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Back pain is a huge problem in developed nations worldwide. It has or will affect most of us.

The current estimate is that 80% of people will experience back pain at least once. It is the single biggest cause for disability and the third most common reason for doctor visits.

It is one of the most common reasons for missing work.

Even locally in south-east Michigan, back pain is one of the most common condition that people suffer from.

In Sterling Heights, Michigan, where we are located, we have seen many patients suffering from back pain. Total cases of lower back pain is much higher than any other conditions people suffer from.

Back and neck pain makes up the biggest healthcare expense in the US

With higher number of cases of lower back and neck pain it is also very expensive.

Back and neck pain makes up the biggest healthcare expense in the US, totaling $134 billion spent in 2016.

The next two most expensive conditions were diabetes — $111 billion in spending — and ischemic heart disease at $89 billion.

Diabetes and heart disease being so expensive to treat doesn’t surprise most folks – they can both lead to other major problems, require long term medication, could require surgery, and both can be fatal.

Back pain won’t kill you, usually doesn’t require long term medication, and usually doesn’t require surgery either.

Then why is it costing this much to our healthcare system?

Why is it so expensive?

The first reason is that it’s so common. 

The second reason is that our current system isn’t very good at treating it.

Current recommendations include starting with activity modification, and active treatments like physical therapy. Research backs this up, showing better outcomes and lower costs with early PT.

Unfortunately, only 2% of people with back pain start with PT, and
only 7% get to PT within 90 days.

At the same time, a study looking at about 2.5 million people with back pain in JAMA showed that 32.3% of these patients received imaging within 30 days of diagnosis and 35.3% received imaging without a trial of physical therapy.

Both of these things go against current practice guidelines for treatment of back pain.

Current trends that we have noticed includes medications, followed by injections to treat back pain by the PCP and if that does not solve the problem may be patient will be referred to PT. 

A Major Reset is Needed to Change The Healthcare Mindset.

A major reset is required to change the healthcare practice and to treat back pain and other musculoskeletal conditions in general.

It is important that not only patients byut

A new pilot program being rolled out by TRICARE, the insurance system used throughout the US military is waiving the payment owed by the patient for up to three PT sessions in an attempt to improve the use of what the Defense Health Agency calls “high value” treatment for low back
pain. 

The theory is that once a person sees some benefit from PT treatment, they’re likely to go back for more.

This is the “try it before you buy it” approach – think of the 7-day free trial Netflix offers, free samples poured in wineries and craft breweries, or the folks you see standing around in supermarkets with food on toothpicks. TRICARE’s data seems to indicate that it works just as well for healthcare as it does for other businesses.

In a press release they state that once people attend one session of physical therapy, they’re likely to go back for more, no matter what their co-pay is.

But TRICARE found that higher co-pays could be a barrier to people trying
that first visit. For the group of patients with the highest co-pays in the system, only 38% of the people prescribed PT attended the first visit. That’s about half the rate of attendance found in the lowest co-pay group.

The fact that such a major insurer is looking into the value of PT is great news for everyone.

If TRICARE can show that lowering the cost of PT for patients can improve outcomes and save insurance companies money, other major insurers will likely follow.

This could improve the lives of millions of people every year while reducing the huge cost of treating low back pain for the country.

That seems like a win for everyone involved.

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