People suffering from back pain are being taken for a ride. Back pain sufferers are spending millions of dollars each year without seeing any significant improvements in their aching backs. How do we explain such contradictory outcome? In fact, the treatment cost of back pain has risen over the past several years. However, there is no evidence indicating that these treatments are effective in eradicating or improving back pain. Current back pain treatments are simply not working; yet, new drugs and devices are being promoted aggressively by manufactures.
Trust in the science behind these products has waned over the years by revelations of misleading advertising, allegations of kickbacks to doctors, and major investments by surgeons in the same exact products they are testing and investigating, (UW & OHSU). This is conflict of interest at its highest level of existence. We will shed some light on the ineffectiveness of back pain treatments and the high cost they are causing patients suffering from such ailments.
Back pain sufferers visit their primary care providers in the hope that their back pains will all be taken care of by taking a few pills, taking a few injections, or even going under the knife but realize the sad truth that none of these medical interventions work. Yet, they still find themselves spending more and more of their hard-earned dollar at doctor's offices. When will there be an end to such dilemma? Patients should be told the truth about the prognosis of their back pain and whether or not it can be cured by medical, surgical, or alternative medical means, but no! This is not happening! Patients are still nevertheless being referred for things such as imaging, medication, injections, and surgery, (UW & OHSU).
According to a study conducted by researchers at the University of Washington (UW) and Oregon Health and Science University (OHSU), management decisions relating to imaging, medication, and referral for injections and surgery are being made in primary care to treat chronic back pain without reason. The study revealed that there have been steady increases in the request for medical tests and surgical interventions for the treatment of back pain that shows no improvements in patient outcomes. For instance, there have been a stark increase in medical expenditures of 629% for epidural steroid injections; a 423% increase for opioids; a 307% increase in the number of lumbar MRI; and a 220% increase in spinal fusion surgeries. The harsh reality is that these dramatic increases in referrals have not showed any significant improvements in patient outcomes.
Low back pain magnetic resonance imaging (MRI) has increased in the Medicare population by 307% during a recent 12 year study. Parallel with the increase of MRI is the increase of surgeries for back pain in certain geographic areas. These high levels of MRI instances are contradictory to proper guidelines established to regulate such practice. The researchers asserted that patient demands, the compelling nature of visual evidence, fear of lawsuits, and financial incentives could be the underlying cause of such increases in MRI.
The UW & OHSU study found that opioid analgesic prescriptions have steadily increased over all, especially for musculoskeletal conditions; in addition, the National Medical Expenditure Panel Survey showed an increase of 108% in opioid prescriptions from 1997 through 2004. The combination of increase use and higher drug prices have resulted in a 423% inflation-adjusted increase in expenditures according to the study. The researchers stated that these trends could have been driven as a result of concern for the under-treatment of pain in the past, especially among terminally ill patients and cancer patients. In fact, the study went even further, stating that many patients receiving opioid analgesics for non-cancer pain have persistent high levels of pain and poor quality of life.
The study also found that spinal injections are very limiting in their effectiveness for treating back pain, further stating that epidural corticosteroid injections may offer temporary relief of sciatica, but they do not reduce the occurrence of surgery. In spite of the limited benefit of epidural injections, Medicare claims rose 271% during a recent 7-year study. In fact, charges for injections increased by 100% during the past 10 years, and the combination of increasing rates and charges resulted in a 629% increase in fees for spinal injections, according to the UW & OHSU study. While this increase was occurring, the Medicare population only increased by 12%, showing us that the expenditure is vastly out gaining patient outcomes.
Spine fusion surgery is being over indicated at an alarming rate. This form of surgery has a well-established role in treating fractures and deformities. However, it is very limited in treating degenerative discs with pack pain alone, a finding discovered in 4 randomized trials conducted by the UW & OHSU researchers. Despite no specific or conclusive reports clarifying improved effectiveness, there was a 220% increase in the rate of lumbar spine fusion surgery from 1990 to 2001 in the United States, according to the study.
Glenford S Robinson, BS, CLS (ASCP), is a Clinical Laboratory Scientist, Journalist (American Chronicle), and Staff Writer for Mstardom.com, a social networking website and articles directory providing its members and visitors with up-to-the-minute news and entertainment and the opportunity to submit articles free. He also provides article writing and press release writing as well as web content copywriter and blog writing services for small and large businesses. Mr. Robinson has a BS degree in Clinical Laboratory Sciences from the State University of New York at Stony Brook and one year of graduate studies in pursuing an MBA in health care management at the University of Phoenix, Phoenix, Arizona. Mr. Glenford S Robinson is also the president, chief executive officer, and founder of Mstardom.com (MyspaceStardom.com). Please send correspondence to Mstardom.com/ranja inbox.
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