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The aim of the study was to determine the effectiveness of an extension-oriented exercise program in the prevention and management of low back/neck pain in nursery school teachers. A Cluster Randomized Controlled Trial was utilized. Seventy-one nursery school teachers working in nine school buildings were randomly divided into two groups, with each school as a unit of randomization. All the teachers in both groups received an ergonomic brochure; teachers in the experimental group also received an extension-oriented exercise program, conducted by a physical therapist. Data were collected at baseline and at a two-month follow-up. The primary outcome measure recorded was the level of disability (Roland Morris Disability Questionnaire and Oswestry Disability Index), while secondary outcome measure included the evaluation of cervical and lumbar physical discomfort (Visual Analogue Scale). At follow-up, a significant improvement was registered in the experimental group as compared to the control group for all the outcomes evaluated. In conclusion an extension-oriented exercise program may be a useful strategy to prevent low back and neck complaints and to reduce consequent LBP functional disability among nursery school teachers.