Book excerpt: Current statistics indicate that 75-80% of people worldwide will experience some form of back pain during their lifetime. Lumbar pain is a leading cause of disability - a global public health burden with serious economic implications. Written by internationally renowned spine experts, the 8th volume in the AOSpine Masters series is a concise, state-of-the-art overview on fundamental management strategies and current issues and challenges. The text covers the full age spectrum - from childhood to older adulthood - and contributing factors such as the sacroiliac joints, genetics, and spine infections. Clinical evaluation, treatment options, recent research advances, and future perspectives are systematically examined and presented in a clear format. With commentary from leading authorities, this compendium presents candid discussion of significant challenges faced by clinicians who treat back pain. Among the issues addressed are managing patients who have undergone multiple operations, chronic back pain, failed spine surgery, and what to do when all nonsurgical and surgical options have been exhausted. Key Highlights Economic considerations, risk factors, and legal aspects Neurological causes, including myopathies, neuromuscular disease, Parkinson disease,and dystonia Conservative treatment options such as drugs, physiotherapy, and complementary medicine The role of minimally invasive surgery in treating degenerative lumbar spine disease Must-read bibliographic references in every chapter Bullet lists of pearls and pitfalls summarize critical points and key concepts The AOSpine Masters series, a co-publication of Thieme and the AOSpine Foundation, addresses current clinical issues featuring international masters sharing their expertise in the core areas in the field. The goal of the series is to contribute to an evolving, dynamic model of evidence-based approach to spine care.