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Background: Back and neck pain are among the most common diagnoses seen in physical therapy, and as many as 540 million people are affected. There has been more push to use a biopsychosocial approach rather than a biomedical approach when managing patients with chronic back pain. Exercise therapy is often used as a first line treatment for patients with chronic back pain. However, literature often focuses only on the effects of exercise on subjective pain levels even though pain levels and function are not always correlated. Thus, the purpose of this case study is to present an example of a patient with chronic back pain who experienced improvement in function despite minimal improvement in pain. Case Description: A few sentences describing your patient. Outcomes: While the patient experienced little to no improvement in pain intensity, strength measurements, or range of motion, he reported decreased difficulty with daily activities and improved balance. He scored a 21/24 on the Dynamic Gait Index (DGI) which indicates a meaningful change for the patient. The patient also demonstrated decreased difficulty with performing the activities in the DGI. Discussion: Management of chronic back pain can be challenging, and it is important to set expectations for patients about outcomes for treatment. While there may be minimal changes in pain intensity, physical therapy can assist in improving function and strategies for managing pain.