The current tools available to physicians for the treatment of back pain are relatively limited, palliative in nature, and often lead to deleterious side effects. As a result, much research is occurring in the biomaterials realm to create new treatments that not only relieve pain, but restore function to the spine and circumvent the unwanted side effects. Both traditional metal/polyethylene hardware approaches, often associated with joint replacements, and more novel regenerative medicine approaches are being investigated. It is currently unclear which procedures and materials will be best suited for the treatment of back pain, but a wide range of materials are being investigated. This chapter reviews the current state of biomaterial-based treatment of intervertebral disc-originated back pain. Topics cover established treatments such as spinal fusion and total disc replacement, as well as novel regenerative treatments such as nucleus pulposus replacement, annulus fibrosus repair, and tissue-engineered total disc replacement.