Chronic low back pain affects 23% of the population worldwide. At the same time, the cost of curating such patients, taking into account the loss in salary and other indirect costs, in the United States alone is estimated at more than $100 billion a year. The analysis of actual literature data on the given problem is carried out. On their basis, the most important diagnostic criteria for pain syndrome at the level of the lumbar spine were identified, and their significance in the choice of treatment method was determined. The practical importance of pain classification is clearly shown, as well as the definition of specific «red flags» that allow one to suspect the presence of severe pathology and establish indications for immediate diagnostic imaging before starting empirical therapy. It follows that, in the absence of red flags, imaging studies are not recommended in patients with low back pain of less than 6 weeks’ duration. It is appropriate to start empirical therapy, the effectiveness of which in most cases is confirmed by a favorable prognosis, regardless of the type of pain. A step-by-step analysis of treatment is given, including both general recommendations and drug therapy.