| Abstract/Notes |
Objective: Manual joint manipulation (MJM) is a widely utilized intervention in chiropractic and osteopathy for neuromusculoskeletal conditions. The theoretical and mechanistic foundations of MJM were significantly advanced by three foundational scholars: John McM. Mennell, MD; Rene Cailliet, MD; and Scott Haldeman, MD, DC, PhD. The objective of this narrative review is to synthesize contemporary evidence (2015–2025) as a modern reappraisal of their foundational frameworks, evaluate current clinical practice guidelines, and assess the safety profile and clinical implications of manual joint manipulation for neuromusculoskeletal medicine practitioners.
Methods: A structured literature search was conducted across PubMed/MEDLINE, CINAHL, Cochrane Library, PEDro, Embase, and the Index to Chiropractic Literature (January 2015–March 2025). Inclusion criteria encompassed randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines addressing MJM for musculoskeletal conditions in adult populations. Seminal foundational texts by Mennell, Cailliet, and Haldeman were included as primary theoretical sources. A narrative review design was selected to accommodate the integrative, theory-evaluative purpose of the review. Evidence was appraised using a four-tier hierarchy (High/Moderate/Low/Foundational).
Results: Contemporary biomechanical and neurophysiological research validates and extends the theoretical frameworks of all three foundational authors. Manual joint manipulation is supported as an effective intervention for acute and chronic low back pain, neck pain, and cervicogenic headache by multiple systematic reviews and updated clinical practice guidelines, including Whalen, Hawk, Daniels et al. (2023) and the WHO guideline (2023). The safety profile of manual joint manipulation remains favorable relative to pharmacological comparators, with contemporary evidence reinforcing prior risk assessments for both lumbar and cervical manipulation.
Conclusion: The frameworks established by Mennell, Cailliet, and Haldeman constitute a living conceptual architecture that continues to be validated by contemporary research. MJM is a guideline-endorsed, evidence-based intervention appropriately integrated into multimodal, biopsychosocial neuromusculoskeletal care.
Keywords: manual joint manipulation; joint play; spinal manipulative therapy; neuromusculoskeletal medicine; clinical practice guidelines; narrative review; joint dysfunction; biomechanics
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