COMLEX-USA licensing exam. Sources: BLS; AACOM; NBOME.
By the numbers
- Chiropractors: about 61,700 jobs in 2025; median pay $79,200 (May 2025). BLS
- Physical therapists: about 283,700 jobs in 2025. BLS
- DOs: more than 141,000 in the US, over 11% of all physicians. AACOM
Side effects to know about
NCCIH says mild, temporary side effects after spinal manipulation – such as soreness, stiffness or headache – are common and usually go away within 24 hours. Serious complications have been reported but are very rare, and may be more likely in people with underlying health problems. Tell the professional about your health history before treatment. Source: NCCIH.
Find a chiropractor near you
Practices in 50 metro areas and towns across the country, listed A to Z with the chiropractors’ names.
Questions
Can a physical therapist or a DO do spinal manipulation?
Yes. NCCIH notes that spinal manipulation is most often performed by chiropractors, and that other licensed professionals, including osteopathic physicians and physical therapists, also use it. Source: NCCIH.
Is a DO a real doctor?
Yes. DOs are fully licensed physicians. According to AACOM, they complete residency training and are licensed to practice medicine, prescribe medication and perform surgery in all 50 states. Source: AACOM.
Who should I see?
That is a question for you and your doctor. Ask each professional what they would do, why, how progress is checked and what it costs. NCCIH encourages people to talk with their health care providers about any approach they use.
General information, not medical advice. Figures from the Bureau of Labor Statistics (May 2025 data) and AACOM, checked October 2026.