The article considers a question of the differential diagnosis and treatment of back pain. The authors recommend the use of generally accepted term «spinal osteoarthritis» to describe changes in the spine, which in the Russian medical literature referred to as «osteochondrosis». The article describes the diagnosis and treatment of myogenic pain, pain due to facet syndrome, herniated disc, cervical and lumbar radiculopathy, spinal stenosis, interspinous bursitis. The authors recommend the use of dexketoprofen (flamadex) and adjuvants (baclofen, flupirtine) for the nociceptive back pain treatment.