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Chris J Main
| The first 150 words of the full text of this article appear below. |
Musculoskeletal symptoms of various types (neck pain, limb
pain, low back pain, joint pain, chronic widespread pain) are a major
reason for consultation in primary care. This article uses the example
of low back pain because it is particularly common and there is a
substantial evidence base for its management. The principles of
management outlined are also applicable to non-specific musculoskeletal
symptoms in general.
The increasing prevalence of musculoskeletal pain, including
back pain, has been described as an epidemic. Pain complaints are
usually self limiting, but if they become chronic the consequences are
serious. These include the distress of patients and their families and
consequences for employers in terms of sickness absence and for society
as a whole in terms of welfare benefits and lost productivity. Many
causes for musculoskeletal pain have been identified. Psychological and
social factors have been shown to play a major role in exacerbating the
biological
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