Rheumatologists and neck pain

Many authors have suggested that chronic pain syndromes are psychosocial in origin; maladaptive behaviours favoured by psychosocial and political fact ors. Sometimes this may be true, but neither the individual patients nor th e accumulated scientific evidence deserve such a routine dismissal. In this editorial I will review issues of responsibility, the nature of referred p ain and referred tenderness, evidence for the value of tender point examina tion as an objective measure, techniques of assessment of the cervical spin e, techniques of assessment of pain behaviour, and the determinants of the specific symptom patterns associated with cervical injury.