title: Economic burden of back and neck pain: effect of a neuropathic component.
abstract: This was a retrospective database analysis (2001-2009) of employees' medical, prescription drug, and absence costs and days from sick leave, short- and long-term disability, and workers' compensation. Employees with an ICD-9 diagnostic code for back or neck pain and an ICD-9 for a back- or neck-related neuropathic condition (eg, myelopathy, compression of the spinal cord, neuritis, radiculitis) or radiculopathy were considered to have nociceptive back or neck pain with a neuropathic component. Employees with an ICD-9 for back pain or neck pain and no ICD-9 for a back- or neck-related neuropathic condition or radiculopathy were defined to have nociceptive back or neck pain. Patients with nociceptive back or neck pain with a neuropathic component were classified as having or not having prior nociceptive pain. Annual costs (medical and prescription drug costs and absence costs) and days from sick leave, short- and long-term disability, and workers' compensation were evaluated. Mean annual total costs were highest ($8512) for nociceptive pain with a neuropathic component with prior nociceptive pain (n=9162 employees), $7126 for nociceptive pain with a neuropathic component with no prior nociceptive pain (n=5172), $5574 for nociceptive pain only (n=35,347), and $3017 for control employees with no back or neck pain diagnosis (n=226,683). Medical, short-term disability, and prescription drugs yielded the highest incremental costs compared to controls. Mean total absence days/year were 8.26, 7.86, 5.70, and 3.44, respectively. The economic burden of back pain or neck pain is increased when associated with a neuropathic component.
authors.affiliation: 1 Human Capital Management Services, Inc. , Cheyenne, Wyoming.
authors.forename: Nathan
authors.initials: N
authors.lastname: Kleinman
authors.forename: Aarti A
authors.initials: AA
authors.lastname: Patel
authors.forename: Carmela
authors.initials: C
authors.lastname: Benson
authors.forename: Alex
authors.initials: A
authors.lastname: Macario
authors.forename: Myoung
authors.initials: M
authors.lastname: Kim
authors.forename: David M
authors.initials: DM
authors.lastname: Biondi
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001416:Back Pain / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D015897:Comorbidity; D017281:Cost of Illness; D016208:Databases, Factual; D004526:Efficiency; D004651:Employment; D005260:Female; D005102:Health Expenditures; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D019547:Neck Pain / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D009437:Neuralgia / Q000191:economics*; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics; D014481:United States
chemical_list: D000700:Analgesics