SUMMARYA hospital‐based cross‐sectional study examined 657 consecutive referrals with low back pain over two years to a district rheumatology service serving a population of about 250,000 people. Five hundred and thirty‐eight had mechanical/degenerative low back pain. The mean age was 48.6 (range 18–80 SD 15.3) years; 64% were women. Patients with radiating pain or neurological deficit (Quebec Task Force classification) were significantly more disabled (Roland disability score p<0.001) and depressed (Modified Zung score p<0.05) than those without radiating pain. Women were more impaired (p=0.02) than men but had similar disabilities (mean Roland score 11.7, range 0–24 SD 6.5). Fifty‐three per cent of patients were receiving benefits and were significantly more likely to have musculoskeletal comorbidities than those in work (p<0.025). It is concluded that the Quebec Task Force classification of low back pain impairment is a helpful descriptor and related to both physical and psychological disability and handicap in employment.