ABSTRACT
Musculoskeletal pain is a major health problem [9] and the most common types of musculoskeletal pain that impact signi cantly on functional disability are spinal pain and knee pain [10,11]. Knee pain in older adults is a common disabling problem, managed in the United Kingdom mostly in primary care [12]. Osteoarthritis is the most likely underlying diagnosis and has been shown by radiography to be present in 70% of community dwelling adults aged 50 or more with knee pain [13]. Structural changes before radiography are common in the remainder [14]. In older people, the risk of disability from knee osteoarthritis is as great as the risk of disability from cardiac disease and greater than that due to any other single medical disorder [15]. The aging population and the increase in prevalence of key risk factors for knee osteoarthritis (such as obesity) means that knee pain related to osteoarthritis is a rising problem. The primary prevention of these musculoskeletal conditions has not proved feasible, and thus modern management approaches, including the “core” intervention of exercise [16,17], focus on reducing symptoms, preventing unnecessary disability, and minimizing morbidity. Many of the therapeutic options are nonpharmacological.
