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