Understanding Treatment Costs

One of the things that makes Olympic Spine & Sound Pain Solutions unique is the comprehensive treatment approach we take.  A central practice principal is continually updating our treatment procedures with new more effective methods. The question we regularly ask ourselves is, “What will get the best results?”. It may seem like this is stating the obvious, but all too often the question asked in healthcare is, “What will insurance pay for?”

Insurance Coverage vs. Treatment Results

What insurance pays for, and what treatment produces the best results for an individual patient can be two very different things. More and more people are deciding that they are not going to let insurance coverage dictate their healthcare choices. For many, this means that they have to re-prioritize their finances. When they consider the limitations that pain and dysfunction have placed on their lives, they decide that it is not worth the financial savings to stay in the insurance “box”. At Olympic Spine & Sound Pain Solutions, we are proud to say that we work for you, not for the insurance companies. With that being said, we do work with nearly all major medical insurances. However, almost all our patient’s treatment plans include therapies that are not covered by insurance. We want you to know upfront that you most likely will incur out-of-pocket expenses.

What to Expect When You Come to See Us

Transparency is an ideal that we carry through every step in our office. It begins with a consultation that is provided at no charge.

1. Consultation (no charge): to determine if we are likely to be able to help you.
2. Detailed examination and testing ($200 – $500): to determine if you are a candidate for treatment.
3. Report of findings (no charge): provided that you are a candidate for treatment, we will create a detailed plan outlining what treatments you need, how long it will take, and how much it will cost.

What treatment do you need?

Regarding treatment cost, of course it depends on each patient’s condition, what treatment they need, and how quickly they respond to care. If your condition is relatively simple sometimes a single type of treatment is sufficient. Chiropractic adjustments or non-invasive laser alone may do the trick.  If your condition is more complex, it is likely that a combination of therapies will be necessary to get the best results.

We create treatment plans based on the individual patient’s examination results. Different treatments are used for different findings/conditions. You can find detailed explanations of our therapies on our website. For the purpose of this explanation, here is a brief description of the procedures we use and their treatment objectives:

Comprehensive Treatment Options

• Bioelectrical therapy to reduce pain and regenerate damaged nerves
• Laser therapy to reduce inflammation and speed soft-tissue repair
• Non-Surgical decompression to reduce disc herniations
• Chiropractic adjustments to improve joint mobility
• Infrared light therapy to speed nerve and blood vessel repair
• Acoustic pressure wave therapy to heal ligaments and tendons
• Trigenics manual therapy to restore muscle balance and strength
• Functional rehabilitation to regain stability and endurance

Better Results, Faster

Having this broad scope of treatments available for our patients is unique, and a key to our exceptional success rate. To make this comprehensive treatment available requires a greater investment including advanced education, training highly skilled staff, and purchasing sophisticated medical devices. Of course, that translates to greater expense. It costs more to provide more treatment.

How Much Does it Cost?

Treatment for complex conditions like neck or back pain due to disc degeneration/herniation, peripheral neuropathy, and chronic joint pain typically require the combination of multiple therapies to get the best results. Patients most often are scheduled for visits 2 to 3 days per week for 4 to 6 weeks (a total of 12 visits) then they are re-examined. Depending on the number of therapies required, treatment costs for 12 visits for complex conditions usually range between $3000 and $6000 for out-of-pocket expense. Since this range of costs is typical for our patients, we offer payment arrangements including breaking up the cost and spreading the payments over six months. Often, patients tell us it was worth the expense many times over to find relief and regain their ability to live life the way they want to.

After the re-examination at the twelfth visit, the test findings are reviewed, and options are discussed. If the patient’s treatment goals have been met, they are discharged. If they are better, and are still improving, they may choose to continue rehabilitative treatment. Typically, this is at a reduced frequency of visits, and with a reduced number of therapies. If the patient has reached their maximum level of improvement and has some residual symptoms because they have permanent damage, supportive care is an option. The goal of supportive care is to see the patient as little as possible for them to maintain their improvement. Most often, visits 1-2 times per month will accomplish this.

