This survey was performed in December 1991 on 555 nursing aides (NAs) in 32 Special Nursing Homes for the Elderly (SNHs) in Kochi Prefecture, Japan. The purpose of the survey was to establish the relationship between low back pain among NAs in SNHs, and the degree of dependency in the activities of daily living (ADL) of the patients under their care. In order to investigate the work-related factors of low back pain, a questionnaire was sent to the NAs, requesting information on the NAs' low back pain condition. Another questionnaire was sent to the 32 SNHs, concerning the status of patients in the respective SNHs. Of the 463 NAs questionnaires which were returned, 443 female NAs' responses were analyzed. The following findings were observed. The prevalence of low back pain among the NAs was high (the one month prevalence was 77.0%), and of the afflicted NAs, 98 (24.5%) were visiting a health care provider. The NAs with low back pain experienced difficulty in completing their care-giving tasks, and complained about their working conditions and working environment more often than the NAs without low back pain. In addition, this study showed that, at SNHs where the proportions of dependence in patients' ADL were high, the prevalence of low back pain among their NAs was high. This fact was also confirmed by multiple logistic regression. We, therefore, suggest in this study that patients' care needs are associated with low back pain among NAs.