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Companies and Employees Need Non-Surgical Care Now More than Ever, Here’s Why:

Updated: Jan 21, 2021

In a world where everything is changing, one thing that has been constant is the seemingly endless rise of healthcare associated costs in the United States. Of course we would expect costs to gradually rise over time with inflation and a growing economy, but the chart below(1) tells a story that is beyond a simple rise. This study puts into perspective how out of control healthcare associated costs have truly become in the last two decades.

If we take a closer look at what these costs are going towards, you may be surprised to see that according to a recent study by the National Business Group on Health organization, the top healthcare conditions impacting healthcare costs in 2019 were musculoskeletal related care(2). Musculoskeletal pain is pain that is reflected in the muscles, bones, joints, ligaments and nerves. If we go one step further, we would find that spine related pain like back and neck pain is the number one musculoskeletal disorder that these employees encounter. The statistics on back pain alone are staggering:

- Worldwide, back pain is the single leading cause of disability. (3)

- Back pain is the third most common reason for doctor’s office visits. (4)

- Experts estimate that up to 80% of the population will experience back pain at some point. (5)

So why does all of this matter? Back and neck pain are expensive, we get it! This is not a surprise and many are aware that back and neck pain have been plaguing our nations workforce for decades. The question of why employees and companies should care is because this particular subset of healthcare has an enormous impact on the bottom line of a company. And as a result, employees and employers are both sharing the burden of this financial pit.

You could have probably guessed by now that back pain is one of the most common reasons for missed work. When it is all said and done, back pain accounts for 264 million lost work days per year. If that number is averaged out, the result is two entire days of missed work per full-time worker in the country(6,7)! The financial impact of this when adding lost wages and associated health care costs is well over $100 billion(8,9). One-hundred billion dollars! At this point, keep two additional things in mind:

1. 264 million lost work days per year are only referring to days actually missed! It is fair to assume that the number of people that “tough it out” and show up to work anyway is at least this large. And of these people, how many do you think are less productive due to their pain? Probably a lot!

2. $100 billion is in reference to low back pain disorders only. We haven’t even added in the costs of other musculoskeletal conditions like neck, shoulder, knee, elbow, hip, etc. What would that cost be if we were able to account for all of these conditions?

Key Takeaways:

- Healthcare Costs are rising at a disproportionate rate.

- Musculoskeletal disorders are one of the largest aspects of this cost.

- Employers and employees are paying the price.

The Good News

According to a June 2018 study by Jan Hartvigsen(10),

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Of course this is great news for individuals health, but it is also great news because it presents a huge opportunity for cost savings, but only if it is managed correctly. Here’s what is meant by that:

The average cost of back surgery in the United States is $31,549. This is the end of the road and the worst case scenario for a back pain patient. If surgery was avoided but a patient relied on a year supply of opioids instead, that cost shoots down to $6,754. And what if we took it a step further and only needed to acquire an MRI of the area to safely determine the next step? Now the cost goes down to only $2,611(11). Not bad, right? Well, what if I told you that the current research doesn’t support doing any of those things first?

The average visit to a chiropractor is $65(12). Theoretically, someone could visit a chiropractor for 12 visits and still be 3 times cheaper than just the MRI. Patients should be seeing conservative health providers like doctors of chiropractic and physical therapists FIRST!

“Surgery is usually not needed and should only be tried if other therapies fail.”

-Journal of American Medical Association

This approach was tried in a 2012 study:

“Reduced odds of surgery were observed for…those whose first provider was a chiropractor. 42.7% of workers [with back injuries] who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor.”(13)

So you’re telling me that when workers saw a chiropractor first, their probability of having a $31,549 surgery went down by 41.2%? Yes, that is exactly what I’m telling you.

These results weren’t just produced in a single study either, again and again similar studies found these savings to be consistent:

“Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.”(14)

“Low back pain initiated with a doctor of chiropractic (DC) saves 20 to 40 percent on health care costs when compared with care initiated through a medical doctor (MD)”(14)

Research that is supported by the American College of Physicians, Harvard Health, and the Joint Commission, all point toward conservative care being the first step in dealing with these disorders. This type of care is safe, drug free, non-surgical, and effective (15)! There are still many hurdles left in implementing this type of care, but creating win-win situations for providers, employers, and employees alike seems well within grasp. Corporations have an opportunity to change the trajectory of healthcare costs and save thousands or maybe even millions of dollars along the way. Maybe it’s time to rethink how we handle musculoskeletal injuries.

About the Author:

Dr. Michael Hozan is a licensed chiropractic physician and the founder of Movement Clinic: Spine & Sports Injury Center, located in Amherst, Ohio. Dr. Hozan practices using a functional approach aimed at not only decreasing pain from injuries and other conditions, but also restoring full function so that people are able to feel better and move better than ever before. If you are in the Northeast Ohio area and are looking for pain and/or injury solutions for nerve, muscle, and/or joint conditions call (440) 984-7176 or visit

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(3) Hoy D, March L, Brooks P, et al The global burden of low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases Published Online First: 24 March 2014. doi: 10.1136/annrheumdis-2013-204428

(4) Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

(5) Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin. 2007; May;25(2):353-71

(6) Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

(7) The Hidden Impact of Musculoskeletal Disorders on Americans, United State Bone and Joint Initiative, 2018.

(8) In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.

(9) Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences [review]. J Bone Joint Surg Am. 2006;88(suppl 2): 21-24.

(10) Hartvigsen J et al. Low Back Pain Series: What Low Back Pain Is and Why We Need to Pay Attention. Lancet, June 2018; Volume 391, Issue 10137; p2356-2367.



(13) Keeney et al. (2012), Spine

(14) Liliedahl et al. (2010), Journal of Manipulative and Physiological Therapeutics


Special thanks to the ACA and Modern Chiropractic Marketing, who gathered a large amount of data in this blog, Check them out at and respectively. For other providers interested in implementing this type of strategy, check out

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