The state-of-the-art in the diagnosis and therapy of low back pain is presented from a biopsychosocial point of view. Among low back pain patients, those dominate in whom psychosocial factors play an eminent role. The early comprehensive (biopsychosocial) integrative diagnosis is essential for further development of the illness. Conversion pain, psychoprosthetic pain and pain-proneness are the most important concepts for establishing a round diagnostic assessment and realistic therapeutic measures.