$86 Billion Spent on Back, Neck Pain
Despite Nation's Dramatic Increase in Spending, Little Improvement Seen in Patients
Steep Rise in Drug Costs continued...
Overall, pharmaceutical expenditures related to back and neck pain increased
by 188% between 1997 and 2005, but cost associated with prescription narcotics
rose by a whopping 423%.
University of Washington Medical Center clinician Richard Deyo, MD, MPH,
tells WebMD that increasing use of the newer narcotics such as the drugs
OxyContin is largely responsible for the increase, even though their use
for chronic pain is controversial.
He says patients need to recognize that the drugs have many potential side
effects, including drowsiness, persistent
constipation, and sexual dysfunction.
Deyo co-directs the University of Washington Center for Cost and Outcomes
Research, and he was a co-author of the study.
"We still don't know much about their long-term efficacy and safety for
chronic back pain," he says. "Patients need to understand that if they
take these (opioid) medications long term, after a few months it will be
difficult to stop. And there is pretty good evidence that long-term use may
actually increase sensitivity to pain."
Too Much Surgery?
spinal fusion surgery or disc replacement surgery, is also a growing and
somewhat controversial treatment for patients with chronic back pain without
"An aggressive arm of the surgical community believes that these
patients benefit from surgery, but this is an area where the evidence is at
best murky and confusing," Deyo says.
Orthopedic surgeon Paul Rubery,
MD, agrees that the benefits of surgery are questionable in this group of
Rubery directs the Spine Center at New York's University of Rochester
He tells WebMD that some of the blame for the rising cost of back and neck
treatment belongs to the patient.
"Patients often want the drugs they see on TV or the one their uncle is
on, even if an older and cheaper drug will work just as well," he says.
"And these days, most patients demand MRIs, even when there is little
medical indication. If patients were willing to accept time-tested treatments
and take more responsibility for their health, costs would come way