What Is the Difference Between Physical Therapy and Occupational Therapy?
Physical Therapy vs. Occupational Therapy
You might be experiencing a nagging pain, searing up and down your neck and back from hours upon hours at your computer, or maybe you accidentally injured yourself while doing yard work. You’re pretty sure you need medical care, but it might be confusing to know exactly where to turn for care. There are two common options: physical therapy and occupational therapy.
What exactly are these two forms of therapy? They each address similar needs. Both physical therapists and occupational therapists help people recover from an injury or illness. Occupational and physical therapists guide people through the rehabilitation process, improving their quality of life by educating them on how to care best for their bodies, setting goals and benchmarks as they progress through their rehabilitation, and enabling them to navigate their home and work environments safely.
The big difference between occupational therapy and physical therapy is that PT centers on movement of a person’s body, while OT zeroes in on the body’s ability to perform common daily tasks. Both are rewarding careers that enable physical and occupational therapists to directly affect the lives and comfort of people who need their services.
What Does a Physical Therapist Do?
The American Physical Therapy Association describes physical therapists as “movement experts” who improve a person’s quality of life through exercise, “hands-on care” and education.
If you pursue a career as a physical therapist, you will be devising personal treatment plans for people suffering from injuries — from sports or other accidents — as well as those with chronic conditions, such as those who experience loss of mobility from a stroke. A physical therapist may work with people of all ages or specialize in a certain age group (e.g., young athletes with injuries at a sports medicine clinic). Physical therapists also work with people who have physical disabilities, including veterans injured in the line of duty.
Physical therapist duties involve taking a medical history and physical assessment and creating a physical therapy plan that promotes fitness and wellness for their clients. They instruct clients on how to perform proper daily stretches and exercises, assist them in navigating exercise equipment and teach them how to use medical devices such as crutches.
Their goal is to tailor a treatment that reduces pain, improves mobility and helps a person function independently again (e.g., without crutches or a brace). PT may also allow someone to avoid surgery.
What Does an Occupational Therapist Do?
Wendy Hildenbrand, the president of the American Occupational Therapy Association (AOTA), has been in the occupational therapy field for 30 years. When she thinks back to what drew her to her field, she says that the first thing that comes to mind is how OT allows you to “support and bring about change in people’s lives that’s meaningful to them.”
“The biggest reward is when people can enter their day feeling that they will be successful,” Hildenbrand said. “Whether that’s at a time of transition in their lives, whether it’s a time of recovery and rehab after injury or illness, or whether it’s how they can live a healthy, satisfying life.”
The reward, she said, is watching people do things for themselves and being empowered by their interface with occupational therapy.
The OT profession is expected to grow: The Bureau of Labor Statistics (BLS) reports that employment for occupational therapists will increase 18% in the decade between 2018 and 2028.
What does an occupational therapist do exactly? The AOTA defines OT as helping people “participate in the things they want and need to do through the therapeutic use of everyday activities.” Occupational therapists create treatment plans, help people relearn essential tasks such as getting dressed in the morning, and educate family members in ways they can assist their loved one.
Occupational therapists work with many types of patients, from children to young adults to seniors. They might help a child who lives with a disability and struggles to participate fully in school, a stroke patient trying to regain movement or someone injured in a car accident. They may create a treatment plan for someone with cerebral palsy or another chronic condition so that they can navigate day-to-day life.
“We are champions at looking at daily life tasks and being able to analyze the challenges of daily living to make them opportunities. Our focus is on elevating the strengths that people possess in the authentic contexts in which they work, live and play,” Hildenbrand said.
How Do I Become a Physical Therapist?
Physical therapy is a highly specialized field that requires extensive training. If you’re interested in this profession, expect to earn a degree, pass an exam and complete a clinical residency or fellowship. Additional certifications are required if you’re interested in specializing in a specific focus area.
