Back pain medicine and management has been rapidly evolving throughout the past decade. Recent literature has revolutionized managing patients with pain varying from new therapeutic modalities technology and medicine. Currently most of the resources that educate physicians and students regarding the proper care that is essential in regards to managing acute and chronic back pain is out of date. The current text is an up to date guideline of the anatomy physiology pathology and proper management of back pain based on the most recent available literature and research.