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Osteopathic Manipulative Treatment: HVLA Procedure - Thoracic Vertebrae


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Osteopathic Manipulative Treatment,Structural and chiropractic

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
2022 Aug 22.


Lauren Hammell  , Manda Null 


Osteopathic manipulative treatment, or OMT for short, is a technique where osteopathic physicians have used their hands to diagnose and treat numerous health conditions for years. This type of hands-on treatment has helped reduce the number of pain medications patients may need for a musculoskeletal injury. High velocity-low amplitude, or HVLA for short, is a type of manipulation in which the provider provides a rapid (high velocity) therapeutic force of brief duration that travels a short distance (low amplitude) within the anatomic range of motion of a joint and engages a restrictive barrier in one or more planes of motion to elicit the release of restriction. This article describes the mechanics of thoracic HVLA and highlights the role of the healthcare team in evaluating and treating this condition.

High velocity, low amplitude manipulation is a common treatment used most often when patients are experiencing pain or loss of joint motion. The most commonly taught method of thoracic HVLA is the "Kirksville Crunch." This method is widely known in the osteopathic community and effectively treats most thoracic joint somatic dysfunctions. It is important to learn this technique as well as its alternatives if a patient is unable to be manipulated using one particular method. Learning how to perform effective thoracic HVLA is essential to the practicing osteopathic physician as it will help improve patient satisfaction by providing immediate results. Additionally, treating a musculoskeletal ailment with thoracic HVLA will decrease the number of pain medications prescribed to the patient.

Publication Date: 

2022 Aug



Hammell, L., Null, M. (2022) 'Osteopathic Manipulative Treatment: HVLA Procedure - Thoracic Vertebrae ', In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2022 Aug 22.

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