Low back pain (LBP) affects 80% of Americans at some point in their life and remains the most expensive cause of work-related disability in terms of worker’s compensation and medical expenses resulting in an annual cost of 0 billion. Unfortunately, LBP does not only affect the elderly; it is the most common cause of disability for those under 45 years. Similar health-related LBP problems exist in the military population. Among Active Duty Service Members (ADSMs) of the U.S. Armed Forces, LBP and other back problems, account for the most medical encounters every year and are the leading musculoskeletal causes for lost work time. Physical therapy (PT) is considered the gold standard for LBP treatment, but many acute and chronic back pain sufferers cannot complete their exercise sessions due to the pain itself. For those individuals, the next course of action is often costly and addictive pain medication and/or spinal injections. When long term pain relief does not occur - spinal surgery is recommended. For this group of failed LBP patients, we propose a new non-surgical treatment option that compliments early PT intervention with a dynamic back brace. The distractive and mobility-enabling orthosis (DMO) applies a distractive force to the lower spine while allowing unconstrained trunk movement. Biomechanical laboratory testing found the DMO provided up to 300N spinal offloading with minimal additional rotational effort needed to move through typical ranges of daily living (25° flexion, 10° extension and 10° axial twisting). The DMO has also undergone clinical assessment in the motion analysis laboratory and found to support the lumbar spine during different dead-lift exercises (0, 8kg, 16kg) without altering muscle activity. For ten healthy individuals, the EMG response of the paraspinal muscles increased consistently as the external load increased but remained similar between the no brace and activated brace (80N of distractive load) conditions for each external dead-lift exercise. We hypothesize utilization of the DMO during early PT interventional treatment for mechanical LBP in the Military Health System will decrease health care utilization and costs and improve pain, function, quality of life, and fitness. The goal of this project is to recruit PT personnel within the Military Health System to collaborate on this study with the objective of evaluating the clinical effectiveness of the DMO to advance PT treatment modalities for the LBP population. There are many different specific and non-specific clinical conditions of LBP. We proposed focusing on two groups of patients: 1) individuals with specific symptoms of radiculopathy (acute pain from pinched nerves and/or mild disc herniation) and 2) individuals with non-specific back pain brought on by prolonged activities (i.e., 2 hours or more). Tentatively, the specific aims will be to 1) determine the clinical effectiveness of the DMO to alleviate pain and enable patients with radiculopathy to complete sufficient PT treatment sessions that will enable them to return to active duty, and 2) determine the clinical effectiveness of the DMO to minimize and alleviate the source of low back pain brought on by prolonged activities.