Spinal disorders and the pain associated with them account for a significant portion of disability at work, with most complaints occurring in the lumbar region. It is a lifestyle problem, unless precipitated by trauma. The most common sites for a herniated lumbar disc are L4-5 and L5-S1. The pain is exacerbated by sitting and bending unlike that of lumbar muscular strain which is aggravated by standing and twisting movements. The majority of patients gain symptom relief within four weeks with conservative management. Only about 10% require surgery. Converse is true in the less common childhood disc prolapse. Microdiscetomy is the standard surgical procedure. Newer minimally invasive procedures await evaluation. In addition to mechanical nerve compression, chemical factors, such as TNF may be involved in pain generation; that explain the persisting pain after decompression. Individualized program of back care exercises should follow after the management of acute pain, whatever modality is chosen. A slipped epiphysis, spondylolisthesis and discitis must be ruled out in children; in children, removal of the disc alone will not relieve the symptoms. Associated herniated bony fragment is looked for and removed. Failed back syndrome may be due to unwarranted surgery or improper choice of surgery; discectomy alone, while not addressing the underlying presence of instability or stenosis can lead to disappointing results. Epidural fibrosis alone, despite the patient’s complaints, is never an indication for resurgery.