Disc lesions are not the sole cause of sciatica and low back pain, but they are the most frequent. Surveys indicate that up to 80% of the American population have suffered at least a temporary disability from low back pain. Perhaps increasing physical activity and increasing life span have made the lumbar spine more vulnerable to decompensation to low back function.

Clinical studies have shown that the onset of the first occurrence of low back pain peaks at the age of 20 to 29 years, when approximately 40% of all disks show degeneration. In contrast to low back pain, the lifetime prevalence of sciatica has been reported to be up to 40% of the population. After two months, more than 50% of the patients with acute sciatica will significantly improve with conservative care alone. There are many factors that can contribute to low back pain. Any anatomical element of the spine could be the source of pain. Excessive strain to the ligaments and muscles that surround the spine can be the source of myofascial pain. Spine abnormalities can account for many causes of low back pain.

The clinical history and physical exam are essential to the correct diagnosis and proper treatment of lumbar disc disease. The evaluation may include other diagnostic testing including xrays, MRI, and or CT scanning, possibly myelography, discography or EMG/NCV. Determining a treatment strategy depends mainly on identifying the location and cause of the pain.