Back Pain Takes Big Toll on U.S. Health Dollar
The medical costs of back pain in this country now exceed $90 billion, with more than $26 billion of that coming from direct treatment of the condition, a new study has found.
The $90 billion figure represented 1 percent of the nation's gross domestic product in 1998, while direct treatment costs of back pain accounted for 2.5 percent of the country's total health care outlay that year.
Experts have long known that back pain -- bad discs, spine disorders, injuries -- is a major sponge for health-care dollars. But previous estimates have been based on 1977 data that were periodically adjusted to reflect present-day dollar values. The latest study, by researchers at Duke University Medical Center, provides the most up-to-date picture of the toll back pain takes on the nation's health-care budget. Their report appears in the January issue of Spine.
However, even the study authors admit their work is incomplete. The figures don't include information about back pain in nursing home patients, who in the 1977 research accounted for about 20 percent of medical costs. As a result, the costs of care for back pain almost certainly top $100 billion.
Nor does the Duke study include non-medical costs of back pain, such as lost productivity. A recent study in the Journal of the American Medical Association (news - web sites) found chronic pain conditions, including arthritis, back problems and other ailments, drain $61.2 billion a year from the U.S. economy. Back pain accounted for about a quarter of the lost or unproductive work, second only to headaches as the most frequent pain complaint of workers. That study didn't include the costs associated with people knocked out of the work force by chronic pain.
Back pain's cost to society is "enormous," says study author Walter Buzz Stewart, director of the Center for Health Research and Rural Advocacy at the Geisinger Health System in Danville, Pa. The figures for health-care expenses are "larger than I would have predicted."
About eight in 10 Americans will suffer a bout of back pain before they die. At any given time, between 15 percent and 20 percent of the country is complaining of the problem.
Not surprisingly, people with back pain consume more health-care dollars than those without back problems. The difference in 1998 was $3,498 vs. $2,177, or about 60 percent. The gap persisted among all categories of expenditures, from inpatient care to prescription drugs to emergency room visits.
However, a relatively small segment of the population consumes the vast bulk of the resources when it comes to treating back pain, says Xuemei Luo, a Duke University health systems researcher and leader of the new study. A quarter of people with back pain account for 75 percent of the costs, she says, while only 10 percent of patients drive more than half the patient spending.
Chronic back pain is usually behind the biggest expenditures, she says. They see doctors more frequently, receive more prescriptions, and consume more of other health services. "This population should be our target population," Luo says.
But that raises another problem: Back pain is notoriously difficult to treat. "Right now there is no clear evidence which treatment is good and cost-effective," Luo says.
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Funny that there hasn't been more research and development done on correcting this huge problem. A surprisingly large amount of money is being spent on back pain issues.
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Never underestimate the predictability of stupidity.
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