Musculoskeletal diseases are extremely common and have important consequences for the
individual and for society. The World Health Organization (WHO) declared musculoskeletal
diseases to be a problem in both the developed and developing world. WHO has, together with
the United Nations and European governments declared 2000-10 the “bone and joint decade”,
with the aim of improving the health related quality of life of people with musculoskeletal
conditions by means of research and by raising awareness of this growing problem.
A British study showed that a quarter of the listed population of a general practice consults at
least once a year for a musculoskeletal problem. The British healthcare system is comparable
to the system in the Netherlands. A Dutch study, the second Dutch national survey of general
practice (DNSGP-2) performed by NIVEL in 2001, on which some of the articles of this thesis are
based, showed that in adults a musculoskeletal problem is the most common reason to consult
the general practitioner and that in children it is the third most common reason to consult the
general practitioner.
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