When my brother-in-law hurt his back at work, he was unable to work for several months. This, plus his treatment, was a financial hardship for him. Many of the treatments he had were expensive but didn't work. Isn't there a set process to follow for back care so you're not doing treatments that won't work?

Caring for low back pain is expensive. The people who are living with the pain frequently can't work and must end up on disability for a while or even take early retirement. In fact, this is something that adds significantly to the cost.

There are many options available to people who have low back pain. Not all treatments are appropriate for everyone and not all treatments work for everyone. While doctors may be able to tell a patient which options aren't open to him or her, a doctor may not be able to tell if a treatment will work or not. This means, while one patient may go and pay for a series of spinal manipulations and feel pain relief, the next person may go for the same treatment but not get any relief, meaning he may have to try another option.

Chronic pain, particularly low back pain, is difficult to treat as there often is something specific to target. If cost is an issue, people like your brother-in-law could research or ask the doctor which treatments are historically the most effective and what their costs are. Then, a decision could be made by looking at the possible benefit versus cost.

Simon Dagenais, DC, PhD, et al. Can cost utility evalutions inform decision making about interventions for low back pain? In The Spine Journal. No. 9. Pp. 944 to 957.

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