The main concern of this chapter presents the back pain. Back Pain is a common symptom which clinicians are struggling to conquer for decades. Low back pain is an important socioeconomic problem all over the world but till recently, statistical documentation of healthcare utilization, work absenteeism and disability came from Western countries Frymoyer. Back Pain is a complex phenomenon. A large number of small joints, vertebral bodies, periosteum, interbody joints, ligaments, muscles and neural elements are involved. Spinal gate control theory, axial back pain, referred pain, radicular pain and paraesthesia, the concept of neural sensitization, myofascial pain syndromes and trigger points and spinal degeneration are the neurophysiologies of low back pain. Neural evaluation: nerve stretch tests, pain assessment instruments, functional evaluation and muscle evaluations are the clinical evaluation of back pain. The short-term goal is to relieve acute pain and the long-term goal will aim at getting the patient back to the active life and prevent recurrence and chronicity. The goals are reviewed weekly and treatment program revised from time to time.