To describe his frustration with treating pain, Sir William Osler once famously quipped, “When I see a patient with arthritis coming in the front door, I leave by the back door.”1 More than 100 years later, chronic musculoskeletal pain remains an equally frustrating and challenging condition for practitioners to diagnose and treat. This is in part because of the widespread prevalence of pain in the general population and relative difficulty in treating pain to the satisfaction of many patients. A recent study found an overall pain prevalence of 46% in southern Sweden, with the prevalence increasing with age into the eighth decade of life, at which time 55% of respondents reported experiencing chronic pain.2 Furthermore, 46% of those who reported chronic pain had not received a formal diagnosis or known the reason for their pain.2
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