The pathological mechanism of pain in vertebral column diseases is discussed in accordance with the theory of Melzack and Wall taking into account both systems of pain sensation control at the spinal level and reticular formation level. The action of pain mediators is discussed as well. The main pathogenetic factors are: compression, stretching and ischaemia. Other factors, functioning particularly at the cervical spine level are, most frequently, developmental anomalies in the occipito-cervical area and faulty posture assumed during occupational work, as well as injuries which may be remote in time and forgotten. Elimination of pain perception may be obtained with surgical methods or by physicochemical means blocking the conduction of pain impulses.