Rehabilitation aims to reduce symptoms, restore function and minimize disability through an interventionist approach that is not always concerned with pathology, disease processes and cure. This approach will be described in the context of spinal pain in the elderly. The syndrome of lower back pain (LBP) is such a common symptom that it is an almost universal human experience. It is the third most commonly reported bodily symptom after headache and fatigue. In 1998, 40% adults were affected by an episode of LBP lasting more than a day, and 40% of those in pain sought medical help. The resources provided for research and clinical management of LBP are concentrated mainly on the working population. This is because of the profound biopsychosocial consequences and huge cost to society of the ‘back pain epidemic’. The direct health care costs of back pain have been estimated as £1632 million in 1998.