• 1 • Chin J Integr Med Musculoskeletal disorders (MSDs) comprise a wide range of conditions, associated with an enormous pain and impaired mobility, and are affecting people's lives and work. It is reported that 70%–84% of adults in the UK experience nonspecific low back pain (1) and 70% experience neck pain (2) during their lifetime. The incidence of MSDs appears to be increasing, with a corresponding impact on primary health care provision. (3) MSDs treatments cost $389 million to the retail industry in the US in 2007. (4) Annually in the UK they cost approximately ￡7.4 billion and cause ￡9.5 million lost working days. (5) Management of MSDs typically involves a multidisciplinary team approach, including reduction in workload, increased rest, stress management, behavioural intervention and physiotherapy. Drug therapies include simple analgseics such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, topically or systemically, opioids and tricyclic antidepressants; as well as surgery. Complementary and alternative medicine (CAM) is commonly used to treat musculoskeletal conditions, especially pain such as back pain, neck pain and shoulder pain. (6-8) The National Institute for Health and Clinical Excellences's (NICE) guideline on low back pain recommends consideration of manual therapy and acupuncture, traditionally considered CAM therapies. (9) A recent systematic review reported the 12-month prevalence of any use and visits to CAM practitioners in ORIGINAL ARTICLE A Pragmatic Observational Feasibility Study on Integrated Treatment for Musculoskeletal Disorders: Design and Protocol Xiaoyang Hu 1 , John Hughes 2 , Peter Fisher 2 , Ava Lorenc 1 , Rachel Purtell 3 , A-La Park 4 , and Nicola Robinson 1 ©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag Berlin Heidelberg 2013 1. Faculty of Health and Social Care, London South Bank University, London, SE1 0AA, UK; 2. Royal London Hospital for Integrated Medicine, University College London Hospital National Health Service Trust, London, WC1N 3HR, UK; 3. Patient representative; 4. Personal Social Services Research Unit, Health and Social Care, the London School of Economics and Political Science, London, WC2A 2AE, UK Correspondence to: Dr. Xiaoyang Hu, Tel: 20-78158350, Fax: 20-78158490 DOI: 10.1007/s11655-013-1557-9 ABSTRACT Background : Musculoskeletal disorders (MSD) comprise a wide range of conditions, associated with an enormous pain and impaired mobility, and are affecting people's lives and work. Management of musculoskeletal disorders typically involves a multidisciplinary team approach. Positive findings have been found in previous studies evaluating the effectiveness of complementary therapies, though little attention has been paid to evaluating of the effectiveness of integrated packages of care combining conventional and complementary approaches for musculoskeletal conditions in a National Health Service (NHS) setting. Objective : To determine the feasibility of all aspects of a pragmatic observational study designed: (1) to evaluate the effectiveness and cost effectiveness of integrated treatments for MSDs in an integrated NHS hospital in the UK; (2) to determine the acceptability of the study design and research process to patients; (3) to explore patients' expectation and experience of receiving integrated treatments. Methods : This is an observational feasibility study, with 1-year recruitment and 1-year follow-up, conducted in Royal London Hospital for Integrated Medicine, University College London Hospital Trust, UK. All eligible patients with MSDs newly referred to the hospital were included in the study. Interventions are integrated packages of care (conventional and complementary) as currently provided in the hospital. SF-36™ Health Survey, short form Brief Pain Inventory, Visual Analogue Scale, and modified Client Service Receipt Inventory will be assessed at 4/5 time points. Semi-structured interview/focus group will be carried out before treatment, and 1 year after commence of treatment. Discussion : We intend to conduct a pragmatic observational study of integrated medical treatment of MSDs at a public sector hospital. It will inform the design of a future trial including recruitment, retention, suitability of the outcome measures and patients experiences. KEYWORDS integrated medicine, musculoskeletal disorders, feasibility study, mixed method