Education
Physiotherapist, physiatrist or chiropractor? Who to see for your pain
Differences between a physiotherapist, a physiatrist and a chiropractor in Colombia: training, regulation, what each one does and who to see in your situation.
Short answer: all three can help with pain, but they do not do the same thing. A physiatrist is a medical doctor specializing in physical medicine and rehabilitation: they diagnose, prescribe and order tests. A physiotherapist is a health professional with university training, regulated in Colombia by Law 528 of 1999, who assesses movement and leads active rehabilitation. A chiropractor focuses on spinal manipulation; in the Colombian regulations we reviewed we did not find a law that regulates it as an independent profession; Law 1164 of 2007, art. 19 only allows authorized health professionals to use alternative and complementary therapies —including "manual therapies"— within their own discipline and with academic certification. That is why it is worth checking who is treating you and where they trained. The right choice depends on your situation: if there are warning signs, see a doctor first.
Comparison table: physiotherapist, physiatrist and chiropractor
| Physiotherapist | Physiatrist | Chiropractor | |
|---|---|---|---|
| What they are | Health professional with a university degree | Medical doctor specialized in physical medicine and rehabilitation | Practitioner of chiropractic |
| Regulation in Colombia | Law 528 of 1999; registration in ReTHUS and professional license (managed by COLFI by delegation) | Regulated medical profession; medical specialty | We did not find a Colombian regulation governing it as an independent profession; Law 1164 of 2007 (art. 19) places alternative therapies, including manual therapies, within the health professions |
| What they mainly do | Assess movement; therapeutic exercise, manual therapy, education and supporting technologies | Medical diagnosis, prescriptions, tests, medical procedures, rehabilitation orders | Adjustments or manipulations, mainly of the spine |
| When it usually makes sense | Injuries, musculoskeletal pain, post-operative recovery, return to sport or work | When you need a medical diagnosis, medication, tests or coordinated rehabilitation management | If you choose one, check their training and license in a country where the profession is recognized |
What does a physiotherapist do?
Law 528 of 1999 defines physiotherapy as a university-level health profession whose purpose is the study, understanding and management of human body movement. In practice, a physiotherapist:
- Carries out an assessment (history, movement, strength and function tests).
- Designs an active plan: therapeutic exercise, manual therapy, education and, when helpful, supporting technologies.
- Reassesses and adjusts the plan; if something needs medical investigation, they refer you.
The same law states that the duty of care does not entail guaranteeing results: be wary of any practitioner who promises you a cure.
What does a physiatrist do?
A physiatrist is a medical doctor specializing in physical medicine and rehabilitation. They can diagnose, prescribe medication, order imaging or tests, perform medical procedures and prescribe a rehabilitation plan. Physiatrists and physiotherapists often work as a team: one leads diagnosis and medical management, the other leads movement rehabilitation.
What does a chiropractor do?
Chiropractic focuses on adjustments or manipulations, especially of the spine. In other countries it is a profession with its own training. In Colombia we did not find a law or resolution that regulates it as an independent profession. What does exist is the framework for alternative therapies: Law 1164 of 2007, art. 19 allows authorized health professionals to use alternative and complementary therapy procedures (the law mentions, among others, "manual therapies") within the scope of their discipline, provided they hold academic certification from a state-recognized institution; earlier, Resolution 2927 of 1998 of the Ministry of Health already regulated these therapies. According to El Tiempo (2024), there is no university degree in chiropractic in Colombia; that article recommends checking that the practitioner trained in a country where the degree is established and holds a license, and being wary of anyone who only shows short-course certificates.
