The Costs of Back Pain (part 1)

Back pain and costs: On the top ten list of diseases in America, low back pain is listed as #8. According to Forbes it costs us $40 billion annually. Low back pain sent over 3 million people to the hospital emergency rooms in 2008 at a cost of $9.5 billion. Low back pain ranked as the 9th most expensive condition treated in U.S. hospitals that year.

In spite of the overwhelming research and the new wave of data that proves much of the current medical/allopathic treatments are ineffective and costly; the medical establishment across the US has failed to read or heed the data and research. They continue to prescribe opiates, epidural steroid injections, and radical surgeries despite the warnings of their peers.

The costs of back surgery are staggering and are among the most expensive. Not including costs such as hospitalizations, imaging, drugs & medications, iatrogenic injuries, and other associated costs; the base costs are listed below:
 Anterior cervical fusion: $44,000
 Cervical fusion: $19,850
 Decompression back surgery: $24,000
 Lumbar laminectomy: $18,000
 Lumbar spinal fusion: $34,500

Dr. Richard Deyo, MD, MPH found that when combined with surgical costs, MRIs, rehab, and disability, spine surgery costs approach $100,000. And the direct costs for lumbar spinal fusion may reach as high as $169,000. A cervical Fusion can cost as high as $112,000.

In 1998 a research study was published in the Annals of Internal Medicine by Dr. Paul G. Shekelle, an internist with the West L.A. Veterans Affairs Medical Center and the UCLA’s RAND corp. He found that chiropractic manipulation was effective for over 46% of the people it was administered to. The research also found that 29% of the study group had chiropractic inappropriately used as a treatment, which means only 25% of appropriately selected patients failed to respond to chiropractic care.

In 24 years of practice as a chiropractic physician I would say that an 85 % success/failure rate is about what my patients and I have experienced. So the aforementioned study isn’t as accurate as real life practice would suggest. I have also learned which cases are going to respond to chiropractic and which ones don’t. So a 29% rate for inappropriate usage of chiropractic as a treatment is also higher than I experience in real life practice. No disrespect to Dr. Skekelle intended.

Lastly, Dr. Shekelle opined of his study, “instead of thinking of chiropractic as an alternative or some kind of therapy separate from other care, we really should consider it equivalent.” He went on to say, “our study basically provides the first systematic look at the quality of chiropractic care.” I believe he was pleasantly impressed with what he saw.

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