240 patients with acute low back pain were randomized to receive one of four treatments in addition to first-line treatment. The first group received a diclofenac drug treatment and placebo manipulative therapy, the second group underwent a spinal manipulative treatment and placebo drug, the third group had a combination of the two interventions, and the fourth group had placebo drug and placebo manipulative treatment. The primary outcome observed was recovery time and the results indicated that the interventions in addition to first-line care did not significantly improve patient's recovery times.