top of page

Osteopathic Manipulative Treatment: HVLA Procedure - Cervical Vertebrae


Full Text Link

Books and documents


Osteopathic Manipulative Treatment,Structural and chiropractic

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
2022 Oct 3.


Bader Elder  , Kevin Tishkowski 


Since the founding of osteopathy by Andrew Taylor Still, M.D., D.O. in 1874, a fundamental principle of osteopathic medicine has been the treatment of somatic dysfunction by using osteopathic manipulative treatment (OMT). Somatic dysfunction is an impaired function of integral components of the somatic system (the body framework). It can include the musculoskeletal, nervous, vascular, and lymphatic systems and combinations of these systems in affected areas of dysfunction.

High-velocity low amplitude (HVLA) OMT is one type of technique utilized by various practitioners that can be used to restore health to the somatic system. Specifically, HVLA therapy is a technique used in manual medicine that employs a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint. The force engages a restrictive barrier to elicit a release of the restriction. HVLA treatment is frequently associated with an audible and palpable "release" in the form of a "pop" accepted to represent cavitation of a spinal intervertebral joint and its subsequent release.

The cervical (neck) region is an area between the cranium and the thorax consisting of vascular, musculoskeletal, and neural pathways. It is a common area of injury and somatic dysfunction, resulting in pain and loss of mobility. Understanding the diagnostic approach and the treatment of cervical spinal somatic dysfunction is a cornerstone of manual medicine.

Dysfunction may occur at one or many anatomical locations: the atlantooccipital joint, the atlantoaxial joint, the paraspinal musculature, or any of the cervical vertebral joints. Collectively, manual (osteopathic) treatment may include various myofascial release techniques, muscle energy techniques, strain-counter strain techniques, and high-velocity low amplitude (HVLA) techniques. HVLA is used to relieve movement restrictions by applying a quick, therapeutic force of rapid duration that travels a short distance within the range of motion of a joint. HVLA therapy aims to restore a more "normal" range of motion within a joint and alleviate pain.

Neck dysfunction is associated with significant health costs and disability, typically due to work-related injuries and improper ergonomic practices. Symptoms involved in cervical musculoskeletal joint dysfunction include neck pain, stiffness, loss of neck mobility, arm pain, tingling in the upper extremities, weakness, dizziness, and headache.

High-velocity low amplitude (HVLA) osteopathic manipulative treatment (OMT) of the cervical spine is a passive, direct therapy that provides a high-velocity, low amplitude manually applied force to treat motion loss in a somatic dysfunction. Passive treatment implies that the patient stays inactive throughout this therapy and does not attempt to assist the physician in executing cervical HVLA treatment. This therapy provides direct engagement into the restrictive barrier of the cervical spine. The treatment goal is to forcefully stretch a contracted musculoskeletal system, producing an aggressive response of afferent nerve impulses from the muscle spindles to the central nervous system. The central nervous system will then send a reflex of inhibitory responses to the muscle spindle, relaxing the muscle.

HVLA therapy of the cervical spine should be performed only by practitioners who have been educated with this technique and have demonstrated practical and cognitive skills. Like any other procedure, education, along with pre-procedural screening for contraindications and a detailed review of the risks and benefits, is imperative before HVLA treatment. Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive advice and ask questions about HVLA treatments so that they can make well-founded decisions.

Publication Date: 

2022 Oct



Elder, B., Tishkowski, K. (2022) 'Osteopathic Manipulative Treatment: HVLA Procedure - Cervical Vertebrae ', In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2022 Oct 3.

Sponsored by 


Search    Explore    About    Join    Web Policy     Contact Us

Copyright © 2023 OsteoEvidence. All Rights Reserved.

bottom of page