Chiro, physio or bio for my back pain?

Should I go to a chiropractor, physiotherapist or biokineticist for my back pain?

This is a question that many health professionals get asked on a regular basis.

To help you make a decision, I spoke to a few local chiros (Dr Martin Khoury and Dr Sarah Heslop), biokineticists (Melissa Johns and Melanie Coetsee) and physios (Marc Colia, Tarryn Graham and Simone Barrett).

When you are in a lot of pain in the initial stages of injury, you would normally choose a chiropractor or physiotherapist as we treat the symptoms.

Once you are better or have a full range of motion, we like to refer you to a biokineticist for rehabilitation.

Chiropractors and physiotherapists do sometimes use similar treatment methods but most of us agree that in a perfect world we would love each patient to have a combination of our treatments (as happens in some first world clinics), as we have slightly different approaches which are both beneficial and complementary and are normally better together.

Chiros focus on diagnosing disease and joint alignment and its relation to muscles, with its specialised joint manipulation/adjustment ‘click’, which has a number of healing effects on the body.

Most chiros who qualified in South Africa can do dry needling, massage, kinesiotape, use pain relief machines and laser but do not always do other techniques.

They also like to educate you and recommend exercises to maintain your spine.

Physiotherapists focus more on muscular injury and weaknesses and their methods of pain relief include massage, taping, pain relief machines, dry needling, laser and mobilisation, but some also do some manipulations.

They also do more in-hospital work than chiropractors, such as rehabilitation post operations, chest work and getting people walking. They can also recommend exercises and educate you to get back to daily activity pain free.

Biokineticists normally function in the phase after acute pain and inflammation to help strengthen and stabilise the body and get you moving correctly to prevent re-injury.

They do specialised exercises with you and give you home exercise programmes to get you strong again. It’s wonderful how often they can get you back to your normal life even after severe injuries.

Although the latest research should be considered, who you choose to treat you is normally a personal preference.

This depends on your injury and what type of treatments your body responds well to and who you respond well to.

Some people love having their spine “clicked”. Some chiropractors give a very strong adjustment while others have a lighter touch and do not manipulate the neck.

Other people hate the feeling of a ‘click’ and prefer a physiotherapist approach like massage or dry needling, or a certain pain relief machine. Some physiotherapists have a lighter touch and people love that, while other physiotherapists give a deeper treatment that many respond better to.

You might have to try one or two different people to find the perfect fit. It helps to find out from a practitioner’s receptionist or their patients what their normal treatment entails.

Once you have found your practitioner, you should be feeling better after several consecutive treatments (depending on your condition) and then ideally be referred to your biokineticist.

Many of us do work in teams on patients and we all agree that it would be more beneficial if we were all able to work together on each patient and put our experience and skills together.

Our different approaches provide a very holistic treatment.

Health professionals who collaborate, instead of competing, provide good care to our community.

Dr Tracey Joelson qualified as chiropractor in 2001 and is working from Eden Health in Salt Rock. She has four children and has a special interest in family wellness and children.

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