Manipulation refers to movements in which the therapist applies an external force to a joint or a muscle in order to achieve a therapeutic aim. Manipulations are typically associated with the spine, in which physical force is used in combination with body and joint ergonomics to move the spine, and sometimes produce a "Cracking" sensation.

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Manipulation is used to test, address and improve any issues with joint mobility and stiffness that may be encountered, and not all manipulation results in a cracking sensation or noise. Manipulation is used to move joints and limbs without the action of the patient's muscles. This allows the therapist to further investigate the nature, progression, and severity of any pain or discomfort that the patient may be experiencing. Manipulation is also used to assess the movement of joint articular surfaces relative to each other, and in this way can be used to investigate the nature of local tissues surrounding the joint, as well as any issues with associated joints nearby.

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In clinic, manipulation will be performed alongside other treatments, to best address the problem and to increase the likelihood of longterm functional improvement. While manipulation alone can be useful for the treatment of individual problems, the application of manipulative forces with other treatments can boost the effectiveness of those treatments and can amplify their clinical effect.

Not every patient will be appropriate for manipulation. Spinal and joint manipulation in the clinic will be used depending on the discretion of your treating clinician as well as the nature, history, and context of your presenting discomfort. Feel free to discuss this treatment with your clinician, either in appointment or during your initial consultation.