INFLAMMATION PROTOCOLS. METHODS IN MOLECULAR BIOLOGY, VOLUME 225. Edited by P. G. Winyard and D. A. Willoughby. $99.50. Humana Press, Totowa, NJ, 2003. 380 pages. ISBN 0-86903-970-6.

Abstract

Chronic musculoskeletal pain is a major health problem affecting a quarter of the population [1], accounting for around a quarter of GP consultations [2]. It has large direct and indirect health care costs, with most available financial data focusing on back pain. In 1998 physical treatments for back pain cost the UK almost £500 million [physiotherapy £251 million (£151 million NHS), osteopathy £173 million and chiropractic £69 million] [3].A range of practitioners, often conceptualized as offering only single therapeutic approaches in either NHS or private primary care, manage the majority of those seeking care for musculoskeletal problems. These include drug therapists (general practitioners and community pharmacists), physical therapists (chiropractors, osteopaths and physiotherapists), behavioural therapists (counsellors, psychologists and psychotherapists) and complementary medicine practitioners (for example, acupuncturists and aromatherapists). Few, if any, of these treatments have robust evidence of lasting efficacy or effectiveness. For most interventions the most we are offering is some alleviation of symptoms, rather than resolution. As there is no evidence to suggest that the problem of chronic musculoskeletal pain is reducing, then current, mainly biomedical approaches are clearly inadequate.