Disk-related complaints, particularly low back pain, are very common. Almost all of us will suffer at some time during our life from symptoms related to degenerative changes of the intervertebral disks: the pathoanatomical studies of Schmorl (1932), Schmorl and Junghanns (1936), Coventry (1945), Hirsch (1960), and, in our institution, Tiedjen and Müller (2001) have shown that all humans over the age of 30 have degenerative changes in their intervertebral disks. The frequency of spondylosis and osteochondrosis, which represent the final stage of degenerative disk disease, rises steadily with age and approaches 100% by age 80 or 90.

Pathoanatomically identified degenerative changes and radiological signs of disk degeneration are not necessarily accompanied by symptoms. Many individuals with documented degenerative changes are asymptomatic, or else their symptoms are not severe enough to require medical help. These “patients” with degenerative disk disease remain undetected by insurance statistics.

There is no evidence that the prevalence of back pain has increased over the past 50 years; what has changed is the way that individuals, the medical community and society respond to back pain (Schöne 2004).

The point prevalence of back pain is 35%; i.e., 35% of individuals will state that they are experiencing back pain on the day they are questioned, and its annual prevalence is 70% (Raspe and Kohlmann 1993, TNS-Emnid 2004, Kohlmann and Schmidt 2005, Schmidt et al. 2007). Back pain is thus at or near the top of the list in all statistical studies of human ailments ranked by frequency. The first serious illness requiring medical help in adulthood is usually a musculoskeletal illness, most often involving the spine (Ludwig et al. 1999).

Many international surveys of low back pain report a point prevalence of 15–30%, a 1-month prevalence between 19% and 43%, and a lifetime prevalence of about 60–80%. The exact figures in different studies appear to depend mainly on the wording of the question rather than any difference in the individuals studied (Nachemson 2004).