Is the Opioid Crisis being Fueled by Insurers’ and Employers’ Approach to Back Pain?

Although effective education, biomechanics skills training and exercise work best to reduce or eliminate lower back pain, health plans make it easier to get opioids.


At some point, 80% of adults will experience lower back pain. In addition, when someone injures their back they are 5 times more likely to suffer another back injury. Low back pain or injury is the 2nd most common reason that adults see a doctor and the most common reason for disability. It is also a microcosm of all the things that are wrong with the U.S. health care system, including its contribution to the opioid crisis.

If you or someone you know has experienced lower back pain, you know that it can be truly debilitating. People will do almost anything to rid themselves of pain. Lower back pain puts people in desperate and vulnerable positions, and it puts doctors under pressure to “Do Something Now.” This may lead to many poor and potentially devastating treatments and choices.

Among the worst is a doctors’ decision to write opioid prescriptions as a treatment for lower back pain and their patients taking these drugs. Lower back pain is one of the most common reasons for an opioid prescription, but there is no evidence that opioids are effective at treating this problem.

At best, opioids mask pain in the short term. It’s like turning up your car’s radio to drown out the horrible noises coming from under the hood while you drive. The radio might sound good, but the car’s underlying problem isn’t getting the attention it deserves and that could cause serious harm. Taking opioids for lower back pain often means the cause is being ignored.

Often when people "Do the right things" to recover from a back injury or chronic back pain, once the pain goes away, they stop doing what worked – until the pain returns or worse!

What works best for lower back pain is a combination of education, biomechanics skills training and proper exercise, not the over-prescription of opioid painkillers. Yet to this day, health plans pay for such non-evidence-based interventions like opioids and make it difficult and expensive for patients to access evidence-based interventions.

That may not make sense until you look at the reason: For the carriers that administer health insurance plans, there is far more profit in pills than education or therapy. This also explains why the three largest pharmacy benefits managers recently merged with insurance carriers.

Our entire health care system is built on a vast web of incentives that push patients down the wrong paths. And in most cases it is the entities that manage the money (insurance carriers) that benefit from doing so. They negotiate prices with health systems and pharmaceutical companies, all of which share the objective of increasing revenues, to craft and sell health plans that offer trumped up “discounts.” As long as carriers negotiate a high price with a provider or a rebate scheme with a drug maker, they can still make a sizable profit even after a 50% discount.

Have you ever wondered why an item such as a knee brace, that you could by the identical one online for $70.00 - costs $700.00 on your health care bill?

This dynamic was accelerated by the Affordable Care Act’s Medical Loss Ratio, which requires that 80% of insurance premium dollars pay for medical expenses and that carriers pocket only 20%. It doesn’t take much to see that the higher the premium, the more they make from that 20%.

By being more concerned about profits than patients, most insurance carriers’ plans are flooding our society with addictive drugs - and employers and employees are blindly buying in.

There is a better solution, and some employers have already taken action.

Accurate Ergonomics offers an education and skills training system that has been proven to prevent pain and injuries. Our integrated approach to improving employee health and preventing painful and costly injuries, engages employees at every level.

Our solutions are all your company will need to improve human and task efficiency and build a culture of prevention that will last years into the future.

In every application the results not only show a significant decline in injuries, they also show that improvements are sustainable