There are a variety of treatment approaches used by the chiropractic profession. Some of these require forceful joint manipulation and some do not. This study is designed to compare outcomes of two such techniques that are common to chiropractic practice. The hypothesis is that there is no difference between forceful and non-forceful approaches to treatment.

The comparison will permit a one month treatment period for both techniques and a three week follow-up. Patients will be assessed at baseline (intake), and at specified intervals and at three weeks following the termination of care.

Inclusion Criteria:

chronic musculoskeletal pain ability to communicate in English

Exclusion Criteria:

pregnancy contraindications to manipulation pending litigation chiropractic care within the last month