Spinal manipulation, one of the oldest forms of therapy for back pain, has mostly been practiced outside of the medical profession. Over the past decade, there has been an escalation of clinical and basic science research on manipulative therapy, which has shown that there is a scientific basis for the treatment of back pain by manipulation. Most family practitioners have neither the time nor inclination to master the art of manipulation and will wish to refer their patients to a skilled practitioner of this therapy. Results of spinal manipulation in 283 patients with low back pain are presented. The physician who makes use of this resource will provide relief for many patients.