Prospective, randomized trial. To compare the McKenzie method of treatment of acute low back pain with patient education in “mini back school” after 5 years; the 1-year results have already been published. The 5-year results after the initial treatment are presented in this study of 89 subjects. Included in the study were 22 women and 67 men with an average age of 39.6 ± 10.5 years (range 22–66 years). Sixty-two subjects (70%) were interviewed by telephone, while the remaining 27 subjects (30%) were examined and interviewed personally. Information of sick leave was obtained from the Swedish National Health Insurance Office. The results showed that subjects who received treatment according to the McKenzie principle 5 years earlier had significantly less recurrences of pain and fewer were on sick leave compared with the subjects who received education in mini back school. The other variables did not show any statistically significant differences. The difference between the two treatments was much less after 5 years compared with the 1-year results.