Reliable information about shoulder girdle pain in relation to work practices is difficult to obtain from routinely acquired statistics. On the basis of data obtained from a special study of 2 648 manual workers from jobs without special demands for neck or shoulder activity, an estimate has been made of the size of the problem. The results indicate that 23% of a manual workforce reported having suffered from pain in the neck, shoulder, or upper arm on at least one occasion during their worklife and that 15% had had such pain during the year prior to the study. These pains arose through a number of causes collectively grouped as shoulder girdle pain. The relative importance of trivial injuries, degenerative changes, and structural abnormalities is considered along with the possible work-related role in contributing to the onset of such painful syndromes. In light of these possibilities the contribution which primary preventive measures could make to reducing the problem by altering the posture at work is discussed, and an indication is given of the likely limitation of secondary preventive measures (screening) in this field. On the other hand there is room for increased diagnostic accuracy to ensure better management and rehabilitation for those with prolonged or recurrent painful symptoms.