When combined with surgical costs, medications, MRI’s, rehab, and disability, every spine surgery case approaches $100,000 or more. The direct costs are astronomical and may reach as high as $169,000 for lumbar fusion and $112,480 for cervical fusion. It seems that spine surgery has become a business rather than an effective treatment for suffers of back pain. And a booming business it is, not only have the costs of spine surgery skyrocketed, so have emerging treatments that have been proven ineffective, although profitable, for example the increased use of opiates and epidural steroid injections.

The recent growth in pain management clinics featuring epidural steroid injections has received criticism from medical experts like Robert J. Barth, a neuropsychologist, who believes these ESI treatments “reliably fail, the treatments seems to lead to a progressive worsening, the ineffective treatment never ends, and the original treating doctors refer the claimants into pain management simply as a means of escaping or dumping a problematic patient”. A new study by Per Sjogren, MD and colleagues found that long term opiate use as treatment for chronic back pain is associated with inadequate pain relief, poor quality of life, long-term unemployment, and high levels of medical care-seeking.

In 1994, the U.S. Public Health Service’s Agency for Health Care Policy & Research conducted a thorough investigation into acute low back pain and concluded in its Patient Guide that, “Even having a lot of back pain does not by itself mean you need surgery. Surgery has been found to be helpful in only 1 in 100 cases of low back problems. In some people, surgery can even cause more problems”. Furthermore, studies have shown that many people with no pain or other symptoms often have some sort of disc problem that shows up on an MRI scan. Dr. Raj Rao, director of spine surgery at the Medical College of Wisconsin, says “You can look at MRI’s of two people, both showing degenerative discs, but in one case there is little to no pain, while in the other, extreme pain. On the other hand, you can see a healthy spine but the patient has severe pain”.

For example, a study published in 2010 revealed data over a two year span from 85,000 Blue Cross Blue Shield beneficiaries with low back pain in Tennessee. The patients had open access to MD’s and DC’s through self referral, and there were no limits applied to the number of visits allowed and no differences in co-pays. Results showed that paid costs for episodes of care initiated by a chiropractor were almost 40 percent less than care initiated through an MD. They estimated that allowing DC- initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.

Additionally, a TRICARE study found that patients are more satisfied with Chiropractic care than traditional medical care for low back pain. Dr. T.W. Meade, of the Wolfson Institute of Preventative Medicine in London, surveyed patients three years after treatment and found that “significantly more of those patients who were treated by chiropractors expressed satisfaction with their outcome at three years than those treated in hospitals: 84.7 percent vs. 65.5 percent.”

So is it time for the medical profession to back off the over treatment of back pain? Treatment with a Chiropractor has been proven to be more effective and less expensive. Insurance companies are starting to catch on that patients want an alternative to invasive spine surgery and that the benefits of Chiropractic significantly out weigh a costly spinal surgery. The future for chronic back pain suffers may be uncertain, but as new research points to the benefits of Chiropractic as the most effective treatment, we hope that more people suffering will utilize the services of Chiropractors.