Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain

Inclusion Criteria: * At least 18 years of age * Acute or sub-acute low back pain * Average low back pain severity ≥3 on the 0-10 numerical rating scale over 7 days * Medium or high risk for persistent disabling back pain according to the STarT Back screening tool * Ability to read and write fluently in English Exclusion Criteria: * Non-mechanical causes of low back pain * Contraindications to study treatments (e.g,. surgical fusion of lumbar spine) * Active management of current episode of low back pain by another healthcare provider * Serious co-morbid health condition that either requires medical attention or has a risk for general health decline over the next year * Pregnancy, current or planned during study period and nursing mothers * Inability or unwillingness to give written informed consent