Diagnostic labels are important in the management of patients. Patients expect a name for their condition. A label shows that the doctor knows what is wrong. But such labels should not be incorrect or specious, lest they lead to therapeutic misadventure. Zygapophysial joint pain and discogenic pain can not be diagnosed clinically 3,4 and are, at best, suppositions.
Some labels are simply wrong and can have deleterious effects.
Moreover, disc degeneration, spondylosis and spinal ostoearthrosis correlate poorly with pain and may be totally asymptomatic. They are age changes and do not constitute diagnoses. They can not be proven clinically and therefore may or may not be correct inferences. Nevertheless, these labels convey the notion that the pain and its cause are not serious. Because it is not possible to render a pathoanatomical diagnosis of back pain, it becomes imperative to distinguish serious from non-serious conditions.