In view of the increased numbers of vertebrogenic complaints in society today, the authors investigated the clinical and morphological relations involved in these conditions. Histological techniques and the scanning electron microscope were used to examine the different structures of the spine under conditions of tensile overload. Chief attention was paid to the structures most exposed to mechanical stress, such as the interface between the vertebral body and the intervertebral disc. The authors found that the insertion of collagen fibres in cartilage or bone in the regions overloaded by tensile forces is identical to that found in epicondylitis in other locations. Such enthesopathies in the spinal region may form a major component of back pain states, and special therapy should be employed for them.