Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints. These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse and costovertebral joints. The therapeutic technique employs a high velocity low amplitude thrust (HVLA) to the various regions of the spine to be treated in order to restore or to enhance joint function, with the general goal of resolving joint inflammation and reducing pain.