Background: Low back pain (LBP) is a leading cause of disability worldwide and is particularly prevalent among agricultural workers due to repetitive physical strain and prolonged manual labor. In rural and tribal communities, pain perception and coping behaviors are often influenced by cultural, religious, and socioeconomic factors.

Objective: To assess pain perception, coping strategies, and psychosocial dimensions related to low back pain among agricultural farmers in Mizoram.

Methods: A community-based cross-sectional study was conducted among 1,012 agricultural farmers aged 40–55 years using convenience sampling. After obtaining informed consent and permission from local leaders, participants completed a structured questionnaire that included both closed- and open-ended items. Quantitative data were analyzed using SPSS version 22. Open-ended responses were analyzed using descriptive thematic coding to identify recurring coping patterns and perceptions.

Result: The prevalence of self-reported LBP was 68.4% (n = 692). Self-medication was the most common coping strategy (43.9%), primarily due to affordability and easy accessibility of over-the-counter analgesics. Approximately 30.2% coped by enduring pain and resting without seeking formal treatment, while 15.3% sought care from local healers. Only 11.9% consulted medically trained professionals. Nearly half (49.3%) reported work-related stress, although job satisfaction was high (88.5%). Pain frequently interfered with work ability in 55.5% of participants.

Conclusion: Low back pain is highly prevalent among agricultural farmers in Mizoram and significantly impacts work capacity. Coping strategies are largely informal and culturally influenced, with limited use of formal healthcare services. Culturally sensitive, community-based interventions are needed to promote appropriate pain management and improve musculoskeletal health in rural farming populations