Licensed physicians who have specialized training and certification specifically for this procedure perform the treatment in a surgical center. A team approach is required to have a safe and successful outcome.

The team includes the anesthesiologist, the primary physician/surgeon who performs the manipulation, and the first assistant, also a physician certified in manipulation under anesthesia.

The combination of manipulation and anesthesia is not new as this treatment has been part of the medical arena for more than 80 years.