Use only the downward gliding movement of the three palpating fingers.
Keep in mind the count as you have established it for that particular spine, recalling one or two very prominent and noticeable vertebrae whose numbers you have noted.
Use a light touch. If necessary, change the patient’s position to make the vertebra more accessible instead of pressing with more force.
When in doubt as to direction, change sides and use the other hand. If still in doubt, take a longer glide, covering six vertebrae instead of three or four.
Keep your mind on your work, forgetful of everything else.
And picture to yourself the entire vertebra and its surroundings; its body, pedicles, and laminae, its transverse processes and all articulations; above all, mentally visualize the foramina and nerves. Estimate from the position of each vertebra the pressure at each foramen. Decide whether the vertebra is rotated, tipped, laterally displaced, anterior or posterior, or whether the subluxation partakes of several of these directions.
Decide in what direction movement of the vertebra would release most pressure and list accordingly.
Never hesitate to change your opinion if you discover evidence that you have made a mistake. Keep at all times an open mind in palpation.