Problem
Kate, 48, had a sedentary job sitting at a computer all day. Her weight was normal and her health had been good, which the nurse could see by looking over her history from previous visits. Kate said she did some cross-country skiing in the winter, and in warmer weather liked to hike with friends. Someone had told her that people always had aches and pains after age 40, and she had gone along with this. But the frequency of pains and tightness in the upper back, neck, shoulders, and lower back had been increasing, and this was of concern to her. The last time she went out hiking, someone else had had to carry her backpack. Was there something responsible for her increased achiness besides just getting a few years older, she asked?