Emphasise early activity and support it with services geared to active management

Back pain is a source of misery to its sufferers, to doctors (who remember the intractable cases), and to the Treasury, which foots a steadily increasing bill for sickness and invalidity benefits. In 1992, at the request of the Department of Health, the Clinical Standards Advisory Group set up a committee on back pain to see whether better management was possible. Its recommendations have now been published, together with the government's response.1

No evidence exists to show that the prevalence of back pain has risen in recent years, yet in the United Kingdom, as well as in other countries with well developed social security systems, the number of people receiving disability payments has risen steadily. A 10% rise is forecast yearly if nothing is done. The report therefore recommends that the Department of Health should discuss the impact of benefit regulations on health care and chronic incapacity with the Department of Social Security. So far European back rehabilitation programmes have …