Cost-Cutting News For Managing Your Employees With Back Pain or Neck Pain

December 9, 2010

As I pointed out at the end of my Nov. 23 blog, as an employer, you are no doubt suffering badly from the very high costs of care for low back and neck pain, in fact from all musculoskeletal disorders.  In the health care marketplace, you are at such a disadvantage, with very little control over your costs, primarily because no one is telling you the truth about the current state of care for these disorders.

Today, I want to cover some very cost-relevant information: things you don’t know that are costing you money, and then some very encouraging news.


  1. The so-called natural history of recovery from low back or neck pain (recovery independent or regardless of any formal care) is simply not reliable in helping your employees recover.  I will discuss this very point in greater detail in an upcoming blog.  Many studies show that 60-70% still have pain a year later, or have one or more recurrences. Recurrences often progressively worsen until episodes no longer recover and pain then becomes chronic.  That means it no longer stops; no more pain-free intervals.
  2. Conventional office evaluations and our most advanced imaging techniques do not provide a confident diagnosis in most cases of low back and neck pain. Many who are having NO pain actually have herniated and/or degenerated discs if they undergo an MRI.  MRIs can therefore actually be misleading, causing inappropriate treatment, including surgery, based on the appearance of “abnormal” discs that are not even the cause of the pain.
  3. Consequently, most clinicians choose their treatment based on their training background and favorite treatment(s), NOT on what is causing your employee’s pain.
  4. Further, there is no standard treatment for low back or neck pain.  What treatment your employee receives is determined by what office (s)he walks into, not on what is actually causing the pain.
  5. Most treatments are therefore minimally effective. Some are even detrimental, especially if they take up valuable time (weeks, even months) when your employee could be recovering with care that targets their specific disorder.
  6. A separate but strongly related issue: the current system of paying clinicians rewards them for lots of care (high volume) and not for its quality. Naturally, many clinicians select treatments that either pay well or need to be repeated.
  7. Some insurance and workers compensation plans know this information but are so focused on their own needs and bottom line, they’re reluctant, or too busy with other matters, to bring this information to their employer-customers.


  1. Using new clinical examination methods, a far more precise diagnosis can now be made for your employee that guides treatment decisions that produce highly effective, predictable recoveries.
  2. Consequently, 80-90% of back and neck pain can now fully recover inexpensively, quickly, and easily by determining the most effective treatment for each individual.
  3. These same methods also teach your employees how to prevent the next episode.  Recurrences over the next year can be reduced from 60-70% to 10%!  And that’s so predictable that some clinicians who use these methods well are “guaranteeing” their results.
  4. Even for those employees who were never initially provided the opportunity to be evaluated, if they reach the point of having spine surgery recommended and if these same evaluation methods are then introduced, three studies report that at least 50% can still be rescued from undergoing surgery, most with a quick, often fairly easy, and complete recovery.  These patients commonly state: “Why hasn’t someone shown me this before?” or “I can’t believe it’s this easy.”
  5. Rather than financially rewarding clinicians for their volume of care, rewarding clinicians’ performance greatly motivates high quality care while substantially lowering the overall cost of care.
  6. Actively addressing all these factors has been shown to save employers 50% in both their direct medical and all indirect costs.

Please visit for more detailed information and the opportunity to sit in on a live webinar specifically for employers wanting to gain control of their spending on musculoskeletal care.  I’ll be talking more about this in future blogs as well.

Dr. Ron

Ronald Donelson, MD, MS

SelfCare First, LLC
See the new patient education book: “Solving The Mystery: The Key to Rapid Recoveries for Back and Neck Pain” at


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