Introduction
Every day, millions of Americans wake up with aching backs. And every year, billions of dollars are spent on treatments and procedures to ease their pain. This week on All Things Considered, NPR’s Alix Spiegel investigates the politics of back pain — how doctors treat it and why so many people have it in the first place.
Every day, millions of Americans wake up with aching backs. And every year, billions of dollars are spent on treatments and procedures to ease their pain.
Back pain is a major health issue in the United States. Sufferers spend billions each year on treatments, and back pain is one of the most commonly cited reasons for missing work. It’s also one of the most misunderstood, with myths about its causes and treatments leading people to seek out expensive and unnecessary procedures.
We have written extensively about issues related to back pain on our website, but we wanted to take an in-depth look at how these issues are being explored by politicians as well as how they affect everyday Americans. To do this, we interviewed some of the leading experts on this topic across different fields: researchers who study patient care; doctors who treat patients; attorneys who litigate cases involving medical professionals; and political scientists who analyze public policy questions surrounding health care delivery systems in America today.”
This week on All Things Considered, NPR’s Alix Spiegel investigates the politics of back pain — how doctors treat it and why so many people have it in the first place.
Back pain is a common and burdensome problem that can be caused by many things, including poor posture, obesity or a muscle strain. Back pain has many causes and symptoms — it can be treated with medication, surgery or other treatments.
“There’s absolutely no question that back pain is a major health issue,” says Susan Toronjo, who teaches in the School of Public Health at the University of Illinois at Chicago and has conducted research on chronic back pain.
Back pain is the leading cause of disability in the United States, according to Susan Toronjo, who teaches in the School of Public Health at the University of Illinois at Chicago and has conducted research on chronic back pain. She says that economic and social costs are rising as well, but there are strategies to help alleviate them.
“There’s absolutely no question that back pain is a major health issue,” says Toronjo. “It’s also a common cause for people to seek medical care.”
Overall, she says, about 80 percent of American adults will experience some form of back pain at some point in their lives: low back pain or upper-back pain. As many as 20 percent of adults have had chronic back pain for three months or more — persistent, debilitating pain.
Overall, she says, about 80 percent of American adults will experience some form of back pain at some point in their lives: low back pain or upper-back pain. As many as 20 percent of adults have had chronic back pain for three months or more — persistent, debilitating pain.
Chronic lower-back pain is a major health issue that costs Americans billions each year in lost productivity and medical treatment. Many people with chronic lower-back problems can’t work because they can’t find ways to manage the symptoms without resorting to drugs such as opioids (often prescribed by their doctors).
“It’s a huge problem,” Toronjo says. “The costs are astronomical.”
The numbers are staggering. Back pain costs the U.S. economy $86 billion annually in lost productivity, according to the Institute of Medicine (IOM). Health care costs alone add up to $40 billion per year—and that’s just for acute cases, which account for just 30% of back pain sufferers. Add in the cost of disability payments and you get a grand total of $100 billion each year—more than any other medical condition except heart disease or cancer.
Back pain is also rising faster than inflation: between 1997 and 2007, health care expenditures related to back pain increased by more than 60%, according to a study published last year in The Spine Journal.* And these figures don’t take into account indirect costs such as time off work and loss of productivity at home or at work—to say nothing of the emotional toll that chronic back pain can take on patients’ lives.*
Well into his 70s, Toronjo’s husband still struggles with the effects of a back injury he suffered at work decades ago.
In addition to being one of the most common causes of disability, back pain is also one of the most expensive. The Center for Disease Control reports that low-back pain accounts for more than $100 billion in annual health care costs and lost productivity in the United States alone.
Well into his 70s, Toronjo’s husband still struggles with the effects of a back injury he suffered at work decades ago. He has undergone multiple surgeries and now relies on prescription opioids for relief—a treatment option that is increasingly controversial due to its potential for addiction and abuse.
“He could never get comfortable,” Toronjo says. “He always had to push himself or pull himself up when he was getting up out of bed or sitting in a chair … He never got comfortable sitting in chairs.”
Back pain is the most common reason people visit their doctor’s office. According to the American Chiropractic Association, 80 percent of adults will experience back pain at some point in their lives and it’s the leading cause of disability worldwide. The estimated cost associated with chronic lower-back disorders in the United States alone is $100 billion per year.
With no cure for back pain, doctors are often unable to offer treatment beyond medication and surgery—two options that can be both expensive and ineffective depending on the case at hand.
Conclusion
In the U.S., back pain is a leading cause of disability and missed work, costing employers billions of dollars in lost productivity every year. But there’s no consensus on how to treat the problem — or even what causes it in the first place. Some researchers think that bad posture and lack of exercise are major risk factors; others say genetics may play an important role.
In other words: The politics of back pain are complicated.