Chiropractic (from Greek chiros and praktikos meaning "done by hand") is a health care profession whose purpose is to diagnose and treat mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health.Manual therapies have been practiced in virtually all societies and cultures throughout recorded history. In western civilization, its practice is recorded in the works of Hippocrates and Galen and has survived to the present in various forms in different societies. In Japan, the majority of practitioners of spinal manipulation are lay practitioners, while in Europe a large percentage are medical physicians who have additional training in the practice. In North America, some medical and osteopathic physicians offer spinal manipulation. Although the osteopathic profession was the first in the USA to organize a body of knowledge in the practice, the great majority of osteopaths do not practice manipulation. At this point of time chiropractors provide the vast majority of these services in North America as well as in many other parts of the world, and are equated in the public perception with the practice of spinal manipulation. Currently, well in excess of 90% of spinal manipulations in the USA are delivered by chiropractors. They also provide a growing percentage of these treatments in Japan, Australia, New Zealand, South Africa and many parts of Europe. This article concerns itself with the current state of chiropractic, focusing on its place in the health-care system in the USA.