Whose in charge

mypainweb has allowed me to understand that I must be in charge of my chronic pain, continually searching for answers to questions like:

  • What do I need to know and do to reduce / eliminate my chronic pain?
  • Why does so much confusion and controversy exist in treating chronic pain?
  • Where do I find the effective treatments to help me return to a productive quality of life?
  • How many people out there are suffering with chronic pain; and are continuing to worsen over time despite a myriad of expensive, extensive medical interventions? It’s obvious that chronic pain is a silent epidemic. Here are a few startling statistics:
  • Lumbar fusion. It’s obvious that chronic pain is a silent epidemic. Here are a few startling statistics: Lumbar Fusions increased 500% during the last decade. In 1992 Medicare spent $75 million for lumbar fusions. That number increased to $482 million by the end of 2002  (NCBI Lumbar Spine Fusions).
  • The rate of back surgery in the United States is at least 40% higher than in any other country and is more than five times those in England and Scotland. Back surgery rates increased almost linearly with the per capita supply of orthopedic and neurosurgeons in the country (NCBI International Back Comparisons).
  • In an effort to manage chronic pain, Americans consume consuming 80% of the global opioid supply, and 99% of the global hydrocodone supply. Yet the U.S. comprises only 4.6% of the world’s population. From 1997 to 2007 retail sales for some of the strongest prescription narcotics like fentanyl, oxycodone, and methadone have increased 525%, 866%, and 1293% respectively (Therapeutic Use, Abuse, and Nonmedical use of Opioids: A Ten-Year Perspective).
  • In 1993 there were 184,000 fusions in the United States with implant device annual sales of $211 million. In 2003 there were 460,000 fusions in the United States with implant device annual sales of $2.5 billion. It is projected that in 2014 there will be 1,100,000 spine surgeries with implant device annual sales of $25 billion. The number of hospitals offering spine surgery services will likely double between 2004 and 2014 (Healthpoint Capital).
  • This increase in spine fusion surgeries along with the enormous increase in associated implant device sales has been called “the spine bubble”. It has been estimated that this spinal repair “bubble” can increase 5X and still only represent half the market (Healthpoint Capital).
  • Failed Back Surgery Syndrome (FBSS) affects close to 80,000 patients a year, as reported by the National Institute of Health (NIH/FBSS).

While the endless reporting of such data raises important questions about chronic pain, the following few reports reveal a greater concern as to a possible motive behind “Who really IS in charge of chronic pain?”:

  • Top Spine Surgeons Reap Royalties, Medicare Bounty (WSJ).
  • From 2004 to 2008, Norton Hospital in Louisville, Ky., performed the third-most spinal fusions on medicare patients in the country (WSJ).
  • Doctors Accused of Kickbacks By Whistleblower (startribune).
  • It has been reported approximately 120 neurosurgeons and orthopedic surgeons along with several distributors were accused of conspiring with a unit of Medtronic to settle claims that kickbacks were paid to docs to get the to use spinal products (unite).
  • Highest Paid U.S. Doctors Get Rich With Fusion Surgery Debunked by Studies (Bloomberg).

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