ArticleSpine2019
Health Care Costs and Opioid Use Associated With High-impact Chronic Spinal Pain in the United States.
Article in Spine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 76 citations in OpenAlex.
- Skill-Based Virtual Reality Therapy in High-Impact Chronic Pain: 2-Year Follow-Up Results From a Secondary Analysis of a Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Differential treatment response to virtual reality in high-impact chronic pain: secondary analysis of a randomized trial.Scientific reports · 2025Trial
- Self-Guided Smartphone Application to Manage Chronic Musculoskeletal Pain: A Randomized, Controlled Pilot Trial.International journal of environmental research and public health · 2022Trial
- Applying an intersectional framework to characterize chronic pain disparities one year following traumatic spinal cord injury.The journal of pain · 2026Observational
- Real-world two-year durability of restorative neurostimulation for treatment of multifidus dysfunction in patients with chronic low back pain: an observational German cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Observational
- What constitutes important change in individual PROMIS-10 global health items in patients with high-impact chronic pain: a qualitative interview study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Chronic neck pain is associated with altered gait performance compared to healthy controls: Cross-sectional observations.Gait & posture · 2026Observational
- Understanding risk and protective factors for pain and healthy aging: an intersectional and resilience-based perspective.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Impact of Pain Self-Efficacy on Health Outcomes in High-Impact Chronic Pain: A Longitudinal Study.The Clinical journal of pain · 2025Article
- Combined chiropractic care and Tai Chi for chronic neck pain: A protocol for a pilot randomized trial.Contemporary clinical trials communications · 2025Article
- Article
- Association Between Opioid Use and Emergency Department Visits for Spine-Related Disorders.Journal of pain research · 2025Article
- Pain severity and opioid use in patients with spine-related diagnoses.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Restorative Neurostimulation for Patients with Mechanical Chronic Low Back Pain and Impaired Neuromuscular Control of the Lumbar Spine | A New Treatment Paradigm.Journal of pain research · 2025Review
- The relationship of PROMIS physical function scores and healthcare resource utilization in patients treated for chronic low back pain.Interventional pain medicine · 2024Article
- Bone mineral density is not associated with incident high-intensity back pain: a 10-year cohort study in men.JBMR plus · 2024Article
- Exploring the Real-Time Variability and Complexity of Sitting Patterns in Office Workers with Non-Specific Chronic Spinal Pain and Pain-Free Individuals.Sensors (Basel, Switzerland) · 2024Article
- The relationship between emotion regulation and pain catastrophizing in patients with chronic pain.Pain medicine (Malden, Mass.) · 2024Article
- Precision Rehabilitation After Neurostimulation Implantation for Multifidus Dysfunction in Nociceptive Mechanical Chronic Low Back Pain.Archives of rehabilitation research and clinical translation · 2024Article
- Healthcare resource utilization for chronic low back pain among high-utilizers.The spine journal : official journal of the North American Spine Society · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
designA descriptive analysis of secondary data.
objectiveThe aim of this study was to estimate health care costs and opioid use for those with high-impact chronic spinal (back and neck) pain. SUMMARY OF BACKGROUND DATA: The US National Pain Strategy introduced a focus on high-impact chronic pain-that is, chronic pain associated with work, social, and self-care restrictions. Chronic neck and low-back pain are common, costly, and associated with long-term opioid use. Although chronic pain is not homogenous, most estimates of its costs are averages that ignore severity (impact).
methodsWe used 2003 to 2015 Medical Expenditures Panel Survey (MEPS) data to identify individuals with chronic spinal pain, their health care expenditures, and use of opioids. We developed prediction models to identify those with high- versus moderate- and low-impact chronic spinal pain based on the variables available in MEPS.
resultsWe found that overall and spine-related health care costs, and the use and dosage of opioids increased significantly with chronic pain impact levels. Overall and spine-related annual per person health care costs for those with high-impact chronic pain ($14,661 SE: $814; and $5979 SE: $471, respectively) were more than double that of those with low-impact, but still clinically significant, chronic pain ($6371 SE: $557; and $2300 SE: $328). Those with high-impact chronic spinal pain also use spine-related opioids at a rate almost four times that of those with low-impact pain (48.4% vs. 12.4%), and on average use over five times the morphine equivalent daily dose (MEDD) in mg (15.3 SE: 1.4 vs. 2.7 SE: 0.6). Opioid use and dosing increased significantly across years, but the increase in inflation-adjusted health care costs was not statistically significant.
conclusionAlthough most studies of chronic spinal pain do not differentiate participants by the impact of their chronic pain, these estimates highlight the importance of identifying chronic pain levels and focusing on those with high-impact chronic pain. LEVEL OF EVIDENCE: 3.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.