Occupational Therapy and Physical Therapy- What Is The Difference?

Published August 18th, 2021 by Dr. Nicole Lombardo, PT, DPT, CSCS
Fact Checked by
Chris Riley
Medically Reviewed:
Erik Rivera

Occupational and physical therapy are healthcare professionals who focus on rehabilitation. Both involve direct hands-on care intended to heal injury, decrease pain, and improve patients' quality of life. However, there are several key differences between the two professions.

What Is Occupational Therapy?

Occupational therapy focuses on improving activities of daily living (ADLs). Their care involves working on gross motor skills, fine motor skills, and finding supports and coping strategies to make ADLs easier and pain-free.

Occupational therapists, or OTs, excel in giving a whole-body approach to improving function for daily activities. OTs work with their patients and their families to help them thrive in their home, work, and social settings.

An initial exam with an OT will include assessing a patient's physical, sensory, emotional, and cognitive abilities when performing daily tasks such as dressing, eating, bathing, housework, job activities, driving, etc.

The OT will then create a plan of care that will optimize the patient's independence with daily activities. Through their care, the OT will continuously monitor the patient's progress and vary the program to ensure they reach their goals.

Typical treatment sessions include manual stretching, range of motion activities, muscle strengthening, cognitive exercises, and ADL practice. Typically, OTs will mimic real-life scenarios to help their patient find the best strategies to optimize independence and quality of life. The session may also involve the custom fitting for splints, orthotics, braces, and assistive devices.

Occupational therapy assistants (OTAs) work alongside an OT. In most cases, OTAs have to be practicing under the direct supervision of an OT. Occupational therapy assistants can treat patients and continue the plan of care set by the occupational therapist. However, they cannot change the plan of care without the OT. All documentation written by an OTA has to be finalized by the supervising OT.

Types of Conditions OT Treats

Occupational therapists see patients of all ages. Conditions that an OT commonly treats include (but are not limited to):

  • Amputees
  • Arthritis 
  • Autism 
  • Behavioral problems
  • Cerebral Palsy 
  • Chronic pain
  • Cognitive disabilities 
  • Developmental delay / Developmental disabilities 
  • Fine motor difficulties 
  • Memory loss / Alziemers
  • Mental health conditions
  • Multiple Sclerosis
  • Parkinson's disease 
  • Sensory processing disorders
  • Spina Bifida
  • Sport injuries 
  • Stroke / Traumatic brain injury
  • Work injuries

OT Settings

Occupational therapists work in a variety of healthcare settings. These settings include:

  • Early intervention
  • Home health care
  • Hospitals
  • Nursing homes
  • Outpatient clinics
  • Rehab facilities
  • Schools

In most cases, an individual needs a referral from an MD before seeing an occupational therapist. However, this varies from state to state and by an individual's insurance coverage. 

Education and Licensure Requirements

All occupational therapists must complete a 4-year bachelor's degree, typically in life science. They then must complete a 2-3 year post-graduate master's or doctorate degree from an accredited university. All OT programs will be doctorate programs by the year 2027.

Occupational therapy assistants need to complete a two-year OTA associate's degree from an accredited program.

Both OT and OTA programs involve coursework and fieldwork under the supervision of practicing OT/OTAs.

OT and OTAs must pass a national board exam and become licensed in their state upon completing the program. Each state has slightly different licensing procedures.

An occupational therapist can choose to continue their studies and become board certified in a specialty area. This process involves practicing a certain amount of hours in the setting and passing an additional national certification exam.

Job Outlook

The job market for occupational therapy is promising. According to the Bureau of Labor and Statistics, in 2020, the average salary for an OT was $86,260. Moreover, the profession is expected to grow 16% over the next ten years.

The average salary for an OTA is $60,950 as of 2020. The OTA profession is expected to grow 32% over the next ten years.

What Is Physical Therapy?

Physical therapy focuses on the movement of the human body. Most people go to physical therapy following surgery to heal an injury or to decrease pain. It is a conservative form of treatment that can prevent surgery, prevent the use of pain medications and prevent injury.

Physical therapists (PTs) or doctors of physical therapy (DPTs) are masters of the musculoskeletal system. They work with patients to improve body mechanics, restore joint range of motion, and improve muscle strength. A PT will perform an initial assessment to understand your goals and learn about your past medical history.

The PT will then form a plan of care that aims to get you back to performing daily activities and leisurely activities without pain and to the capacity you were before your injury or surgery.

A typical PT session involves hands-on care, such as massage, joint mobilizations, and stretching. Exercises also accompany manual care to improve joint range of motion, as well as muscle strength and flexibility. The exercise program may also include functional training related to what you are hoping to get back to. A physical therapist will also give you a home exercise program, which may be a variation or offshoot of the work you perform in the office.

Physical therapy assistants (PTAs) work similarly to OTAs in that they can work under the direct supervision of a physical therapist. They cannot change the care plan, but can continue sessions just as the PT has planned.

