With 12-month prevalence rates of more than 70%, back pain is currently one of the major health problems for German adults and entails major economic consequences. The aim of this study was to estimate back pain-related costs from a societal perspective and to determine the impact of sociodemographic variables on costs. Based on back pain-related survey data of a large German adult sample (9267 respondents, response rate 60%), costs were assessed using a prevalence-based bottom-up approach. Direct costs caused by utilisation of healthcare services, as well as indirect costs due to back pain-related production losses were considered. All prices are expressed in 2005 Euros. Average total back pain costs per patient were estimated to be 1,322 euro (95% CI [1173-1487]) per year. These costs are split between direct (46%) and indirect (54%) costs. Bivariate analysis showed considerable differences in total costs between the Von Korff back pain grades (GCPS Group I: Mean 414.4, 95% CI [333.2-506.3]; II: 783.6 [574.5-1044.4]; III: 3017.2 [2392.9-3708.6]; IV: 7115.7 [5418.5-9006.5]). Male gender, increasing age, single status, low education, unemployment, and increasing back pain grade had a significant positive impact on the cost magnitude in multivariate analysis. Despite several limitations, this study provides important information concerning the relevance of back pain as a health problem and its socioeconomic consequences. The information may be of value for decision-making and allocation of research fund resources.