Neck and Back Pain: How Much Is It Costing Us?

Public health policies are influenced by the kinds of health problems Americans report. Evidence from research is a second driving factor in how common conditions like neck and back pain are treated. One way to reduce medical costs is to analyze where money is being spent and look for trends in care and utilization of medical services.

Treatment of back and neck (spine) problems accounts for billions (not just millions, but billions) of dollars every year. Low back pain alone accounts for 90 billion dollars in diagnosis and treatment. It is estimated that another 20 billion can be chalked up to lost wages and lost productivity. And those figures don’t include similar costs associated with neck pain and problems.

Given that up to 80 per cent of all adults will have back pain at least once (and often more than once) in a lifetime, this problem has grabbed the attention of health care policy makers. It’s their job it is to hold costs down without compromising care or outcomes (results).

When care exceeds recommendations made based on evidence, then health care policy makers get concerned. In this report, money spent on spine problems (including both the neck and back) is linked to specialty services that don’t necessarily improve results. Expensive MRIs and other imaging tests, referrals to orthopedic surgeons and neurologists, visits to the emergency department, and unnecessary lab testing make up some of the specialty costs that might be considered unnecessary.

In addition to expanded diagnostic tests thanks to improved technology, more aggressive marketing of medical supplies has driven some costs up. And the rising costs of care associated with these services don’t come with improved results.

On the other hand, dollars spent on spine care provided by general practitioners (GPs), chiropractors, and physical therapists have not gone up. This is contrasted with evidence that these services provide improved outcomes. Future research is needed to determine what is the most cost effective treatment (i.e., least cost and most benefits).

With the continued rise in health care costs, finding ways to improve results of treatment for spine problems (again, at a lower cost) is important to health care policy makers. It may be necessary to limit patient access to specialty care by restricting (rather than expanding) reimbursement. Policies that encourage better reimbursement can be put in place as more research is done to identify effective spine care.