Socioeconomic factors are important risk factors for lumbar pain and disability. The total costs of low-back pain in the United States exceed $100 billion per year. Two-thirds of these costs are indirect, due to lost wages and reduced productivity. Each year, the fewer than 5% of the patients who have an episode of low-back pain account for 75% of the total costs. Because indirect costs rely heavily on changes in work status, total costs are difficult to calculate for many women and students as well as elderly and disabled patients. These methodologic challenges notwithstanding, the toll of lumbar disc disorders is enormous, underscoring the critical importance of identifying strategies to prevent these disorders and their consequences.