CurrentPT, Physical therapist
Spinal manipulation
Choose your profession and state in Your lens above, and this page answers for you first.
At a glance
- DC, ChiropractorChiropractorWithin scopeSpinal adjustment is the core procedure named in chiropractic practice acts.
- PT, Physical therapistPhysical therapistVaries by stateThe national model act and many physical therapy laws include thrust manipulation, but some states restrict spinal manipulation by physical therapists. Washington requires a separate endorsement, West Virginia and Tennessee require extensive added training, Florida bars specific chiropractic spinal manipulation, and Arkansas's act excludes it.
- PTA, Physical therapist assistantPhysical therapist assistantNot yet covered
- OT, Occupational therapistOccupational therapistNot typicalOccupational therapy laws generally do not include spinal manipulation, and several, including Maryland's and Nebraska's, expressly exclude it.
- OTA, Occupational therapy assistantOccupational therapy assistantNot yet covered
- AT, Athletic trainerAthletic trainerNot typicalAthletic training laws that address it exclude spinal manipulation and thrust techniques, and the national certification body's practice analysis does not include them.
- LMT, Massage therapistMassage therapistNot typicalMassage therapy laws generally exclude spinal adjustment and thrust manipulation.
- CSCS, Strength and conditioning specialistStrength and conditioning specialistNot yet covered
- CPT, Personal trainerPersonal trainerNot yet covered
What it is
A quick, small, controlled push to a joint in the spine, often with an audible pop. It is one of the most studied manual therapies for back and neck pain.
Names across professions
| Profession | Term in practice acts | Note |
|---|---|---|
| Chiropractor | Adjustment | The usual chiropractic term |
| Physical therapist | Thrust manipulation | Common in physical therapy literature |
| Across professions | HVLA thrust | High-velocity, low-amplitude; used across professions |
What the bodies say
CurrentDC, Chiropractor
Practice Analysis of Chiropractic 2025
CurrentDC, ChiropractorPT, Physical therapistOT, Occupational therapist
WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings
CurrentPT, Physical therapist
Lateral Elbow Pain and Muscle Function Impairments
CurrentDC, Chiropractor
Best practices for chiropractic management of adult patients with mechanical low back pain: a clinical practice guideline for chiropractors in the United States
CurrentPT, Physical therapist
Interventions for the management of acute and chronic low back pain: revision 2021
CurrentPT, Physical therapist
Patellofemoral pain
CurrentPT, Physical therapist
Neck pain: revision 2017
Check your state
Find your licensing board
Get licensed links to the board for each profession in each state, so you can read its rules or ask it directly.
Go to Get licensedState-by-state detail
This topic varies enough between states to warrant a state table, with the statute and board for each cell.