Neck and back pain are common work-related complaints. The natural history of these symptoms favors rapid recovery. Medical management of workers with these complaints relies on carefully managing this natural history, while attempting to minimize the resulting disability. Medical advice should focus on decreasing patients' fears and encouraging a rapid return to function (including work) as acute pain symptoms improve. Interventions should be as limited as possible and promote self care. Patients with radicular symptoms may require additional interventions but, there, too, the natural history is favorable. Surgery may be necessary in a small percentage of patients with catastrophic and severe neurologic symptoms or persistent, severe pain. Chronic neck and back pain symptoms are commonly encountered. Medical and reversible causes of pain should be sought in such patients. When none is found, interventions aimed at maximizing back and neck function and improving tolerance for physical activities may be beneficial in returning these workers to productive lifestyles.