Manipulation is the application of a high velocity thrust to a specific joint, usually in the spine, and is often characterised by an audible and sometimes palpable click or cracking sound.

Research has shown manipulation to be effective in the treatment of spinal pain, especially when used in conjunction with other modalities such as acupuncture, mobilisations and exercise-based programmes.

A manipulative procedure will only be performed following a thorough medical history and physical examination, where no contradictions to manipulations exist and the clinical presentation indicates such an intervention.