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by Dr. David Borenstein M.D., Medically Reviewed by Dr. C.H. Weaver M.D. Updated 11/2021

Researchers at the Institute for Health Metrics and Evaluation in Seattle, Washington reviewed government budgets, insurance claims, facility records, household surveys and official US records from 1996 to 2016. They estimated the spending for 154 health conditions. Spending growth rates were calculated for each payer and health condition.

Total health care spending increased from an estimated $1.4 trillion in 1996 (13.3% of gross domestic product [GDP], $5259 per person) to an estimated $3.1 trillion in 2016(17.9% of GDP, $9655 per person). In 2016, an estimated 48% was pain by private insurance, 43% by public insurance, and 9% by out-of-pocket payments.

In 2016, among the 154 conditions, low back and neck pain had the highest amount of health care spending with an estimated $134.5 billion in spending. Most of the spending occurred with both men and women between the ages of 45 to70. Other musculoskeletal disorders accounted for the second highest amount of health care spending estimated at $129.8 billion. In this group, women outspent men from 50 to 75. Diabetes was the third most costly medical disorder at $$111.2 billion. Osteoarthritis, another common musculoskeletal condition, cost about $80billion.

These expenditures suggest that low back and neck pain are common problems that affect a wide range of individuals even though the study did not quantify the number of patients who had these problems. Low back pain is estimated to be second to the cold, the most common affliction of mankind. Colds are common and bothersome, but last for short periods of time. Most low back pain episodes resolve with a couple weeks to months. But those individuals with chronic low back pain may have pain that will last for years. These are the individuals who make back pain so expensive.



  1. Dieleman JLet al. US Health Care Spending by Payer and Health Condition, 1996-2016. JAMA 2020;323:863-884