Manipulation is a generally accepted, well-established therapeutic intervention for cervical spine pain, thoracic spine pain, and low back pain. Chiropractic adjustments or manipulations are a high velocity, low amplitude technique which means the joint is moved to its end range of motion and moves into the zone of accessory joint movement, well within the limits of anatomical integrity. Contraindications for manipulation include joint instability, fractures, severe osteoporosis, infection, metastatic cancer, active inflammatory arthritides, and signs of progressive neurological deficits, myelopathy, vertebrobasilar insufficiency, or carotid artery disease.

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