No data are available on the incidence of pelvic pain and organic dysfunction (PPOD) in patients suffering from low back pain. PPOD is not an uncommon finding in the low back pain patient. Women appear to be more frequently involved than men. The results of recent electrophysiologic investigations indicate that many patients with urological, bowel or anorectal dysfunction demonstrate evidence of denervation neuropathy in muscles innervated by the branches of the pudendal nerve. Six patients with low back pain meeting predetermined criteria, indicating the presence of PPOD as a result of suspected lower sacral nerve root compression (LSNRC) secondary to a mechanical disorder of the low back were treated with chiropractic distractive decompressive manipulation of the lumbar spine. Symptoms of PPOD, and indicators of LSNRC were assessed prior to the onset, and following the termination of treatment. It appears that selected indicators of LSNRC represent the most sensitive clinical signs of identifying the presence of PPOD which may respond to manipulative treatment, and may also provide the most sensitive measure of overall PPOD response. These findings, although preliminary suggest a possible etiology of PPOD in the low back pain patient with evidence of LSNRC. Further work in this area is encouraged.