To outline the usefulness of the medical history and physical examination in the diagnosis of herniated lumbar discs, and to review the essential properties of a test, including sensitivity, specificity, and clinical value. None of the tests that are part of a history and physical examination of a patient with a disc herniation has a high diagnostic accuracy by itself. This is because positive and negative predictive values of common clinical indicators are limited. Confirmatory tests are necessary for a definitive diagnosis when making management decisions. Combining the results of history and physical findings will increase the predictive value of these basic diagnostic tools.