June 2008

Back pain costs up, outcomes unchanged

Although expenses related to back and neck problems have increased substantially in the last decade, outcomes such as functional disability and work limitations do not appear to be improving, according to a study in the February 13 issue of JAMA.

Back and neck problems are among the symptoms most commonly encountered in clinical practice. In a 2002 survey of US adults, 26 percent reported low back pain and 14 percent reported neck pain in the previous three months, according to background information in the article. Rates of imaging and therapy for back and neck (spine) problems have increased substantially in the last decade, but it is not clear how this has affected expenditures or health outcomes for individuals with these problems.

Brook I. Martin, MPH, of the University of Washington, Seattle, and colleagues conducted a study to examine changes in expenditures and health status related to spine problems. They found that expenditures increased each year. In 1997,the average medical cost for patients with spinal problems was $4,695; in 2005, that figure rose to $6,096 -- an estimated 65 percent increase. The average cost for people with non-spinal related medical problems went from $2,731 to $3,516, a 29 percent increase.

Yet, during the same time period, positive outcomes increased only about 4 percent. In fact, adjusted self-reported measures of mental health, physical functioning, work or school limitations, and social limitations among adults with spine problems were worse in 2005 than in 1997.