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Back pain=Higher cost & no health improvement in M

More Pain than Gain in Treating Backache - Many with spinal problems pay higher costs and do not see improvements in health, a study finds.

Chicago-The total cost of treating back pain in the U.S. has risen 65% in the last decade, even after all the pricey treatments, many people are still left with an aching back, and an empty wallet. U.S. researchers said Tuesday. Treating spine problems in the U.S. costs $85.9 billion a year, rivaling the economic burden of treating cancer, which cost $89 billion. Higher spending on prescription drugs, more advanced diagnostic tests and more frequent outpatient visits helped drive the increases, as well as greater patient demand for treatment and more use of spinal fusion surgery and instruments, researchers said. Yet, for all the spending, they found people with spine problems actually felt worse. “Expenditures for people with spinal problems have increased 65% since 1997. Within that, pharmaceutical expenditures have increased 171%”, said Brock Martin of the University of Washington, whose study appears in the Journal of the American Medical Association. “If we are spending that much money on spine problems, we would expect to see improvements in the health of the population,” Martin said. The proportion of spine patients reporting physical, social, and work limitations rose to 24.7% in 2005 up from 20.7% in 1997. “What we’re seeing is that although costs have gone up, outcomes have not changed, which is really discouraging,” said Dr.Orly Avitzur, a neurologist from Tarrytown, New York, and advisor to Consumer Reports, which named back surgery on its top-10 list of “Medical Gotchas.” The research follows a number of recent studies showing that some patients who skip surgery for back pain do as well over time as those who have the surgery. “It’s best to be conservative and take a wait-and-see approach, especially in the initial stages of low back pain,” said Avitzur. Dr. Paul Rubery, a spine surgeon at the University of Rochester Medical Center in New York, said that higher drug spending and increased use of diagnostic tests such as MRI accounted for a lot of the increased costs. He said the study emphasized the need for treatments with proven benefits.

Reuters, Los Angeles Times Wednesday, February 13, 2008 - A21

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