Chiropractic manipulation, also known as spinal manipulation, is a technique involving the delivery of a high speed, low amplitude thrust usually to some part of the spinal column, commonly called the backbone. This therapy, which often is employed to treat and correct pain in the lower back, can be carried out by hand after the chiropractor palpates the vertebrae to detect problems with alignment. It also can be performed using a handheld tool connected to a computer and used to scan the spine to diagnose any abnormalities in alignment. The purpose of chiropractic manipulation is to restore a joint's range of motion to normal, because misalignment can interfere with a person's ability to move.

Chiropractic manipulation sometimes produces a popping or cracking noise as various gases such as oxygen and carbon dioxide are released, but it rarely is a painful procedure. Patients who are not relaxed might experience some discomfort during the treatment because of spasmic muscle tissue surrounding the joint. Various methods to induce muscle relaxation can be used to ensure that the manipulation is effective. A chiropractor might massage the area, do electrical stimulation or simply encourage the patient to rest for a while before the procedure. The release of these gases relieves pressure on the joint.

Generally, the patient is instructed to lie on his or her stomach. Often the table that is used is specialized and heavily padded to aid the doctor, who might need to change positions to properly deliver chiropractic manipulation. The number of treatments a patient could need depends on the severity of the misalignment of the entire spine or parts of it. Obtaining relief from pain usually is of the highest priority when beginning treatments, so manipulation techniques typically center on this goal. Chiropractic manipulation could involve other treatments and therapies, such as massage and nutritional counseling, to aid or speed up recovery.