A randomized clinical trial of rotational manipulation was conducted on 95 patients with low back pain selected for the absence of any contraindications for vertebral manipulation, the absence of any psychosocial problems that might affect the outcome of treatment, the absence of any previous experience with manipulative therapy, and the presence of palpatory cues indicating that manipulation might be successful. Patients were randomly assigned to 1 of 2 groups: an experimental group receiving manipulation therapy and a control group receiving soft-tisse massage. Patients who received manipulative treatment were much more likely to report immediate relief after the 1st treatment. At discharge, there was no significant difference between the 2 groups; both showed substantial improvement.