In the lumbar spine most problems originate from either the zygaphyseal (facet) joints or an intervertebral disc. In this context, the disc can be a source of pain when it is internally disrupted, and is no longer able to tolerate the stress applied to it by normal activities of daily living. Pain from the disc is perceived in the back but can also be referred as a deep aching pain into the pelvic girdle, buttocks and thighs. Discogenic pain should not be confused with disc herniation. Herniation irritates nerve roots and causes sharp pain shooting into the lower limb.

Back pain has commonly been ascribed to spondylosis (disc degeneration or osteoarthritis), but this condition is a normal aging change and the correlation with pain is poor.

Spinal canal stenosis can be a complication of spondylosis in the elderly but it does not cause back pain. The hallmark of spinal stenosis is claudication-like pain and loss of neurological function in the lower limbs, brought on by walking but promptly relieved by resting.