Back pain is 1 of the leading primary care chief complaints. With mounting evidence for the use of dry needling, manipulation, targeted movement control therapy, and electromyography feedback, physical therapy is a rapidly expanding science that offers dynamic, movement based treatment for this common condition. Interventional pain therapy is much more than “epidurals." Over the past 20 years, chronic pain physicians have developed multiple minimally invasive, evidence based, opioid sparing interventions including ablative, neuromodulative, and restorative therapies. During this debate, a physical therapist and an interventional pain therapist will discuss their approach to the patient with low back pain. They will also debate the evidence behind both philosophies, provide a cost-benefit analysis, and determine if they can co-exist in the world of low back pain.