Back pain is common (80-90% population), conservative treatment is usually successful. Lumbar disc herniation and sciatica are fairly common but are far less frequent than is idiopathic low back pain. Sciatica is usually due to lumbar disc herniation; the outcome is usually favorable. Surgery for lumbar disc herniation and sciatica is indicated if acute bladder and bowel impairment is present (cauda equine syndrome) or if sciatic pain is incapacitating and persistent for more than 6 to 12 weeks. Confirmation of the clinical level of disc herniation must be made by imaging (CT or MRI). With proper patient selection, surgery for lumbar disc herniation and sciatica can be expected to lead to excellent results in the majority of patients.