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The position for lumbar spine manipulation is very similar to that used during sacroiliac joint techniques. The patient is again placed in this lateral recumbent position, and we try to isolate the area to be manipulated by hooking the spinous process of the lumbar vertebra. The joint is then stressed to its end range of motion with the forearm placed over the ischial tuberosity. At this point, a high-velocity, low-amplitude impulse can be applied. An alternate technique is to place the hypothenar eminence on the paraspinal tissues and again stress the joint to its end range of motion. A high-velocity, low-amplitude impulse is again applied.
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