BACKGROUND INFORMATION Lumbar disc degeneration has been proposed as a possible risk factor for low back pain studies contributing to this estimate are of low methodological quality. Lumbar disc degeneration (LDD) is characterized by the presence of endplate sclerosis, osteophytes and disc space narrowing. The relative importance of each of these individual radiological features (IRF) has not yet been established, nor studied in a prospective way in the same patient sample. As such, we are currently not sure how to combine these IRFs to arrive at a meaningful definition of LDD, particularly one that can relate to the clinical presence of low back pain. There is also uncertainty about whether the lumbosacral disc should be included in such evaluations. Clarifying these queries was the goal of this study – which explored the association of the IRFs with self-reported LBP. CONCLUSIONS AND PRACTICAL APPLICATIONS This study was one of the first to report different definitions of LDD (i.e. single versus multi-level disc narrowing, ± the L5/S1 level) and how they relate to LBP in a large sample. The literature, to date, on the association of osteophytes and LBP is inconclusive – not to mention whether treatment can reverse such changes (take note those of you who use such findings to convince patients to commit to excessive treatment plans!). This study adds to previous literature by suggesting that disc narrowing, particularly at multiple levels, may be a more important finding and that the presence of osteophytes alone does not seem clinically relevant for LBP. It is worth noting here that this study could not establish whether the presence of LDD could predict LBP over time. The authors suggest that reduced disc space may be more likely to increase forces on facets and intervertebral ligaments, thus causing more pain. Further research is required to evaluate this hypothesis. The authors also propose that removing the L5/S1 disc from analysis may strengthen the associations in this study because the narrowing of this level is often overstated (this disc is normally narrower than L4-L5). Further, the literature suggests that this disc exhibits the most variability in relative size compared to other lumbar levels, regardless of disease status (2). Overall, clinicians can derive the following general take-home points from this study:disc space narrowing appeared to be moderately associated with LBP compared to osteophytes, particularly in men .... disc space narrowing at two or more levels appeared to be more strongly associated with LBP than single level narrowing the strength of associations increased in those with chronic LBP the majority of associations are strengthened by removing the L5/S1 disc from the analysis To see this review, in full – including Study Methods, Results, Study Strengths/Weaknesses, and references, please visit “Current Issue” at www.canadianchiropractor.ca.