Objective: To introduce and describe a standardized protocol for a functional, pre-manipulative assessment procedure for spinal pain. Design: Two brief case reports and the clinical utility of this maneuver is compared with another commonly used orthopedic test in a retrospective study involving 50 subjects. Setting: Northwestern Health Sciences University's Bloomington Natural Care Center. Results: The use of the proposed pre-manipulative orthopedic assessment maneuver may have clinical utility for patients presenting with back and/or leg pain. There were differences in the subjective responses of some subjects between the use of the torsion test and the straight leg raise and some results that suggest a correlation between the two tests. Conclusion: The test described may be useful as an additional assessment procedure since it closely reflects those spinal stressors that are commonly present when manual therapy is being employed. Additionally, the torsion test may have practical utility since it can be modified to reflect different techniques employed by different health care providers.