301 patients were included in this study to determine the short- and long-term efficacy of high-dose, supervised low-tech trunk exercise, chiropractic spinal manipulation therapy (SMT), and a short course of home exercise for treatment of chronic low back pain. After 12 and 52 week evaluations, patients who received supervised trunk exercise were most satisfied and had greatest gains in trunk muscle endurance and strength. However, they did not significantly differ from chiropractic spinal manipulation or home exercise in other patient perceived outcomes.