Who to see depending on your situation
| Your situation | Suggested first step |
|---|---|
| Severe pain after a blow or fall, suspected fracture | Emergency room or doctor |
| Back pain with loss of strength, changes in bladder or bowel control, or numbness in the genital area | Emergency room |
| Pain with fever, unexplained weight loss or a history of cancer | Doctor |
| Musculoskeletal pain (back, neck, shoulder, knee) without warning signs | Physiotherapy assessment or doctor; both are valid paths |
| Recovery after surgery | Physiotherapy, within the surgeon's protocol |
| You need medication, sick leave or tests | Doctor (GP, physiatrist or other specialist) |
| Sports injury and return to sport | Physiotherapy, with a doctor if a structural injury is suspected |
How to verify your practitioner
- Physiotherapist: ask for their professional license or check their registration in ReTHUS. COLFI manages ReTHUS registration and professional licenses for physiotherapy by delegation (COLFI regulations).
- Doctor/physiatrist: also listed in ReTHUS.
- Chiropractor: ask where they trained and whether they hold a license in a country where the profession is recognized.
At Esencial
We are a physiotherapy center in El Poblado, Medellín. Care is provided by Vanny Pulgarín, a licensed physiotherapist, on a private, one-to-one (1:1) basis. We start with a 60-minute assessment and, if we see something that needs medical investigation, we tell you and guide you. Learn about our integrative physiotherapy service or read about back pain.
Frequently asked questions
Is it better to see a physiotherapist or a chiropractor? It depends on what you need. To rehabilitate an injury, regain movement after surgery or manage musculoskeletal pain with an active plan, a physiotherapist is a health professional regulated in Colombia by Law 528 of 1999. If you choose a chiropractor, check where they trained. What is the difference between a physiotherapist and a physiatrist? A physiatrist is a medical doctor specializing in physical medicine and rehabilitation: they diagnose, prescribe medication, order tests and can refer you to physiotherapy. A physiotherapist is a university-trained professional who assesses movement and carries out the rehabilitation plan. They often work as a team. Is chiropractic regulated in Colombia? In the regulations we reviewed we did not find a law that regulates it as an independent profession. Law 1164 of 2007 (art. 19) allows authorized health professionals to use alternative and complementary therapies, such as manual therapies, within their discipline and with academic certification. According to El Tiempo (2024), there is no university degree in chiropractic in the country, so it is worth checking where the practitioner trained. How do I check that a physiotherapist is licensed? In Colombia, physiotherapists must be registered in ReTHUS and hold a professional license; COLFI manages that registry by delegation (Resolution 0325 of 2025). You can ask them for their details or look them up in ReTHUS. I have sciatica or a herniated disc. Who should I see first? If there are warning signs (loss of strength, changes in bladder or bowel control, numbness in the genital area), go to the emergency room or see your doctor. If not, you can start with a physiotherapy assessment or with your doctor; if your case needs medical investigation, the physiotherapist will tell you. Do I need a doctor's referral to see a physiotherapist? Not for private care at Esencial. If you have a referral, test results or a diagnosis, bring them.
Book your assessment
If you are not sure where to start, an assessment gives you clarity. Book your 60-minute assessment via WhatsApp or at /es/agenda. Private, one-to-one (1:1) care at Torre Médica El Tesoro 2, El Poblado, Medellín. We also see patients in English.
This content is for educational purposes and does not replace an assessment by your doctor, surgeon or physiotherapist.
Sources: Law 528 of 1999, arts. 1 and 2 (Supersalud legal database: https://normograma.supersalud.gov.co/compilacion/docs/ley_0528_1999.htm); COLFI, Regulations / Resolution 0325 of 2025 (https://www.colfi.co/normatividad-colfi/); Law 1164 of 2007, art. 19 (Supersalud legal database: https://normograma.supersalud.gov.co/compilacion/docs/ley_1164_2007.htm); Resolution 2927 of 1998, Ministry of Health (Supersalud legal database: https://normograma.supersalud.gov.co/compilacion/docs/resolucion_minsalud_r2927_98.htm); El Tiempo, "¿Es lo mismo quiropráctico y fisioterapeuta? Especialista lo explica" (Mar 1, 2024).