BackgroundLow back pain (LBP) is a common musculoskeletal disorder that affects people of all ages. This study investigates the effects of the addition of hands-on procedures to McKenzie exercises on patients with LBP and derangement syndrome.MethodsForty-eight female patients were randomly assigned to either the experimental group or control group. All the patients in both groups underwent McKenzie exercises, transcutaneous electrical nerve stimulation (TENS) and education for 35 min/session–45 min/ session, with three sessions/week for 2 weeks. Hands-on procedures were added to the McKenzie extension exercises only for the patients in the experimental group. A visual analogue scale (VAS), the Oswestry disability index (ODI), back range of motion (BROM) and body diagrams were used to measure pain, functional disability, BROM and the centralisation of symptoms, respectively.ResultsThe mean values of VAS, ODI and BROM significantly improved after the interventions in both groups (P< 0.05), whereas the results of repeated measures ANOVA and Mann-Whitney U tests showed statistically non-significant differences between the two groups (P> 0.05).ConclusionThe addition of hands-on procedures to McKenzie exercises, TENS and education significantly alleviated back pain and functional disability and improved the back mobility and centralisation of symptoms in patients with LBP and derangement syndrome; however, these measures did not result in any significant additional benefits for such patients.