Neck pain is very common and creates a heavy cost on the American health care system. It affects approximately 14% of the population yearly. Yet, the current treatment for neck pain is often uncoordinated, disorganized, and costly. Most sufferers will consult their medical doctor, receiving muscle relaxant, anti-inflammatory or pain medications, or if that fails, a referral for physical therapy or traction.
After repeated failures, frustrated chronic neck pain sufferers may turn to such alternatives as Chiropractors, Naturopaths, acupuncture, or massage. Each approach has its successes—and its failures. Researchers are beginning to look into ways to increase the patient’s health and satisfaction, while hopefully reducing costs.
Dr. Niteesh Choudhry, MD, PhD of Harvard Medical School and Dr. Arnold Milstein, MD, MPH of Mercer Health and Benefits examined the costs and benefits of the various health care approaches to treating neck pain. The full Mercer Report is attached to this article or it can be accessed at http://www.yes2chiropractic.org/files/2012/05/evidence_based_assessment.pdf.
In order to evaluate overall treatment effectiveness and costs, researchers use the Quality Adjusted Life Year (QALY) to compare outcomes. A value of 1 would be symptom-free or “perfect” health, a 0 is death, and 0.5 means moderate pain which limits some self-care abilities. The total costs of a treatment that yields an additional year of ideal health determines the cost per QALY. This incremental cost-effectiveness ratio can then be used to determine the comparative value of various treatments. Interventions with cost-effectiveness ratios below $50000 to $100000 per QALY are generally considered to be cost-effective.
Doctors Choudhry and Milstein reported in the Mercer Report that medical physician care for neck pain cost $579 (not including muscle relaxant, anti-inflammatory or pain medications) with an efficacy (QALY) of 0.77. Physiotherapy-led exercise had an efficacy of 0.79 at a cost of $952. This results in an incremental cost effectiveness ratio of $18665 (increased cost divided by increased efficacy, numbers have been rounded). This is well below the $50000 to $100000 threshold for being acceptable as cost-effective. Chiropractic care had an efficacy of 0.82 at a cost of only $277, resulting in an incremental cost effectiveness ratio of negative $6035. Not only was Chiropractic more effective, it resulted in a greatly reduced cost to achieve this effectiveness!
Because sufficiently detailed drug costs were lacking, drug expenditures were not included in the analysis. This would very likely have increased the medical costs compared to the Chiropractic costs, further increasing the cost savings seen in Chiropractic care.
Dr. J G Moellendorf, DC, ND, LCP notes, “What makes this information especially significant is that we have two highly respected medical researchers concluding that seeing a Chiropractor for neck pain is not only more effective, but less costly than other forms of treatment!”
To see just how cost efficient Chiropractic care was, Doctors Choudhry and Milstein found that by doubling the fees for Chiropractic care, the savings were only reduced from $6035 to $5995. If the costs were increased by five times, the savings would still be $5875 compared to medical care (medication costs not included). If exercise therapy was done by Chiropractors rather than by physical therapists, the 1 year costs would drop to $464, saving $114 per patient.
The Mercer Report also noted the findings of researchers Nelson, Metz, and LaBrot who observed that when Chiropractic care was utilized, there was reduced use of x-ray, MRI, CT scan, hospitalization, and surgery; resulting in substantial cost savings long term.
It was observed by the Mercer Report that nearly 50% of chronic spinal pain sufferers consult a Chiropractor for care. Chiropractic was found to be more effective than other modalities in treating neck pain. When combined with other modalities such as exercise, it was even more effective.
Unless otherwise attributed, all content is written by Kyle Johnson, DC, of Johnson Family Chiropractic of Peoria.
All images used are under Creative Commons license.
Although every effort has been made to provide an accurate description of our chiropractic care and its benefits, the information given on this website and blog is not intended to be, nor should it be interpreted as, medical advice for any condition.
If you have any questions regarding your condition, you should seek the help of Dr. Johnson in person, so that he may properly assess your condition.
This blog is provided by Johnson Family Chiropractic of Peoria, S.C., proudly located in Peoria, IL.