Neck and back pain are common symptoms which vary from the trivial to the incapacitating. Conventional medical textbooks concentrate disproportion­ ately on those causes which have clear-cut diagnostic patterns and pathological features demonstrable by investigations. Discussions of treatment often overemphasize the importance of the tiny minority of patients who proceed to surgery. Real life is very different. The majority of patients who consult their general practitioners do not suffer from readily categorized diseases, have no diagnostic investigational signs, and often respond to treatment in no other way than that expected from the passage of time. It is not surprising that such a situation has led to