Myth Busters: Fact vs Fiction behind most spine, muscle and joint problems

A study done in 2016 by the American Academy of Orthopedic Surgeons estimated that 126.6 million Americans (1 in 2 adults) are affected by a musculoskeletal (MSK) condition.

• MSK is the top cost driver of healthcare spending in the US, reaching an estimated $600 billion in annual treatment and lost wages.
• We spend more money on MSK than heart disease, cancer and diabetes combined!

So what is driving up these costs?? 

In the past 10 years: 

• 89% increase in spinal fusions
• 35% increase in MRI utilization
• 291% increase in spinal injections

This accounts for an overall 65% increase in total MSK spending in the last decade.

The only way that this cost can be justified is if patient outcomes associated with these procedures are also increasing at the same rate. Unfortunately, this is not the case at all. 

• Approximately 40% of MSK disorders are mis-diagnosed
• 50% reoccur within the same year
• 45% have failed conservative care

Many studies have demonstrated that surgeries, imaging, injections, and opioids do not effectively resolve spine and joint pain. While these treatment strategies can be effective for certain musculoskeletal conditions, for the majority of patients, this is not the case. 

The biggest issue that we are faced with today is the variability in treatment.  The care that many patients receive is dependent on what office they walk into. Proper patient selection for these different treatment strategies is essential for successful patient outcomes.

So, what are the real statistics behind musculoskeletal disorders?

• 92% of all spine, joint and muscle problems are mechanical. This means that they can be managed conservatively with different movement strategies that are individually tailored to your condition.
• 3% are chemically driven. These conditions often respond well to different movements and exercises, but they may also need some form of chemical help such as medications/ injections.
•  < 2% are surgical candidates. Bone fractures, tendon ruptures, spinal cord compression are all examples of when surgery is a great tool.
•  < 1% are behavioral. These conditions are central nervous system driven and often respond well to Neurostimulation, Acupuncture, Cognitive Behavioral Therapy, and certain medications.
• < 1% are Red Flags. These conditions are very rare. Examples are things such as bone tumors, cysts, spinal cord compression, etc.

Here at Lakeside Spine and Wellness all of our doctors have advanced clinical training and education in Mechanical Diagnosis and Therapy (MDT). MDT is a classification system that seeks to differentiate between mechanical and non-mechanical sources of pain and functional limitation. These symptomatic and mechanical changes are assessed using repeated end range movements and sustained positions. Why is this important? This assessment process allows our doctors the ability to identify the source of our patient’s problem within 3-4 visits. This allows our patients to feel confident in whatever treatment they receive knowing that they will have a successful outcome, whether that with us or another healthcare provider. Not only does MDT have amazing clinical results (quickly), we also teach our patients prevention techniques to reduce future occurrences of their pain.

Key things to take away from this post: 

1. Musculoskeletal issues in the US account for more spending in healthcare than any other issue. (This is mainly due to misdiagnosis, lack of quality conservative care, overuse of surgery, imaging, and joint injections.)
2. One in two adults will be affected by some sort of MSK condition in their lifetime. Most of these issues are treatable and even preventable with the right education and care. 
3. 92% of MSK issues are MECHANICAL, and when diagnosed properly, can be treated with evidence-based, ethical conservative care. 
4. MDT (McKenzie method of Mechanical Diagnosis and Therapy) is an extremely accurate form of diagnosing and treating any type of MSK condition. The doctors at Lakeside will be able to know in a few short visits if the patient can be treated with our care, and if not get them to the right place. 

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