Why Back Pain in the Workplace is Costing You

by Jacqueline C. Cox, RN, BSN, MPA, CNHC and President/CEO of SpecialtyHealth

If the current trends continue, over 43 percent of the U.S. population will be obese—adding $344 billion to annual healthcare spending.

The trends indicate that citizens are paying more but are getting sicker. According to a report by PBS News Hour, healthcare costs will hit $3.35 trillion this year, which works out to $10,345 for every individual. Yet, it’s estimated that $2.24 trillion (70%) of the costs are spent on preventable diseases.

Lifestyle (nutrition, fitness, stress management and sleep), the foundation to prevention and good health, are only paid after someone is diagnosed with diabetes (blood sugars of 126+) or a heart attack. Patients must be morbidly obese (BMI 40+) before being approved for lifestyle coaching or gastric bypass surgery. What’s wrong with this picture?

Employers say they can’t budget for prevention programs but keep paying for chronic illnesses while health plan costs escalate! When will we stop giving lip service to prevention and start spending our healthcare dollars where they will count, on prevention? Prevention identifies health risks before someone becomes diabetic or has a heart attack.

How does healthcare of Americans affect employers?                           

Employers are faced with an increasingly aging, deconditioned and obese workforce:

  • 9% or more have diabetes, reaching epidemic level
  • 17% smoke despite the warnings of increased risk of heart & lung disease
  • 50% are sedentary
  • 63% are classified as overweight or obese BMI>30
  • 50% have insulin resistance and other metabolic conditions


Obese workers file twice as many workers compensation claims and lose 169.4 more work days, costing the employer $53,782 more for an indemnity claim. Medical claims are costing employers $43,588 more than the normal weight employee.

Back pain in the U.S.

Each year in the U.S. $2.2 trillion is spent on back pain. It’s the most expensive healthcare problem next to heart disease, type 2 diabetes (DM2) and cancer. It’s the most common reason for prescribing opioids and for a medical appointment. It’s the most expensive industrial claim, reason for disability, and musculoskeletal problem by far.

Obesity and back pain, is there a connection?  

Increased abdominal fat seen in an obese, insulin resistant person increases the load on the spine, narrowing the spinal canal and dramatically increases weight on the spine. More studies suggest there is a connection between back pain, obesity, insulin resistance, DM2, degenerative joint disease and osteoarthritis affecting the spine.

A different approach

Have we been looking at back pain in the wrong way? Are there non-surgical solutions to acute back pain?  A recent study comparing incidences of inpatient back surgery with SpecialtyHealth’s “Back on Track” Program suggest alternative treatments. Most patients recover in 90 days unless they have metabolic problems interfering with the body’s biomechanics and ability to heal.

Patients receive a neurological examination to make sure all is well, along with metabolic testing. There are no routine MRI’s, CT scans or narcotics.

The unique part of this program addresses any metabolic issues and provides the patient with structured exercises and physical therapy. Patients complete a health questionnaire and an advanced blood test to determine if they’re insulin resistant or have other metabolic issues. A team of health coaches make lifestyle change recommendations. Compared to typical treatments, the results are great. Costs are lower than fusion surgeries and the long-term outcomes are far better.

Study Results:The following are the rates of patients who underwent inpatient back surgery compared to the “Back on Track” program results:

National                     4.3%

Nevada                      5.4%

Reno, Nevada          9.95% (672 fusion surgeries 2011-2012)

Back on Track          1.37%


Isn’t it time to look at back pain treatment through a different lens?


The American Public Health Association, George C. Benjamin. NHI Survey 2014 and Chose wood, L. Casey (July 19, 2012. CDC – NIOSH science blog – Safer and Healthier at Any Age; Strategies for an aging workforce; National Institute for Occupational Safety and Health. 2012-07-25

The Duke University Study; 10,000 Duke University employees found that Body Mass Index (BMI) is the best indicator of work-related claims frequency and severity.

Study by the University of Nevada, School of Medicine and school of Public Health Bonnie Ferrara, MD and Scott Hall, MD.

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