The paper reviews low back pain (LBP) studies with economic implications in order to determine whether the societal cost attributed to lower back pain (LBP) have changed since 2001, a time during which LBP treatment guidelines were updated. A Medline search of publications 2001 and 2007 using broadly defined keywords produced 338 abstracts that were screened, of which 68 potentially relevant articles were retrieved and reviewed. Cost estimates for the management of LBP were high, consistent with the results of review of LBP economic studies published prior to 2001. Pharmacotherapy plays an important role in LBP treatment, although drug cost data in LBP is limited. Newer, more costly agents such cyclooxengenase-2 selective nonsterioidal anti-inflammatory agents will increase drug costs as a portion of total costs, particularly if not used in accordance with treatment guidelines.