The emotional status and marital adjustment of spouses of chronic low back pain patients were investigated. One hundred and seventeen spouses and patients were administered the MMPI, the Locke-Wallace Marital Adjustment Scale, and the Areas of Change Questionnaire as part of a comprehensive psychosocial assessment in a chronic pain treatment program. Twenty percent of the spouses reported clinically significant depressive symptoms and over 35% rated their marriages as maladjusted. Spouses' emotional distress was related to patients' emotional distress, and spouses' marital adjustment was significantly related to patients' level of functional impairment, specifically social interaction deficits. These results call for routine evaluation of spouses of patients with chronic low back pain and inclusion of families in the treatment of this chronic illness.