Back pain is an important health and social problem. Over the last 30 years the amount of time lost from work because of spinal problems has increased across all developed countries. In the United Kingdom, there was a 266% increase in the days of Invalidity Benefit paid for spinal disorders in the 10 years to 1994.¹ Since then, Incapacity Benefit has replaced Invalidity Benefit, and the number of days of benefit paid for spinal disorders (for periods of greater than six months) has stabilised at around 90 million a year (DSS figures). Notwithstanding this increase in benefit payments, the prevalence of back pain in the general population appears unchanged.¹ This suggests that there may be an epidemic of back pain disability rather than an epidemic of back pain itself. About one in six of the population report having back pain on any one day, one in three sometime in the last month, and 6% will have had …