The question of whether chiropractors perform massage therapy stems from the hands-on nature of both practices. Chiropractic care focuses on the diagnosis and treatment of musculoskeletal and nervous system disorders, primarily through manual adjustments. Because this discipline involves interacting with the muscular system surrounding the spine and joints, the manual techniques used often look similar to certain types of massage. This article clarifies the distinctions between the two professions and explains how a Doctor of Chiropractic (DC) integrates soft tissue work into a treatment plan.
Chiropractic vs. Massage Therapy
The two professions have fundamentally different primary objectives and educational paths. Chiropractic care is a form of healthcare focusing on the relationship between the body’s structure, mainly the spine, and its function coordinated by the nervous system. A Doctor of Chiropractic completes a doctoral program, typically a four-year post-graduate degree, covering extensive anatomy, physiology, and differential diagnosis. The primary treatment method, the chiropractic adjustment, is designed to restore joint mobility and improve neurological function.
Massage therapy focuses on the manual manipulation of soft tissues, including muscles, tendons, ligaments, and fascia. The primary goals of a Licensed Massage Therapist (LMT) are to relieve muscular tension, improve circulation, and promote relaxation. LMTs receive training through certificate or associate degree programs, usually involving a few hundred hours of instruction. The LMT scope of practice does not permit diagnosis or the application of spinal adjustments.
Soft Tissue Techniques Performed by Chiropractors
Chiropractors regularly incorporate specific soft tissue techniques as an adjunctive component to the joint adjustment. These targeted techniques address hypertonic, or overly tight, muscles that may contribute to joint restriction or pain. Addressing the surrounding musculature often makes the spinal adjustment more effective and longer-lasting.
Active Release Technique (ART)
ART involves applying direct tension to a muscle while the patient actively moves the joint through a specific range of motion. This process is designed to break up adhesions or scar tissue that can restrict movement and cause pain.
Instrument-Assisted Soft Tissue Mobilization (IASTM)
IASTM, sometimes known by brand names like Graston Technique, involves using specialized stainless steel tools to detect and treat fascial restrictions and fibrotic tissue. These restrictions often feel like gritty or bumpy areas under the skin.
Trigger Point Therapy
Chiropractors also utilize Trigger Point Therapy, applying sustained, deep pressure to localized, irritable spots within a taut band of muscle tissue. Releasing these “muscle knots” can alleviate referred pain patterns that extend beyond the immediate area. These interventions are typically brief, lasting only a few minutes per area, and are directly related to the specific condition being treated.
Integrated Care and Dual Licensing
The confusion about chiropractors and massage is often compounded by the modern practice of integrated care. Many chiropractic clinics employ Licensed Massage Therapists (LMTs) to provide full therapeutic massage services to patients. In this model, the LMT offers services within their full scope of practice, separate from the chiropractor’s adjustment. This coordination allows the patient to benefit from both soft tissue relaxation and joint alignment.
The ability of a Doctor of Chiropractic to personally perform a full massage service is determined by state-specific regulations. While a DC’s education allows them to perform soft tissue work within their scope of practice, many states require a separate LMT credential to perform and bill for a general, full-body massage. Some chiropractors obtain this dual licensure by completing the required training and examination. These providers are legally qualified to offer both the chiropractic adjustment and the full range of massage therapy services.