Spinal manipulative therapy (SMT), predominantly used by chiropractors, is a form of manual therapy that involves restoring normal spinal segmental joint function, traditionally via a controlled high-velocity low-amplitude (HVLA) impulse by the provider’s hands to the vertebra into the direction of joint restriction. Chiropractors are now also trained to used lower force manipulative techniques to achieve the same therapeutic goal.  The term ‘spinal adjustment’ and ‘SMT’ are often interchanged and both identify the same maneuver.
There is a significant amount of contemporary high-quality research evidence that has shown SMT to be an effective non-invasive treatment for acute and chronic back pain.