Patients often report what may seem to the health-care professional to be bizarre or
irrational beliefs. However, when we investigate further the background of these beliefs they
can often have a simple, if important, route. The above statement, for example, was spoken
in clinic by a chronic back pain patient who had been informed that he had markeddisc
degeneration'on x-ray findings. For all patients with pain, what is understood about the
meaning of pain, disease and/or disability will play a part in the presentation of the problem …