This was a stratified, random telephone survey of adults in North Carolina. To determine the prevalence of chronic low back pain and the extent to which treatment is sought for this condition. Chronic low back pain is a major problem. Previous studies often have combined acute and chronic back pain. Telephone interviews regarding back pain were conducted with 4437 North Carolina adults during 1992. Chronic back pain affects 3.9% of the North Carolina population. Thirty-four percent considered themselves permanently disabled and 52% assessed their overall health as fair or poor. The median number of bed-disability days per year was three. Seventy-three percent saw a health care provider. Of those who sought care, 91% saw a medical doctor, 29% saw a physical therapist, and 25% saw a chiropractor. Use of technology was extensive: 37% received a computed tomography scan, 25% received a magnetic resonance imaging scan, and 10.4% underwent surgery. Chronic back pain is common, and the level of care-seeking and costs of care among those afflicted are extremely high.