TUESDAY, Feb. 12 (HealthDay News) -- Americans are spending more
money trying to ease back and neck pain, but new research suggests
those extra dollars aren't buying more relief.
The increased expenditures were expected, said the authors of a
study in the Feb. 13 issue of the
Journal of the American Medical Association, but the lack of
results weren't.
"This calls into question whether we're providing treatments to
people who aren't going to benefit," said study author Brook
Martin, a research scientist in the department of orthopedics and
sports medicine at the University of Washington, in Seattle. "This
calls for a need for more effectiveness studies and looking at
which patients would benefit from treatments and diagnostic
tests."
"Spine problems are the most common reason why people of middle
age have pain and disability, and we need to continue to search for
better solutions because, although we have come up with newer
techniques of treatments, we still have a large percentage of the
of population with spine problems who are still disabled," added
Dr. Andrew Sherman, head of medical rehabilitation at the Spine
Institute at the University of Miami Miller School of Medicine.
That said, Sherman continued, "just because [the study authors]
did not find improvement over the entire group doesn't mean that
many individuals are not deriving benefit from treatment. There are
many individual patients who do see improvements."
According to background information in the article, 26 percent
of U.S. adults in 2002 reported lower back pain, and 14 percent
reported neck pain during the previous three months.
Low back pain alone accounted for about 2 percent of all
doctor's office visits, exceeded only by routine exams,
hypertension and diabetes. At the same time, there have been
increases in the rates of imaging, injections, use of opiates and
surgery all related to spine pain.
But have these expenditures resulted in any actual improvements
for the patient?
The authors sought to answer this question using data from the
Medical Expenditure Panel Survey, which sampled individuals around
the nation aged 17 and older from 1997 to 2005.
In 1997, 23,045 individuals were sampled, including 3,139 who
reported spine problems. At this time, medical costs for those with
spine problems was $4,695 compared with just $2,731 for those
without spine problems.
In 2005, the survey included 22,258 respondents, including 3,187
with self-reported spine problems. Medical expenditures for those
with spine problems was now $6,096 versus $3,516 for those without
back and neck problems.
During that period, expenditures increased 65 percent from 1997
to 2005 for those with spine problems, which was more than for
overall health expenditures during the same time period. There was
only a small increase in the estimated number of U.S. adults with
spine problems.
The estimated proportion of people with self-reported physical
disabilities resulting from spine problems also increased, from
20.7 percent to 24.7 percent.
Most of the cost difference came from outpatient and inpatient
services, with a smaller proportion accounted for by prescription
medicines. However, the percentage of expenditures related to
prescription medications went up more rapidly than expenses for
other services.
"That includes a 423 percent increase in expenditures related to
narcotic analgesics over that time," Martin said.
In addition, "there's been a steady stream of new devices and
surgical techniques and imaging methods being used over time," he
pointed out. "There's also been a moderate increase in people with
back problems."
The annual expenditures for spine problems are comparable to the
amount spent annually on arthritis, diabetes and cancer. All of
those figures are dwarfed by the enormous sums spent in this
country on heart disease and stroke.
More information
The
National Institute of Neurological Disorders and
Stroke has more on back pain.