A 2005 consensus statement from the American Academy of Osteopathy indicates that research and publication is limited for the use and effectiveness of MUA. More recently, it has been reported that there are gaps in the medical literature for spinal MUA in the areas of patient selection and treatment protocols. On account of that, a Delphi process was undertaken to develop evidence-informed and consensus-based guidelines for the chiropractic profession. The outcome of that process offers direction to MUA practitioners and facilities, although not intended for individual patients.