Cervical spine manipulations are commonly performed in the supine position and interfallangial contact is placed over the articulating pillar of the affected joint. The joint is then placed at its end range of motion and all joint play is then locked out. A high-velocity, low-amplitude impulse(HVLA) is then applied. Cervical spine manipulation techniques may be selected that require a minimum of neck rotation and extension. For example, the patient may be placed prone on the examination table with the headpiece slightly flexed. A contact is then made over the facet articulation and counter-pressure is applied to the opposite side. The manipulative force then is administered through the facet joint without rotating the patient’s neck.

Dr. Matthew Kowalski is a chiropractor and President of New England Spine Institute. He has more than 25 years of experience providing chiropractic services.