Introduction
In the Netherlands, approximately 3 million people (19% of the population) suffer from musculoskeletal complaints. These include non-specific complaints such as back pain, neck pain or repetitive strain injury, chronic inflammatory or degenerative rheumatic disorders and a wide range of sports injuries. Most of these complaints have a tendency to become chronic, especially later on in life. Apart from the personal suffering endured by patients, musculoskeletal disorders cause substantial social economic problems because of the high costs incurred by work absenteeism and work disability.
Musculoskeletal disorders are one of the main reasons for which patients visit their general practitioner and physiotherapist. Due to the ageing of the population and unhealthy life-styles, it is anticipated that the incidence and prevalence of musculoskeletal disorders will increase substantially in the near future. Despite the magnitude of the problem, surprisingly little is known about the etiology and clinical course of most musculoskeletal disorders, or about the determinants of a healthy musculoskeletal system. Moreover, insight into the value of available diagnostic tests and commonly used therapeutic interventions is often lacking.
These circumstances have led to the formulation of a consensus document, ‘The Bone and Joint Decade 2000-2010 for prevention and treatment of musculoskeletal disorders’ (Acta Orthop Scand [Suppl 281] 1998;69). This is an initiative of multiple national and international medical scientific societies and medical journals, with the general purpose of improving the health-related quality of life for people with musculoskeletal disorders throughout the world.
In the Netherlands a substantial number of multiprofessional guidelines for the diagnosis, treatment and prevention of musculoskeletal disorders exist, however succesfull implementation is hampered by lack of knowledge on implementation, lack of fundamental and intervention research necessary to infuse evidence into guidelines and lack of willingness to use guidelines by the medical profession. The latter is being caused mainly because use of guidelines does not give the professional the impression that it leads to better health care or improved health for the patient.

Mission statement
The objective of the Caphri program ‘epidemiology of musculoskeletal disorders’ is to obtain knowledge about the occurrence, prognosis and treatment of musculoskeletal disorders in the transmural setting. The emphasis lies on disorders that occur frequently, combining research towards etiology, therapy and prognosis of musculoskeletal disorders of a predominantly chronic nature that constitute a large health care burden. A link with fundamental research will be pursued or developed where necessary. Research findings will be incorporated in (multi) professional systematic reviews en guidelines, in accordance with the principles of evidence based medicine. The program will also use feedback from implementation- and benchmarking research, and develop continuous electronic monitoring of relevant patient groups therewith providing health care workers with up-to-date information about treatment and cost effectiveness.

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