The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: (1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; (2) to track the length of CLBP relief; and (3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34 to 51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. Chronic low back pain status was measured by modified-modified Schober, Cybex Liftask, and Oswestry procedures. Results revealed that: (1) only low-tech and high-tech exercise produced significant improvements (p < 0.05) in CLBP, (2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and (3) low-tech exercise was most cost-effective. It was concluded that: (1) low-tech and high-tech exercise were the only effective treatments for CLBP, (2) low-tech exercise produced the longest period of CLBP relief, and (3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.

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