For acute low back pain (duration 4 weeks), spinal manipulation administered by providers with appropriate training is associated with small to moderate short-term
benefits (108). Supervised exercise therapy and home exercise regimens are not effective for acute low back pain (109), and the optimal time to start exercise therapy after the onset of symptoms is unclear. Other guidelines suggest starting exercise after 2 to 6 weeks, but these recommendations seem to be based on poor-quality evidence (25, 110). Other nonpharmacologic treatments have not been proven to be effective for acute low back pain.