Manipulation, as a physical modality in treatment of pain, has a long and controversial history. Both beneficial effects (in minor painful musculoskeletal derangements) and catastrophic accidents have been reported. The inherently serious risks associated with its use, in view of difficulty in excluding underlying spinal and osseous pathology even after careful roentgen and clinical evaluation, have made the clinician wary of its acceptance. Explanations of its pathodynamics that are often at variance with accepted medical experience tend to make it unappealing to the physician and scientist, particularly since most conditions treated generally are amenable to more conservative, less dramatic therapy.
This book represents an approach to manipulation therapy in its attempt to delineate indications and contraindications and in presentation of a different methodology. The title Orthopedic Medicine is inappropriate; it is not an orthopedic thesis, although it deals with musculoskeletal problems. Since a relatively small portion of orthopedic practice represents