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Healthcare Expenditures for Back and Neck Pain

The costs of treating neck and back and neck pain are high and are increasing, without a corresponding apparent functional benefit.

In a 2002 survey, one quarter of U.S. adults reported low back pain in the prior 3 months, and 14% reported neck pain. The cost of healthcare for these spine problems has now been assessed in a nationally representative survey. All 23,000 respondents self-reported health status; roughly 3200 reported spine problems.

After adjustment for age and sex, total annual health expenses for respondents with spine problems rose from a mean of US$4695 in 1997 to $6096 in 2005; these expenditures were 73% higher than mean expenditures for those without spine problems. Medication accounted for the largest relative jump in expenses, with an inflation-adjusted increase of 171% from 1997 to 2005. People with spine problems were two to three times more likely to report limitations in physical, work, and social functions.

Comment: The authors estimate that the total national medical cost of treating spine problems is $86 billion (roughly 9% of total healthcare costs); in comparison, cancer care costs $89 billion and diabetes care costs $98 billion. The dramatic increase in pharmacy expenses — mostly attributable to expensive new drugs such as gabapentin, fentanyl, and time-released oxycodone — has not resulted in a corresponding improvement in functional status for these patients.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine February 12, 2008

Citation(s):

Martin BI et al. Expenditures and health status among adults with back and neck problems. JAMA 2008 Feb 13; 299:656.

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