by Dr. Michael Pritsker, DC
When someone is in pain, all they want is to feel better. This may be why back pain treatment is estimated to become a 23-billion-dollar industry by the year 2018.
And it’s likely the reason why that number is largely driven by symptom-treating opiates and pain killers.
The problem, for individuals and the economy, is that many causes of back pain present themselves with similar symptoms. This makes it difficult and time consuming for doctors to diagnose the root cause of the pain. For example, disc herniation is a common cause of back pain, but its symptoms can be similar to spinal stenosis and degenerative disc disease.
But a study published in Arthritis Research and Therapy suggests that there may be a faster way to diagnose the cause of chronic back pain. Researchers evaluated the biochemical profile of participants with low back pain. Specifically, they studied proteins known as cytokines to determine how they affected the behavior and pain levels of participants with lower back pain.
The findings suggest that patients who experience low back pain have low-grade inflammation. Profiling circulating cytokines can help differentiate whether the pain is due to spinal stenosis, degenerative disc disease or intervertebral disc herniation.
Body mass, symptom duration and participant age were considered, and they did not appear to have any effect on the outcome.
Shortening the Window Between Pain and Treatment
When a patient first visits the doctor with complaints of back pain, they are likely to undergo a series of imaging tests in an attempt to diagnose the issue. In the meantime, many rely on prescribed or OTC pain medication for temporary symptom relief. On the other hand, if a simple blood test could shorten the time from pain to diagnosis, we can expect that treatment would also be administered in a shorter time.
Treatments vary in duration, efficacy and cost, and the appropriate course depends largely on the situation.
Spinal Decompression Therapy
Spinal decompression therapy is performed by a motorized form of mechanical traction. These machines are advertised as noninvasive alternatives to surgery. They aim to relieve low back pain by decompressing discs and improving nutrient flow into the disc.
The machine itself can cost up to $125,0000, and procedures are typically priced between $100 and $200 per visit. It may take up to 20 visits to achieve treatment goals.
Spinal Decompression Surgery
An extensive 5-year study was done to determine whether surgical or non-surgical treatments for herniated discs were more effective. Surgery was the clear winner, but inexpensive, non-surgical treatments, such as physical therapy or exercise, showed substantial improvement over time.
Research shows that spinal decompression surgery is the most effective, but still, it’s not for every patient. Some prefer not to go “under the knife” while others may see great results from less invasive treatments.
This surgery is usually covered by insurance, but if it is not, it can cost a patient between $20,000 and $50,000.
The goal of physical therapy is to offer immediate pain relief and to help condition the body to prevent further injury. There are a variety of techniques that can be characterized as passive or active. Passive treatments include deep tissue massage, electrical stimulation, hydrotherapy, and hot and cold therapy.
This treatment method is most effective over time, and the number of visits will depend on the case.
Physical therapy sessions are often covered by insurance, but the average cost is about $100 per visit.
Spinal manipulation, also referred to as an adjustment, is a treatment for herniated disc symptoms that can be performed at a chiropractor’s office. Depending on the situation, the chiropractor may also recommend manual therapy and therapeutic exercises as part of the overall treatment plan. Manipulation under anesthesia, on the other hand, must be performed at an ambulatory care center or hospital. This treatment is usually performed in one to three sessions two to four weeks apart. Chiropractic sessions can range in price from $34 to $106 per session.
Although treatments vary in cost and length, reducing the time and cost of diagnosis can have a significant impact on the effects of back pain. A quicker diagnosis can minimize healthcare costs and any reliance on short-term pain solutions.
Dr. Michael Pritsker, Doctor of Chiropractic , is a back pain specialist practicing in San Diego, California.