This requires a consistent (primary) diagnosis with pain analysis under the premise that LBP is always specific if it is structurally and functionally conditioned. A broad bio-psycho-social anamnesis and structure-based clinical diagnosis (imaging) with functional differentiation according to MM principles and, if necessary, interventional blocks, should result in the expression of a three-level diagnosis as a prerequisite for a mechanism-based, hierarchic step therapy in LBP. In this article, this is presented in a pragmatic, case-oriented manner, with the implementation of techniques and evidence of TLI and MM.