Why Americans Spend More on Back and Neck Pain Than Any Other Health Issue

  • A new study reports that Americans spent $134 billion from 1996 to 2016 on treatments for neck and lower back pain.
  • That’s more than treatments for diabetes or heart disease.
  • Experts say our longevity as well as our lifestyle are the reasons for the high rates of neck and back pain.

For people with back and neck pain, that discomfort is often only just the start.

It increases when they see the bill.

From 1996 to 2016, healthcare spending in the United States soared from $1.4 trillion to around $3 trillion, according to a new study in the journal JAMA.

Of those dollars, back and neck pain were the costliest in aggregate, accounting for $134 billion in care paid out-of-pocket expenses as well as by public and private and insurance companies.

All told, treatments for lower back and neck pain cost nearly $77 billion by private insurance, $45 billion by public insurance, and $12 billion out of pocket by patients themselves, the new research from the Institute for Health Metrics and Evaluation (IHME) shows.

In addition, the figure for low back and neck pain tops $380 billion when combined with other musculoskeletal ailments, such as rheumatoid arthritis and other joint and limb pain.

Rounding out the top three conditions Americans spend the most on are diabetes — $111 billion in spending in 2016 — and ischemic heart disease at $89 billion.

Why lower back and neck pain? 

The high total cost of diabetes and heart disease treatment makes sense.

After all, more than 34 million Americans — around 10 percent of the population — have type 2 diabetes.

Meanwhile, 18 million adults over the age of 20 have ischemic heart disease (known more commonly as coronary artery disease) — nearly 7 percent of the population.

The costs of low back and neck pain are varied, but like diabetes and heart disease, they probably have a lot do with our lifestyles as well as genetics.

“The spinal column is the center of human motion,” Lev Kalika, owner of the New York Dynamic Neuromuscular Rehabilitation & Physical Therapy (NYDN Rehab) in New York City, told Healthline.

“Evolution allowed Homo sapiens to move on two feet, which created more demands for stability, [but] the human locomotor system was just not designed for high life expectancy with a sedentary lifestyle and sporadic gym abuse. How we live is just not natural,” he said.

That might be one reason that as many as 4 in 5 adults experience lower back pain in their lives, according to the National Institutes of Health.

With neck and back pain that common, it’s no surprise we spend a lot of money treating it.

One reason is that back and neck pain treatment is complicated and often time consuming.

“Even in the most efficient healthcare systems, treatment of back and neck pain takes proportionally significant amounts of resources due to the fact that back pain is a multifactorial disease for which the segregation of modern medicine does not provide holistic approaches,” Kalika said.

“Needless to say about our healthcare system — which is the least efficient among all developed countries — there is humongous overreliance on unnecessary and expensive diagnostics and invasive care, which do not resonate with modern research but are still widely used,” he added.

The out-of-pocket cost

In addition to the cost of lower back and neck pain to the body, it’s likely that people are paying more out of pocket now to treat it as well.

Looking at the big picture, the IMHE researchers found that healthcare spending went up from 13 percent of gross domestic product (GDP) in 1996, or $5,259 per person, to almost 18 percent of GDP in 2016, or $9,655 per person.

Not only that, the share of healthcare spending being paid out of pocket and not by public or private insurance remained nearly the same as a percentage of that increase, going from 9.4 percent out of pocket to 9.2 percent.

While those look like similar numbers, 9.4 percent of $5,000 is considerably less than 9.2 percent of nearly $10,000, so the average patient is paying more.

“What is happening today and right now is that the insurance industry is forcing people to pay for this kind of care from their own pockets,” Kalika said.

What to do about it 

Short of overhauling the nation’s healthcare system, Americans can lessen the need for treatment for lower back and neck pain by trying to reduce the likelihood of these issues developing in the first place.

“Avoid excessive sitting. Take natural movement activities rather than the artificial ones. Listen to your body,” Kalika said.

“And check your movement system, posture, and stability with a qualified physical therapist or a chiropractor,” he added.

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