The burden is huge and not reflected in national health priorities

Musculoskeletal conditions have an enormous and growing impact world wide. “Health 21,” the health for all policy framework for the World Health Organization's European region,1 identifies musculoskeletal conditions as a target, yet national health care priorities in the United Kingdom and most European countries do not include them. To address this imbalance the United Nation, the WHO, governments, and professional and patients' organisations have declared 2000-10 the “bone and joint decade” with the aim of improving the health related quality of life of people with musculoskeletal conditions.

Although one of the aims of the decade is to increase the recognition and understanding of the burden posed by musculoskeletal conditions, there are already enough data to show the size of the problem. Musculoskeletal impairments ranked number one in chronic impairments in the United States,2 and chronic musculoskeletal pain is reported in surveys by 1 in 4 people in both less and more developed countries.3 Musculoskeletal conditions were the most expensive disease category in a Swedish cost of …