The association between radiographically detectable degenerative changes in the lumbar spine and back symptoms was studied, along with the possible effect of occupational work load. The subjects were 216 concrete reinforcement workers and 201 house painters. A questionnaire provided information on work history and earlier back accidents, and a standardized interview produced data on back symptoms. The occurrence of disc space narrowing, anterior and posterior spondylophytes, and end-plate sclerosis was recorded separately for each intervertebral space from lateral lumbar radiographs. Moderate to severe degenerative changes were associated with increased risk of sciatic pain but not with the occurrence of lumbago or nonspecific back pain. The different types of degenerative changes provided no further information. In a multivariate logistic regression analysis degenerative changes and earlier back accidents were significant independent predictors of sciatic pain. When these two variates were allowed for, the effect of occupation was not significant.