Types of Conditions PT Treats

Physical therapists can treat all musculoskeletal and most neurological disorders. Diagnoses and conditions that PTs often see include (but are not limited to):

  • Amputees
  • Arthritis
  • Cerebral Palsy 
  • Chronic pain
  • Developmental delay / Developmental disabilities 
  • Disorders of the back
  • Gait abnormalities
  • Joint pain
  • Ligament sprains
  • Multiple Sclerosis
  • Muscle pain
  • Muscle strain
  • Muscle weakness
  • Parkinson's disease
  • Post fracture
  • Post joint replacement surgery
  • Post tendon/ligament repair surgery
  • Scoliosis
  • Sensory processing disorders
  • Spina Bifida
  • Spinal cord injuries
  • Sport injuries
  • Stroke/ traumatic brain injury
  • Work injuries

PT Settings

Physical therapists can work in a variety of settings such as:

  • Early intervention
  • Home health care
  • Hospitals
  • Nursing homes
  • Outpatient clinics 
  • Rehab facilities
  • Schools
  • Sports teams

An individual might receive a prescription to go to physical therapy, but it is not necessary. Unless you are a Medicare patient, you can see a physical therapist through direct access. This means that you can walk into a PT clinic and ask for care. Physical therapists are trained to note whether or not your condition is within their scope of practice or if you need to be referred to an MD for medical care. 

Education and Licensure Requirements

To become a physical therapist, you must complete a 4-year bachelor's degree. You then must complete a 3-year doctoral degree from an accredited DPT program. This was once a master's program that evolved into a doctorate program. However, as of 2015, all physical therapy programs in the US had made the transition to doctorate programs.

Physical therapy assistants need to complete a 2-year associate's degree from an accredited program. Both PT and PTA programs involve coursework and fieldwork under the supervision of a practicing physical therapist and physical therapy assistants.

After completing their degree, PTs and PTAs must pass their respective national board exam and become licensed in the state they plan on practicing in. State licensure will differ slightly from state to state.

If they choose, a physical therapist can specialize in a specific area. There are ten specialty board certifications. Each one will involve supervised work in that specialty as well as passing an additional exam in that content area.

Job Outlook

Physical therapy is also a career that is in high demand. According to the US Bureau of Labor and Statistics, the national annual average for a physical therapist in 2020 was $91,010. In addition, the profession is expected to grow 18% over the next ten years.

The average salary for a PTA in 2020 was $49,970. The PTA profession is expected to grow 29% over the next ten years.

Similarities

Both PT and OT work to improve function and quality of life. These practitioners work to educate their patients on their bodies and instruct movement with hands-on care and exercise prescription.

They work with patients of all ages and abilities and can work in a variety of settings. Often PTs and OTs work together as a team. This is especially seen in hospitals, schools, nursing homes, and rehabs where a multidisciplinary approach is the standard of care.

A Whole Team Approach

Below is how both PT and OT work together with a female patient recovering from a stroke. As you will see, there is some overlap with what they do.

This patient is a 60-year old female who is left-handed and drives a bus for work. She lives alone in a 2-story home and has a pet dog. She loves to ride her bike around her neighborhood three times a week. As a result of her stroke, she has weakness and decreased coordination in her left arm and left leg. 

  • The OT will help her work on activities such as:
    • Dressing.
    • Showering. 
    • Using a knife and fork to eat.
    • Strengthening muscles and working on coordination to grab and hold a fork/knife spoon, as well as a pen/pencil.
    • Handwriting.
    • Getting into and out of the car, as well as driving/handling a steering wheel.
    • Grasping her dog's leash.
    • Cooking for herself.
    • Feeding her dog.
  • The PT help her with:
    • Stair and gait training with assistive devices and then return to independent walking.
    • Strengthening muscles to regain the strength back to walk her dog.
    • Shoulder, elbow, hand, hip, knee, and ankle range of motion exercises to regain prior levels and prevent loss of motion.
    • Shoulder, elbow, hand, hip, knee, and ankle strengthening exercises to regain previous levels and prevent compensations.
    • Coordination, balance, and strength training to return to bike riding. 

So Who Can I See?

If you have pain, injury, or any of the above-mentioned conditions, a physical or occupational therapist might be able to help you. If you are still unsure who would be the best fit for you, ask your doctor for a referral.

References and Resources:

Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handbook, 

Occupational Therapy Assistants and Aides, at https://www.bls.gov/ooh/healthcare/occupational-therapy-assistants-and-aides.htm (visited August 16, 2021).

​​Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handbook, 

Occupational Therapists, at 

https://www.bls.gov/ooh/healthcare/occupational-therapists.htm (visited August 16, 2021).

Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handbook, 

Physical Therapists, at https://www.bls.gov/ooh/healthcare/physical-therapists.htm 

(visited August 16, 2021).

Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handbook, 

Physical Therapist Assistants and Aides, at https://www.bls.gov/ooh/healthcare/physical-therapist-assistants-and-aides.htm (visited August 16, 2021).

Physical therapy vs occupational therapy. University of St. Augustine for Health Sciences.(2020, 

June 8). https://www.usa.edu/blog/physical-therapy-vs-occupational-therapy/. (visited 

August 16, 2021).

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