Chiropractic Techniques and Selecting Best Option for Individuals

AK, AO, ART, BEST, NET, NIMMO, NUCCA, SOT, and more. What are all these terms? Patients and even Chiropractors get confused about these terms and techniques. There are about a thousand chiropractic techniques to treat different conditions. Today, we will attempt to talk about some of the more common and/or more effective techniques.


I learnt Chiropractic from the original Chiropractic College in the world, Palmer College of Chiropractic, USA, founded by Dr Daniel David Palmer, in 1895.  While I learnt many techniques in school, mentors and practitioners advised me to study with world-renowned Chiropractic mentors. Through my almost four years at Palmer, I took over 70 seminars in various states in USA and Europe to deepen and enrich my understanding and practice of the profession. I am humbled that my learning in this field is and will continue to be a lifelong journey.

MOST COMMON TECHNIQUES: At Palmer, they teach the ‘Palmer Package’, which is the core curriculum, and includes techniques like Diversified, Gonstead, Thompson, and Toggle (Upper Cervical Specific). In terms of electives, they also offer Activator Methods, SOT (Sacro Occipital Technique), Logan Basic, AO (Atlas Orthogonal), NUCCA (focuses on correction of misalignment of the upper cervical spine) and other techniques.


Diversified: This is the most common technique used in the chiropractic profession. About 97% of DC (Doctors of Chiropractic) adopt this technique. Most chiropractic colleges teach this as their core technique. Most Randomised Controlled Clinical Trials (RCTs) on chiropractic use the Diversified technique, too. It is a manual or hands-on technique, known by laypersons as the ‘cracking’ of the spine. It does often involve cavitation or moving bones in a way that makes a ‘popping’ sound.

Gonstead: This technique is common at Palmer, and is one of the top five most common techniques used in the field (57% of chiropractors use this technique for some patients). This is also a manual technique and involves cavitation, too. For neck adjusting, this technique often involves the patient seated on a specialised chair.

Thompson:  This technique is a low force option within the ‘Palmer Package’. Thompson uses a specialised table with ‘drop pieces’, to facilitate the adjustment of the spine. Thompson Technique is an elective course at Palmer. Thompson is one of the top five most common techniques used in the chiropractic field (61% of DCs use this technique for some patients).

Toggle/UPPER CERVICAL SPECIFIC KNEE CHEST: Dr Bartlett Joshua Palmer, the Founder’s son, developed this technique to address the upper cervical spine (1st and 2nd vertebrae in the neck) specifically. This technique uses a specialised table with a drop piece, in which the patient lies on one side. Less commonly, DCs may also employ this technique (or Kale Technique) using a Knee-Chest Table.

ZONE THERAPY/ZONE TECHNIQUE: Thurman Fleet from San Antonio, Texas, developed this technique in 1931. He was a Chiropractor and metaphysical healer. He had to move his practice three times in order to comply with fire safety codes, as his offices/clinics were ‘overcrowded’ with people that posed safety risks. Patients traveled from everywhere to see Dr. Fleet to heal from all types of health conditions.

In 1931, Dr. Fleet had an illuminating experience that resulted in him bringing to the world a phenomenal chiropractic healing technique and an unparalleled correlation of the world’s Truth, Wisdom, and Knowledge called Concept Therapy. He founded a new technique called the Zone Therapy, which focuses on Five Zonal Areas that could be the cause(s) of one’s health issues or projects. Later on, his Grand student renamed his technique as the Zone Technique, and taught this around the world, helping to start a re-birth of the Zone Technique Movement globally.

Activator Methods: Activator Methods uses a hand-held instrument to give a very high speed, low force adjustment to the spine or extremities. This technique uses leg checks to assess where to adjust, and if the adjustment was successful. Activator Methods is the second most commonly used chiropractic technique in the field, and may be the most common technique used for older patients or physically frail patients (70% of DCs use this technique on some patients.) This technique is an elective at Palmer College.

Sacro-Occipital Technique (SOT): This technique focuses on the sacrum (the bone that makes up the foundation at the bottom of the spine) and the occiput, the bony part of the base of the skull. This ‘top and bottom’ approach is very low force and is known for using padded wedges or SOT ‘blocks’ under the patient’s hips for a low force adjustment using gravity and the patient’s weight over a longer time (1-2 minutes or more.)  This is the sixth most common technique used in the field (50 % of DCs use this with some patients), and is taught as an elective course at Palmer.

Logan Basic: This is a very low force adjustment focusing on the sacrum, and addresses postural imbalances throughout the spine (used by 26% of DCs). This technique is suitable for frail or older patients, infants or young children, or those who cannot (or do not wish to) tolerate a more ‘forceful’ adjustment. This technique is an elective at Palmer College.

Applied Kinesiology (AK): This technique, used by 38% of DCs (not taught at Palmer) uses muscle testing to assess where and how to adjust. AK also focuses on the relationship among muscles, nerves, and organ systems, and incorporates some elements of Traditional Chinese Medicine (TCM) to balance energy/metaphysical forces in the body.

Atlas Orthogonal (AO) TechniqueAO is an upper cervical technique that uses a special table and instrument to perform very specific low force adjustments to the atlas or 1st vertebra of the neck. This technique is an elective at Palmer College.

NUCCA (abbreviation for National Upper Cervical Chiropractic Association). NUCCA is a very low force upper cervical technique, taught as an elective at Palmer College, focusing on adjustments of the atlas vertebra. It uses very carefully measured X-rays to determine the specific vector of the adjustment, done manually by hand.

Pettibon: This full spine technique also relies heavily on X-rays for analysis of spinal misalignment and issues. This technique uses high velocity, low amplitude adjustments to the spine, along with exercises and stretches to rehabilitate the spine and improve the posture. The technique also uses specialised tables, and handheld instruments, blocks, wedges and traction to assist in the adjustment of the spine.

OTHER CHIROPRACTIC PRACTICE TRIVIA: About 95 % of DCs use ice packs, 91% do trigger point therapy and 90% offer nutritional advice to patients. Over 80% of DCs recommend braces or neck collars, massage therapy and/or heat packs. The majority of DCs also use complementary therapies, such as traction, electrical stimulation, heel lifts, therapeutic ultrasound, acupressure and more in their practices.

What is the Best Option for Individuals?

There is no ‘One-Size-Fits-All’ Technique/s in Chiropractic Care.  Chiropractic is a very diverse field; techniques evolve or new ones discovered over time. Hence, ALL of the above-mentioned techniques and therapeutic interventions help some patients some of the time. None of it helps every patient every time. This is because every person’s anatomy, brain, nervous system, health conditions and thinking are not similar.

At Dr. Chiro, Dr. Nicholas Lim has chosen to use mainly the Zone Technique after extensive studies and research. He still uses other methods and techniques, but 80% of the time, he uses the Zone Technique. He will choose the technique(s) that is/are Patient-centered, and considered the best option for the patient after assessment.


The Practice Analysis of Chiropractic 2010: A project report, survey analysis and summary of the practice of chiropractic within the United States. National Board of Chiropractic Examiners

Technique Systems in Chiropractic: Edited and Authored by Robert Cooperstein and Brian Gleberzon. Churchill/Livingstone. 2004, Toronto. Assessed 24/1/2022


Your Trusted
Chiropractor Singapore


Dr. Nicholas Lim, D.C., ANutr, B.Sc. (Hons)

[Dr. of Chiropractic & Nutritionist &

Secretary of Chiropractic Association of Singapore]

WhatsApp :+65 9352 8828

Telephone : +65 6970 8152

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