Americans are spending more money trying to ease back and neck pain, but new research says much of the money may be wasted, as patients do not feel any better.

Researchers from the University of Washington, Seattle, estimated the cost of treating back pain by using data from the Medical Expenditure Panel Survey, an annual federal survey of 23,000 people. The new study took a broad-brush approach to examine whether overall spending on back treatments is making people feel better.

The findings were surprising. People with spine problems in 2005 spent $2,500 more in medical expenses than those without such problems, which means a rise of $2,000 compared to 1997. Overall costs of treating back pain rose 65 percent from 1997 to 2005 to an estimated $85, 9 billion nationally, rivaling the economic burden of treating cancer, which costs $89 billion.

“Health care expenditures for people with spinal problems have increased substantially –65 percent since 1997. Within that, we found pharmaceutical expenditures have increased 171 percent. If we are spending that much money on spine problems, we would expect to see improvements in the health of the population,” said Brook Martin of the University of Washington in Seattle, who led the study in a telephone interview with Reuters.

Increased use of painkillers was one of the biggest drivers of spending. University of Washington Medical Center clinician Richard Deyo, MD, MPH, said increasing use of newer narcotics such as the drugs Vicodin and OxyContin is largely responsible for the increase, even though their use for chronic pain is controversial. Spending on narcotic drugs for pain soared an astonishing 423 percent during the period. Deyo co-directs the University of Washington Center for Cost and Outcomes Research, and he was a co-author of the study.

"We still don't know much about their long-term efficacy and safety for chronic back pain. Patients need to understand that if they take these (opioid) medications long term, after a few months it will be difficult to stop. And there is pretty good evidence that long-term use may actually increase sensitivity to pain." Deyo told WebMD.

However, the researchers found no improvement whatsoever over the eight-year period. Moreover, people actually got slightly worse during the period. Patients reported more disability from back and neck pain, including more depression and physical limitations.

“We are putting a lot more money into this problem and not seeing any improvement in health. The bottom line is, we are spending a lot and not getting a lot of value,” Martin said in the study.

Dr. Richard Fessler, a professor of neurosurgery at Northwestern University called the study “fatally flawed.” The methodologies in the paper are atrocious. I can’t imagine how this got published,” he wrote in an e-mail to Reuters.
Fessler said the study fails to mention several large recent clinical trials that showed certain patients undergoing spinal surgery improved significantly. That’s why he worries the study will drive away people who might benefit from surgery.

“Some people are so afraid to have surgery [after reading] these type of articles that they choose to continue suffering” rather than do a simple procedure that can fix the problem, he says. “Our patients are getting out of the hospital faster with less blood loss, less pain and less complications.”

The research, partially funded by the National Institute of Arthritis and Lusculoskeletal and Skin Diseases, was published in the February 13 issue of the Journal of the American Medical Association.