Back pain continues to be a growing problem in Western society. As well as orthodox therapies there have become established several alternative or complementary therapies that often have little scientific foundation to their use or value. Vertebral manipulation has often been included with these alternative therapies and although it is now more widely used in the medical profession, many clinicians still view the technique with suspicion. This book sets out to establish vertebral manipulation as an orthodox part of musculo-skeletal medicine. It begins by identifying the criteria for scientific acceptability and goes on to present the proven physiological phenomena upon which vertebral manipulation can be legitimately based. Popular hypotheses are reviewed against these criteria. A useful series of appendices provides background to a basic syllabus for teaching and also a selection of simple techniques.