As Back-Pain Spending Rises, Results Worsen

Eight years have seen a huge increase in spending on back-pain problems in America. Ironically, however, the proportion of Americans suffering from spine problems has actually increased, too, according to a recent study.

The findings, published in the Journal of the American Medical Association, showed that the public’s outlays on spine issues were almost $86 billion in 2005, which represents a jump of 65 percent from 1997, after taking account of inflation. At the same time, the fraction of citizens with debilitating back difficulties rose during the same period, even after adjusting for the increasing proportion of aged people.

“You’d think if you’re putting a lot of money into a problem, you’d see some improvements in health status,” said lead author Brook I. Martin, research scientist at the University of Washington’s department of orthopedics and sports medicine. “We’re putting a lot of money into this problem, and it’s a big investment in health care expenditures, but we’re not seeing health status commensurate with those investments.”

The study joins a number of recent reports all suggesting there are deep-rooted systemic problems in the nation’s approach to the treatment of back pain. These problems could involve the use of ineffective or even detrimental surgical techniques, and the overuse of injections and narcotic pain medications.

“I think the truth is we have perhaps oversold what we have to offer,” said Richard A. Deyo, a doctor at the Oregon Health & Science University in Portland and a coauthor of the report. “All the imaging we do, all the drug treatments, all the injections, all the operations have some benefit for some patients. But I think in each of those situations we’ve begun using those tests or treatments more widely than science would really support.”

In the current study, the research team looked at yearly household survey data from the Agency for Healthcare Research and Quality on about 23,000 people a year from 1997 to 2005. The survey showed that men and women with spine problems spent $6,096 each on medical care in 2005, compared with $3,516 among those without spine problems.

During the eight years, spending on drugs rose most precipitously – $20 billion in 2005, a 171 percent rise from 1997.

Yet, amid all of the spending, the back-pain problem expanded, according to the study. In 1997, some 21 percent of the adult population was afflicted with function-limiting back or neck problems, the scientists estimated. By 2005, that proportion had grown to about 26 percent, after adjusting the figures for age and gender.