Physical Therapist Education Requirements
In the United States, only the Doctor of Physical Therapy degree is available if you’re looking to enter the field. This degree program must be fully accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE).
This physical therapist degree usually takes three years to complete, and your course of study will generally include biology and anatomy, physiology, exercise physiology, cellular biology, biomechanics, kinesiology, neuroscience, pharmacology, pathology, behavioral sciences, communication and ethics, among others, according to APTA. Most PT programs require applicants to have earned a bachelor’s degree, but there are a few programs that recruit students straight out of high school.
You will receive mentorship from a licensed physical therapist during your training, and this clinical experience will give you the invaluable interpersonal skills and technical adeptness needed to advance in your career. About 80% of the DPT curriculum centers on classroom and lab study, while 20% is spent on clinical training. If you pursue your physical therapist education, expect to spend about an average of 27 to 28 weeks on your clinical training.
Physical Therapist License Requirements
Once you’ve finished your degree, you have to pass the national physical therapy exam (NPTE), a necessary step to getting your license. The test is administered four times throughout the year. You are given five hours to complete the 250-question exam, which is broken up into five sections of 50 questions each. The exam’s scaled scoring system ranges from 200 to 800, with 600 or above considered a passing score.
You are allowed to retake the exam a maximum of three times in any 12-month period. There’s a lifetime limit, meaning you can only take the test a total of six times, and those who receive two extremely low scores of 400 or below twice are not allowed to take the test again.
Physical Therapy Residency
A clinical residency and clinical fellowship offer continuing education opportunities after you earn a DPT degree. This is an optional path that could help advance your knowledge and career path. The APTA notes that a physical therapy clinical residency is designed to “advance a physical therapist resident’s preparation as a provider of patient care services in a defined area of clinical practice.”
Residents will frequently go on to pursue a fellowship, and the area of study you choose must concentrate on a specialty, be intensive and focused on “mentored clinical experience,” and involve a “sufficient and appropriate patient population.”
You also need to obtain a physical therapy license before pursuing a residency or fellowship.
Physical Therapy Certification Requirements
Becoming a board-certified specialist is another appealing career path choice for some physical therapists. There are currently nine clinical specialty areas sanctioned by the American Board of Physical Therapy Specialties:
- Cardiovascular and Pulmonary
- Clinical Electrophysiology
- Geriatrics
- Neurology
- Oncology
- Orthopedics
- Pediatrics
- Sports
- Women's Health
To earn certification, you must complete 2,000 hours of clinical work or take on an accredited residency program and pass an additional exam.
How Do I Become an Occupational Therapist?
If you’re interested in the occupational therapist profession, expect to earn a master’s degree, participate in a clinical rotation or fellowship and pass a standardized exam. Additional certifications are required to specialize in a specific focus area.
Occupational Therapist Education Requirements
There are several points of entry. Those who wish to be OTs can pursue either an entry-level master’s degree or an entry-level doctorate. Either way, an advanced occupational therapy degree beyond the bachelor’s level is required to enter this field. A doctoral degree can offer a more comprehensive education in a specialty area as well as the added clout that comes with that level of degree. Regardless of what type of occupational therapy degree you seek, the program has to be one fully accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).
These occupational therapy programs will take you between two and three years to complete. There are also some combined undergraduate and graduate degree programs and online Doctor of Occupational Therapy program options. Regardless of what you choose, you will need to complete fieldwork under the guidance of an occupational therapist in order to finish your program.
Occupational Therapy Residency
There are some fellowship opportunities available to occupational therapists once they’ve completed their graduate education. These programs help individuals hone skills in a specific area of focus. The AOTA provides an online directory of available OT fellowship programs. Areas of practice may include acute and critical care, assistive technology, burns, dysphagia, gerontology, hand therapy, mental health, neurology, pediatrics and physical rehabilitation.
