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Because patient satisfaction with medical care for back pain is an important outcome and may correlate with compliance or other outcomes, the authors devised a brief (9- item) satisfaction scale and demonstrated its reliability and validity. The most frequently cited source of dissatisfaction among 140 patients with mechanical low-back pain (LBP) was failure to receive an adequate explanation of the problem. Compared with patients who reported an adequate explanation, those who did not wanted more diagnostic tests, were less satisfied with their visit, and were less likely to want the same doctor again. Receiving an adequate explanation was not associated with more tests or physician time. Thus, explanation of symptoms has a high priority among patients with LBP, and this need should be explicitly acknowledged and addressed by their physicians.