OBJECTIVE: There is a lack of updated information on healthcare expenditures and expenditure patterns for individuals with back pain in the US. The objective of this study is to use a recently released national survey database to estimate total healthcare expenditures incurred by individuals with back pain in the US, calculate the incremental expenditures attributable to back pain among these individuals, and describe healthcare expenditure patterns of individuals with back pain. METHODS: This study used data from 1998 Medical Expenditure Panel Survey (MEPS), a national survey on healthcare utilization and expenditures. Total healthcare expenditures and per-capita expenditures among individuals with back pain were calculated. Multivariate regression models were used to estimate the incremental expenditures attributable to back pain. The expenditure patterns were examined by stratifying individuals with back pain by socio-demographic characteristics and medical diagnosis, and calculating per-capita expenditures for each stratified category. RESULTS: In 1998, total healthcare expenditures incurred by individuals with back pain in the US reached $90.7 billion and total incremental expenditures attributable to back pain among these persons were approximately $26.3 billion. On average, individuals with back pain incurred expenditures about 60% higher than individuals without back pain ($3495 vs. 2178). Among back pain individuals, at least 75% of service expenditures were attributed to those with top 25% expenditure and per-capita expenditures were generally higher for those who were older, female, whites, medically insured or suffered from disc disorders. CONCLUSIONS: Healthcare expenditures for back pain in the US in 1998 were substantial. The expenditures demonstrated wide variations among individuals with different clinical, demographic and socioeconomic characteristics.