An article published in Spine (1995; 20(5):615–619) reviewed the roles of exercise, mobility, and spinal manipulation in the management of back pain. The authors noted that bed rest or significant activity restriction was no longer considered an important part of recovery. Instead, physical therapy and exercise were described as more effective approaches for helping patients recover and return to work. The article cited a study in which 90% of patients with back pain responded to vigorous exercise, and 92% were able to return to work; four of the six patients who did not respond were later found to have spinal stenosis. The authors also reported that mobilization and spinal manipulation may play a role in addressing the mechanical components of acute back pain and may help speed recovery, even though many cases of acute back pain resolve on their own over time.