Spine related
disorders (SRDs) are one of the most common and costly health problems
in society, affecting almost every person at some point in life. These
disorders encompass a group of conditions directly related to the spine:
back pain, neck pain, many types of headache, radiculopathy or referred
pain, and a variety of other symptoms.
Recent statistics indicate the cost to the United States health system is huge, and growing. Well over $100 billion is spent annually on SRDs. Yet despite the fact that between 1997 and 2005 expenditures for back and neck pain alone rose by 65 percent (inflation adjusted), patients with SRDs are now worse off than ever. In fact, measures of physical functioning, work productivity, school and social activity, and mental health among patients with SRDs all declined during the same period. Clearly, the dramatic increase in health care costs for diagnosis and medical treatment of SRDs has failed to improve the health of patients. Instead, chronicity and disability related to these disorders continues to steadily rise.
Recent statistics indicate the cost to the United States health system is huge, and growing. Well over $100 billion is spent annually on SRDs. Yet despite the fact that between 1997 and 2005 expenditures for back and neck pain alone rose by 65 percent (inflation adjusted), patients with SRDs are now worse off than ever. In fact, measures of physical functioning, work productivity, school and social activity, and mental health among patients with SRDs all declined during the same period. Clearly, the dramatic increase in health care costs for diagnosis and medical treatment of SRDs has failed to improve the health of patients. Instead, chronicity and disability related to these disorders continues to steadily rise.
So, you might be saying, “This is
just another example of the health system not working… what’s new?”
Because spine related disorders account for a significant drain to our
health system, it would make sense for policy makers to look at ways
that these disorders can be better managed.
In the late 1990s this is exactly
what a group of health economists from the University of Ottawa did.
They were commissioned by the Ontario government to examine ways to
reduce the financial costs of SRDs to the province’s health system. The
researchers reviewed every study, every trial, every government inquiry
and every scrap of evidence done to date related to treatment of back
and neck associated disorders.
What these researchers found was
profound: by transferring the care of back pain alone from medical
doctors to chiropractors, the government health system would be able to
save an estimated 12 percent of its annual health budget annually. The
savings could be significantly higher if care of other spine related
conditions, such as neck pain and various forms of headache, were also
transferred to chiropractic doctors. The researchers showed that the
benefit would be not only financial. They concluded that chiropractic
care for these conditions was not only significantly more cost effective
than medical care, it was more effective (better outcomes) and safer.
Numerous studies on patient satisfaction have underlined this
conclusion: patients are about three times more satisfied with
chiropractic care for back pain than medical care.
Clearly, the time has come for a
major change in our management of spine related disorders. It is time
for policy makers to get serious about this crippling problem and begin
to do what is best for patients and the health system: take steps to
establish chiropractic doctors as “primary spine care specialists”.
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