Spine-Related Disability: Understanding the Global Burden of Disease Studies

Highlight from the 2nd Annual Spine 10 x 25 Summit: Technology Update

Understanding the global burden of spine-related disability was the focus of a recent presentation by Nicola V. Hawkinson, DNP, RN, RNFA at the 2nd Annual Spine 10 x 25 Summit: Technology Update, in Burr Ridge, IL. Dr. Hawkinson emphasized the far-reaching effects of spine-related disability. “It isn’t just the physicians and providers who are affected,” she said, “but the people who surround us in our communities every day.” For every identified back pain patient, there is a ripple of impact to their family, their employer and their community.
Assortment of keys with health related words on keytags“Who is more likely to fall into this category of spine-related disability, and how can we prevent them from getting there?” Photo Source: 123RF.com.Dr. Hawkinson reported that chronic back pain is the single leading cause of disability worldwide. It is one of the most common causes of missed work, and the second most common reason for doctor office visits. In the United States, 51 million people report having a disability, and 14 million report spine injury as the primary cause.

Direct Costs

Dr. Hawkinson differentiated between the direct and indirect costs of spine-related disability. Direct costs are easiest to calculate. Examples include surgical costs, doctor visits, rehabilitation visits, prescription costs, and days lost from work. With 65 million Americans suffering from back pain and back-related injuries, this adds up to 385 million lost work days yearly, Dr. Hawkinson reported. Back pain is the reason for 40% of absenteeism, and 20% of patients with spine pain report that they cannot continue to work. All direct costs together amount to an estimated “cost of pain” that ranges from $560-$635 billion annually.

Dr. Hawkinson emphasized a need for prevention. “We need to identify the risk factors for a particular patient population; who is more likely to fall into this category of spine-related disability, and how can we prevent them from getting there?” she queried. With social security disability pay outs at $144 billion per year, and a 43% increase in disability beneficiaries between 2003 and 2013, the costs of disability to society as a whole are steadily rising. About $40 billion of those benefits go to people with spine-related impairments; Social Security receives more disability applications for back pain than any other illness or injury.

Indirect Costs

Added to this mounting financial burden are the indirect costs, which are much harder to calculate, Dr. Hawkinson noted. As an example of an indirect cost to society, she described a father unable to fulfill coaching duties because of back pain, resulting in his community center having to hire a substitute.

Even harder to assess is the emotional impact that chronic pain and disability have on patients and families. Because of their decreased work status, loss of income, and physical pain, patients are prone to depression, stress and anxiety. They may feel worthless or hopeless, with the financial burden of medical bills only adding to the stress of lost income. The patient’s condition affects family members, with increased financial and emotional stress often resulting.

Next Steps

Dr. Hawkinson indicated that to respond to the global health crisis of spine-related disability, society must better understand the direct and indirect costs, and recognize the wider impact on families, employers and communities. Identifying the full financial and emotional impact, the risk factors, and the stakeholders will help us work toward a resolution, she noted. With 80% of the population likely to have a back problem at some point in their lives, this is a global burden that touches all of us in some way.

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Updated on: 10/28/19
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