OBJECTIVE: To review literature pertaining to low back pain (including lumbar disk herniation) and its treatment by manipulative therapy and rehabilitative exercises.

DATA SOURCES: A Medline literature search was performed. English and foreign language materials were reviewed. Key words included the following: manipulation, manipulative therapy, lumbar intervertebral disk herniation, lower back pain.

STUDY SELECTION: The studies detailed the neurologic and biomechanical aspects of manipulative therapy, as well as the efficacy of manipulative and rehabilitative management of mechanical low back pain. Also included were studies detailing the etiology of mechanical low back pain.

DATA SYNTHESIS: Recent studies have indicated there are certain activities that commonly precipitate lower back injuries. Several methods of treatment for these injuries are discussed. The review indicated the most effective form of treatment is manipulative therapy. The neurologic and biomechanical aspects of manipulation are discussed.

CONCLUSION: Low back pain is a common cause of physical, emotional and financial distress. This paper concluded that manipulative therapy is an efficacious as well as cost-effective method of treatment in cases of mechanical low back pain.

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