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Why is the information on cost effectiveness of interventions to manage neck and upper limb symptoms still lacking, while all stakeholders would benefit from this information?
  1. Paulien M Bongers
  1. Correspondence to:
 Dr P M Bongers
 TNO Arbeid, Polaris Avenue 151, PO Box 718, Hoofdorp NL-2130, The Netherlands; p.bongers{at}arbeid.tno.nl

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High quality studies that evaluate cost-effective interventions in neck and upper extremity musculoskeletal conditions are needed

There is general consensus on the widespread and multifactorial nature of musculoskeletal pain in modern society. The costs to society and to companies, which stem from lost productivity and reduced performance among affected workers, are high. This in turn has encouraged certain interventions, such as ergonomic work place adaptations or training, to be widely applied. One would expect, given this combination of a common problem, high costs and widely applied interventions, that there would be ample knowledge among employees and employers about the most effective and even the most cost-effective solutions. Unfortunately, this is not the case. Although still limited, the knowledge on effective prevention and return to work for workers with low back pain has improved greatly in the past few years. But comparable evidence for neck and upper limb symptoms is still largely absent in 2007. In my view that is a missed opportunity. If workers, employers and occupational health experts are to spend time, energy and money on prevention of these problems, they had better spend it on effective measures or spend it not at all. This is in the interests of all stakeholders.

In order to reach a soundly based and robust conclusion on effectiveness of these interventions, multiple high-quality studies are needed that evaluate effectiveness in a sufficiently comparable way. The fact that such studies are only rarely available can at least be partly attributed to the …

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