Several pathways in the evolution of chiropractic manipulation.

Chiropractors' manual methods of healing have diverse origins. Unlike the older traditions of bonesetters, chiropractors apply their techniques to health problems beyond the musculoskeletal system. The ideas of the Palmers were seminal, but innovation has been a prominent characteristic in the evolution of technique, and borrowing of methods between "brand-name" techniques has been common. Manipulative strategies have also been influenced by various instruments for diagnosing (ie, detecting) putative subluxations. Influences from beyond the profession (eg, from osteopathy) are also apparent; chiropractors have not confined themselves to the high-velocity adjustive procedures that marked the profession's inception. Technique has been a source of controversy within the profession, but little has been done to determine the relative merits of various manual assessment and intervention procedures. The proprietary nature of many chiropractic methods has promoted both innovation and secrecy. Extensive research will be needed to separate the chaff from the wheat.