Occupational Therapist License Requirements
As with physical therapists, occupational therapists need to pass a standardized exam in order to obtain their license to practice. The National Board for Certification in Occupational Therapy (NBCOT) is the national certification body for U.S. OT professionals. The NBCOT exam application fee is $515, and the test time runs for five total hours. The scaled score ranges from 300 to 600. A minimum score of 450 is needed to pass. Check out the NBCOT Certification Exam Handbook (PDF, 1.6 MB) for additional information on scheduling an exam.
For those who fail, there is a 30-day waiting period after the last exam date before they can retake the test for a second or third time. Starting in 2020, you will have to wait 60 days before taking the exam again the fourth or sixth time; those testing for the seventh or more time must wait six months from their last exam. Part of the exam requirement includes a character review and passing a background check.
That isn't the end of the line: As an occupational therapist, you’ll need to obtain a license to practice in your given state. Applying for a license varies state to state, but generally, you’ll need an NBCOT score, your academic transcripts and a background check. Your state might require you to continue to take classes to keep your license up to date.
Occupational Therapy Certification Requirements
It's optional, but you can also opt for board certification or specialty certification through AOTA-approved certification programs. The certification allows OT professionals to enhance their skills in a particular area of health. There are nine different certification areas: gerontology; mental health; pediatrics; physical rehabilitation; driving and community mobility; environmental modification; feeding, eating and swallowing; low vision; and school systems.
OT vs. PT Careers
Occupational therapy and physical therapy careers share some similarities but also offer clear differences. While a PT focuses on healing injuries and — in the case of a college or professional athlete, for example — preventing injuries, an OT takes a more holistic approach and aims to help patients move independently to their best ability.
The BLS reports that employment opportunities for occupational therapists are expected to grow 18% in the decade between 2018 to 2028, while the job outlook for physical therapists is even better, with that number standing at 22% over the same 10-year period. Both types of therapists work in a variety of environments: hospitals and clinics, self-owned practices, and nursing and residential care facilities.
PT and OT Salaries
What about occupational therapy versus physical therapy salary? The pay is fairly evenly matched. When it comes to occupational therapy salary, the median annual wage in the United States in 2018 stood at $84,270. The lowest 10% earned below $55,490, while those in the top 10% earned more than $120,750.
For physical therapy salary, the median annual wage in 2018 was $87,930, according to the BLS. The lowest 10% earned less than $60,390, and the highest 10% earned over $123,350.
To compare, here are the average annual and hourly salaries for occupational and physical therapists in the United States in 2018, according to the BLS:
| Occupation | Hourly mean wage | Annual mean wage |
|---|---|---|
| Occupational Therapists | $41.04 | $85,350 |
| Physical Therapists | $42.34 | $88,080 |
PT and OT Job Specializations
If you’re considering PT or OT, you’ll find that there are three common specializations that both fields of work share: sports medicine, geriatrics and orthopedics.
Sports Medicine Specialties
OTs and PTs specializing in sports medicine can work with athletes of all ages. Both understand the musculoskeletal system and may use some of the same therapy techniques. But where a physical therapist might focus on healing from a hand injury and improving movement and strength, an occupational therapist’s goal is to get that athlete get back to using their hand for normal daily life even beyond their sport: to use utensils, brush their teeth and button a shirt. This specialty often focuses on a range of motion improvement after a sports injury or repetitive motion injuries.
Orthopedic Specialties
In this specialty, occupational and physical therapists work with people who have musculoskeletal injuries and those who suffer from degenerative diseases and infections. OTs and PTs working in this specialty area may interact with young and older patients, veterans, bone cancer patients and people who live with disabilities.
Geriatric Specialties
Specialists in this area work with elderly patients regain motion after a fall, cancer-related issues, a stroke or other health challenges. They help people who live with chronic conditions such as arthritis or who have difficulty carrying out certain day-to-day physical activities as a result of age-related conditions.
Disclaimer: Information related to PT or OT requirements, salary ranges, examination procedures and regulations is accurate as of October 2019 but is subject to change.