Ask any assembled group of medical practitioners to pick one word to characterize the natural history of back pain and the chances are that the word they come up with will be “recurrent”. A typical family practitioner could see around 20 patients suffering from back pain each week. Of these, 17 could be suffering from a condition which is work-related (see p. 69). But in how many of these cases will the patient’s working activities ever be analysed in sufficient detail to identify those features of his working life which are placing him at risk? Instead he may well be told that his problems are due to the fact that he “has a long back” or that “back pain is the price that human beings have to pay for standing upright”. (Any vet will tell you that quadrupeds have back problems too.)
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