Pain disability in the course of degenerative spine disease produces the pathological deterioration of quality of life and ability to work. Pain is usually associated with changes of the spinal motion segment and part of the neuro-vascular system located in the vertebral canals. The types of pain are different because of different mechanisms of its origin. It should be included in the therapeutic procedure if the standard analgesic treatment is insufficient. The authors distinguish 3 essential clinically selected types of pain: • musculoskeletal (nonspecific, mechanical, pseudoradicular) referable to the intervertebral disc, facet joints: traumatic and inflammatory origin, • radicular neuralgia caused by compression and inflammation, including also neuropathic pain. • neurogenic intermittent claudication type of pain related to acquired spinal canal stenosis: generated by compression and radicular ischaemia. We describe therapeutic approaches in different spine pains according to the pathomechanism of their origin.