The study presents data of hospital examination and treatment of 405 patients suffering from acute low back pain; in 247 of them have been revealed changes in bone mineral density of the vertebrae the type of osteopenia and osteoporosis. The majority of patients had bulging disk detected during MRI and CT examinations. 340 people have been managed to eliminate pain using conservative orthopedic treatment. Due to the inefficiency of the conservative-orthopedic treatment in 65 patients performed the surgery operations. It was noted the situations requiring different solutions:

- Mono-lateral pain with a large protrusion of one disk and minor protrusions of adjacent disks:

- Bilateral pain caused by large protrusions of 2 adjacent disks and instability or major segments of the protrusion of the 1st disk and moderate protrusion of adjacent disk involved in the creation of the clinical picture of bilateral pain.

In each of these situations, was performed intervention to ensure the ventral and dorsal decompression of spinal canal elements and the elimination of spinal instability.

Back pain is a multi-factorial phenomenon, and therefore the detection at MRI, CT studies of disk prolapse should not serve as a basis for making a hasty decision for surgical treatment. In most cases, conservative orthopedic treatment has a positive effect. In this case, the basis of the treatment should be made using of orthopedic aids in case of the prolonged immobilization and unloading of the spine, as well as measures to normalize bone mineral density. Surgical treatment should be undertaken only after failure of orthopedic treatment, followed by a continuation of conservative measures to normalize the mineral density of bone structures.

Keywords: multi-etiological lumbar pain, abnormalities of the lumbosacral area, osteopenia, osteoporosis, orthopedic treatment, surgical treatment