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This paper aims to describe the rehabilitation of a patient with severe knee pain and chronic low back dysfunction. The patient was referred to physiotherapy by her general practitioner with a diagnosis of knee sprain. Clinical examination by analysis of passive and active movements elicited pain in the knee, and pain referred to the knee from the hip and lumbar spine. Treatment consisted of joint mobilization and specific stabilizing exercises prescribed based on comprehensive clinical reasoning processes. In the first 6 visits the knee was treated, decreasing the level of perceived pain from 7 to 4 on a 10 cm visual analogue scale. In the last six visits the lumbar spine dysfunction was addressed, leading to complete relief from symptoms, a situation that was maintained at 12 month follow-up. This case report emphasizes the importance of examining both signs and symptoms of the spine in patients presenting with peripheral joint dysfunctions. [ABSTRACT FROM AUTHOR]