Throwing money at back pain treatments does not guarantee relief

Feb 13 2008

A new study by researchers in the United States has revealed that despite the billions of dollars spent in recent years on treating back pain, many people gain little relief.

The researchers say treating back and neck problems in the U.S. costs $85.9 billion a year, which is almost as much as treating cancer and while back pain costs rise the pain persists.

The scientists from the University of Washington in Seattle say costs are driven by more being spent on prescription drugs, better diagnostic tests and more outpatient visits, as well as greater patient demand for treatment and increased use of spinal fusion surgery and instruments.

However they say people with back problems actually feel worse.

Lead researcher Dr. Brook Martin says when such amounts of money are being spent, the expectation is that there will be an improvements in the health of the population but the study shows there are not the commensurate improvements among people with spine problems.

In their study Dr. Martin and colleagues analyzed data from 1997 to 2005 from a nationally representative survey of patient health expenditures and health status.

They found that people with back and neck problems on average spent $4,695 per year in 1997 on health costs, compared with the average $2,731 spent for people without back problems and those figures rose in 2005 to $6,096 for spine patients, compared to $3,516 for people without such problems.

Also up were the number of spine patients reporting physical, social and work limitations, from 20.7 percent in 1997 to 24.7 percent in 2005.

Back and neck problems are among the symptoms most commonly encountered in clinical practice and experts say it is discouraging to find that though costs have risen, outcomes have not changed.

The research in some respects supports a number of recent studies which have shown that some patients who decide against surgery for back pain, over time do as well as those who have the surgery, which has prompted many specialists to advise a wait and see approach.

They say the study emphasises the need for treatments with proven benefits.

The researchers say the data suggests that spine problems are expensive, due both to the large numbers of people affected and to high costs involved and they say improvements in health outcomes were commensurate with the increased costs over time.

They suggest that the amount spent on spine problems could be reduced without a worsening of outcomes.

In Australia, back problems are the leading specific musculoskeletal cause of health system expenditure and claims lodged for back injury with the workers' compensation scheme cost the community billions each year.

The study appears in the Journal of the American Medical Association.