1. Counterworking in Supine Position
The patient lies in the supine position with a spring cushion under his back, his trunk inclining anterior-superiorly, and his two arms crossing in front of the chest to grasp the opposite shoulders with the hands to make the thoracic frame become a more steady whole. Standing by the suffered side, with his fist under the lower rim of the suffered facet joint of the thoracic vertebra or costoverebral joint, the practitioner pushes the elbows of the patients crossed alms forward to extend the spine to its limit position with the other hand. Then the patient is asked to take a deep breath．During the exhaling period when the muscle is relaxed, the practitioner thrusts the elbows suddenly and controllably to expend the extension range of the spine 3 to 5 degrees. Thus the joint is restored (Fig 293)．This manipulation is quite safe and the patient is easy to relax, therefore it  is suitable for those aged or feeble patients as well as pregnant women with the subluxation of thoracic facet joint or the costoverebral joint. Click to read Pemphigus Vulgaris in TCM.

2. Counter working in SiRing Position
Sitting on a chair, the patient extends the trunk slightly, and his other postures are the same as the above. Sitting behind the patient, the practitioner puts a globose cushion between the patient’s back and his chest, where is just at the lower rim of the suffered joint. Then the practitioner holds the patient’s two elbows to pull them posteriorly and superiorly. In this w, the spine is extended and hauled to its limit position. Later 0n the patient is asked to take a deep breath. When the patient is exhaling and his muscles are re1axed, the practitioner wrenches the patient trunk backward suddenly and controlledly with the chest counterworking anteriorly to restore the joint (Fig 294)．The manipulation is applicable to the reduction of thoracic facet joint subluxation and costoverebral joint subluxation which are above the level of T8．Click to read Chinese medicine Treatment for Pemphigus Vulgaris.

3. Counterworking in Standing Position
The patient is in the standing position with his trunk inclining poteriorly, and his other postures are the same as the above. Sitting behind the patient, the practitioner puts a globose cushion between his chest and the patient’s back, where is just at the lower rim of the suffered joint. Then the practitioner wrenches the patient trunk backward suddenly and controlledly with the chest counterworking anteriorly to make it restore (Fig 295)．Its indications are the same as the above．