This paper considers occupational back injuries as they are described by injured workers, including the impact on their abilities to function in family and social roles. In this study, we interviewed people with work-related back injuries in Florida and Wisconsin. The sample was chosen from among workers who either lost more than 28 days from work or who received workers' compensation permanent partial disability benefits. Respondents indicated a wide range of limitations on family and social roles, including physical impacts that hampered respondents' ability to do household chores, to take part in raising children, and to engage in leisure activities with their spouses. Spouses and children took over family responsibilities once carried on by injured workers. The impacts of limitations resulted in a restructuring of family and social roles, relationships, and self-identities. In addition, these impacts led to depression and anger among the injured workers and to stress and strain in family relationships. Unlike the effects on work, many of these outcomes are not valued in the marketplace and, as a consequence, are less visible. They are nonetheless important and suggest that priorities based only on economic outcomes may understate the importance of preventive activities. Moreover, they suggest that attention should be focused on social structural factors such as the provision of medical services and social support to reduce the impact of chronic back pain on family members.