Here’s Why Low Back Pain So Expensive To Treat

January 18, 2017

There’s a price to pay for back pain. It’s not just the high cost of treatment; it’s the toll that back pain takes on your ability to work, think, and just get through the day. It’s the cost of losing years of what could otherwise be a healthy, happy life.

In 2008, the Journal of the American Medical Association published a study to estimate the total medical cost — via inpatient, outpatient, emergency department, and pharmacy expenditures — related to spine problems in the U.S. The study looked at annual samples of Medical Expenditure Panel Survey (MEPS) respondents from 1997 to 2005.

Here was the shocking conclusion: each year, people with spine problems spent $2,580 more than people without spine problems. That’s a 76% difference in medical expenditures for people already suffering from the physical and mental consequences of back pain.

Now, multiply $2,580 by the tens of millions of people with spine problems, and you get $85.9 billion in added health expenditures. That grossly high number is right up there with America’s worst chronic diseases. Arthritis, the leading cause of disability in the U.S., totals $80.3 billion — $5.6 billion less than spine problems — in medical costs. Cancer costs $89 billion every year, and diabetes costs $98.1 billion. Only heart disease and stroke incur substantially higher costs than spine problems.

And there’s more bad news. Despite increased spending on treatment for back pain, respondents reported no improvement of health status, functional ability, work limitations, or social interaction. In fact, the physical limitations caused by back pain increased over that time period.

Back Pain’s Hidden Costs

Back pain is costly because it affects so many sectors of the economy. Let’s break expenditures down into three categories: treatment, employee, and employer costs.

  • Treatment costs include the direct expenses you pay for prescription drugs, doctor visits, hospital stays, medical imaging (MRIs, CT scans, X-rays, etc.), spinal surgery, etc.
  • Employee costs include the wages you lose from missed days of work due to back pain. If you have to quit your job because of the pain, you also lose the important benefits (i.e. health insurance) that come with employment.
  • Employer costs include the amount employers lose each year (more than $20 billion!) due to employees’ missed days of work, decreased productivity, workers compensation claims, and the cost of hiring and training workers to cover or replace employees who can’t work because of back problems.

And let’s not forget the indirect costs of back pain. Say you miss a day of work because of debilitating back pain. That’s a day of lost productivity, plus the cost of getting someone else to run your errands or watch your kids.

Chronic back pain also takes a huge toll on your mental health. According to a 2004 study in The Journal of International Association of the Study of Pain, back pain is the strongest predictor of major depression. All in all, low back has a debilitating impact on your work, personal health, physical function, and quality of life.

Why Is Back Pain So Expensive?

Since the JAMA study was published in 2005, disabilities from musculoskeletal injuries (including low back pain) have increased. What’s also risen is the type and amount of treatment sought for back pain.

More prescriptions have been written for brand-name medications — like gabapentin, fentanyl, and time-release oxycodone — in place of generic, over-the-counter options. More advanced medical procedures — including invasive surgical procedures, steroid injections, and medical imaging — have been used to diagnose and treat spine problems. And you can bet the price tag for these interventions have increased substantially.

In sum, the cost of treating back pain, and the number of people suffering from it, has continued, yet health outcomes still haven’t improved.

Is There A Way To Improve Health Outcomes?

Part of the difficulty of treating back pain is that doctors and specialists don’t know what to treat. Back pain can be attributed to multiple factors, some of which are out of your control. That means doctors can’t always pinpoint how and where to treat the pain.
Surgery and high-tech treatments can be effective. But there are cheaper, possibly more effective options than the advanced treatments we mentioned earlier.

Those options: self-care through physical therapy, exercise, and education. In a study published in the BMC Health Services Research in 2015, researchers evaluated how physical therapy affected cost for participants with low back pain (LBP). For participants who received early physical therapy (within 14 days of seeing their doctor), total LBP-related costs were 60% lower during the two-year follow-up period.

Another study published in Health Services Research compared expenditures among LBP patients who received first referrals for PT versus advanced imaging. Results showed that patients who were referred to PT incurred less than half the costs than those who received advanced imaging as the first step to manage their pain.

There are two explanations for this significant cost difference:

1. Patients who received imaging as a first referral were more likely to receive expensive medical care via injections, medication, specialist visits, ER visits, and possible surgery.

2. Advanced imaging puts an unnecessary diagnosis on back pain conditions that can’t be fixed by specific treatments. This incentivizes patients to seek additional (and very expensive) care that doesn’t guarantee results.

Physical therapy and guided exercise programs, on the other hand, give patients the skills to self-manage their condition — so they might not jump the gun on seeking excessive treatment or surgery.

Here’s the big takeaway: People with LBP are burdened with the cost of unnecessary and excessive treatment. When back pain is treated through early intervention, patients have less need for expensive, possibly ineffective care.

A Better Way To Manage Back Pain

Back pain treatment can throw you down a rabbit hole of misplaced diagnoses, anxiety, and uncertainty about how to reduce your pain. And that rabbit hole can cost you a pretty penny to climb out of.

That’s why Nuspine was created as a cost-effective tool to reduce chronic LBP. The 30-day online program gives users access to short, daily exercise videos focused on breath work, core strength, flexibility, and balance. Plus, in an analysis verified by The Validation Institute, Nuspine users had comparable or better results than physician-directed usual care.

“NuSpine is a comprehensive, foundational program for individuals that qualify. The goal of NuSpine is to provide an additional option for patients suffering from back pain in order to improve their overall quality of life,” says Navid Hannanvash, Doctor of Physical Therapy and Certified Athletic Trainer.

Whatever the reason for your LBP, and however you decide to treat it, Nuspine gives chronic LBP sufferers the tools to self-manage their pain.

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