Primary, secondary and tertiary prevention are usually differentiated. All preventive measures have to prevail against criteria of effectiveness and efficiency. In the case of primary prevention, the search for risk factors is particularly important. The present limits of prevention of back pain are discussed in some detail; these exist mainly because at present our knowledge is incomplete. In the long run, prevention in the absence of a solid scientific basis is counter-productive. The only successful way of identifying effective preventive measures for back pain is to intensify research.