I keep hearing that the cost of caring for people with low back pain is skyrocketing. Where's all the money going?

There are two basic costs associated with low back pain. The direct cost of health care and services is the easiest to calculate. This includes visits to the doctor, physical therapist, or chiropractor. It also covers the cost of imaging studies, steroid injections, visits to the emergency department, or surgery. Indirect costs can be a little more difficult to estimate. Time lost from work can be judged using absenteeism. But loss of work productivity in dollars and cents is a little more difficult to figure out. This is especially true if the patient returns to work but at a different job or with a reduced workload. And that's just for first-time episodes of back pain. It doesn't account for repeat episodes and recurring costs for office visits, urgent care, additional surgeries, or prescription medications. Researchers are continuing to look at this problem carefully. Guidelines for treatment based on evidence suggest an active approach to rehab and recovery. A recent study from the University of Utah Department of Physical Therapy has added to our knowledge of how to treat low back pain. They showed that patients who receive active exercise and activity-based intervention (versus passive modality-based treatment) have reduced costs and better long-term results. It looks like an effort is being made to identify ways to reduce healthcare utilization and costs for low back pain. Physical therapy following current evidence-based guidelines providing active care is one important way to reduce the economic burden of caring for patients with back pain.

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