How Do I Know it Will Work?

No doctor can guarantee results, but what we can do is guarantee that we will not proceed with treatment if it doesn’t work for you. To accomplish this, we use a specific treatment assessment protocol. Stated simply, our criteria are that we need to see evidence that a patient can respond to treatment in the first three visits, and we need to see progression of improvement by the sixth visit. We called these checkpoints 1 and 2.

 For checkpoint 1, the technical term is a diagnostic trial. We test objective findings like restricted motion and weakness, we apply treatment and then we retest. The doctor and the patient both need to be able to observe improvement on the post test. If three attempts are made and there is no response, the patient would be discharged from treatment and an appropriate referral would be made.

For checkpoint 2, repeat testing needs to demonstrate progression of objective improvement. Some of the gain following treatment needs to be retained from visit to visit. Additionally, the patient needs to be able to report that their condition is changing, and they are improving. If they cannot, they would be discharged from treatment and an appropriate referral would be made. Using this protocol, we can limit expense and expedite referral if other treatment is necessary. Your results are our priority!

Our Commitment to Your Results

Once we determine that a patient is a candidate for treatment, we want to make sure the treatment plan works for them in all respects. This includes finances, time, and effort.  Finances are part of the picture, but not the whole picture. Before we look at some of the other pieces, let’s look at other treatment approaches.

Spinal Surgery Statistics

According to the National Center for Health Statistics, 1.2 million spinal surgeries are performed nationally each year. The procedures that are the fastest-growing are lumbar spinal fusions that range from $60,000-$110,000 per procedure. It is not uncommon to have patients agree that those procedures are very expensive and say something like: “but my insurance will cover it.” We will look at what the out of pocket expense cost is. But before we do, there are two other concerns to factor in where surgery is concerned:

• What are the risks?
• Will it work?

Having most of the expense covered is great, but what if it doesn’t work, or worse yet, what if there are “complications”? According to a 2011 study published in the journal Spine, back surgeries have a failure rate of 74%. 

The Hidden Cost of Back Surgery

According to Dr. Scott Hodges, orthopedic spine surgeon: “less than a third of the money spent on fusions is for the procedure itself”. Back surgery patients also pay significantly for:

1. Procedures before and after surgery: visits to other doctors and therapists, tests like MRI, EMG/NCV, treatments like injections or prescription medications.
2. Time lost from work: often, patients are unable to work before surgery because of the pain. Following surgery, it’s not uncommon for patients to miss weeks or months of work during the recovery process. Low back pain is the leading cause of disability worldwide.
3. Complications and additional surgery: according to a 2017 study published in the journal Spine, one out of five patients that have spine surgery are re-hospitalized within 30 days. Nearly 60% were emergency room visits, usually for infection and unmanageable pain. Over 26% of those patients ultimately were scheduled for an additional surgical procedure.

Surgical Shortcomings

Now that we have looked at the numbers, let’s look at what a spinal surgery potentially can do for you, and what it can’t. The objective of decompression surgery is to reduce pressure on the nerves exiting from the spine. For a decompression and fusion surgery, in addition to reducing nerve pressure, one or more spinal joints are immobilized, typically using a plate and screws.

Our Stance on Surgery

It may sound like we’re against all surgery – we want to be clear that we are not. Every year, there are a handful of patients that we refer for surgery. There is a time when surgery is a patient’s best option. If there is a tumor or compression to nerves producing a loss of bowel or bladder function, surgery is likely the best solution. However, according to current research, patients that suffer from chronic low back pain should seek non-surgical treatment alternatives first. 

Surgery: All or Nothing

This brings up another problem with surgery, it’s all or nothing. You can’t “try a little of it” to see if it works for you. Once it’s done, it’s done. This also relates to our discussion about treatment costs. As explained previously, we do not continue treatment if we do not see evidence that the patient can respond to treatment in the first three visits, and that they are progressing by the sixth visit. With our conservative treatment approach, the patient is in control, visit to visit. They have the option of testing treatment with a trial phase of care, unlike surgery that is “all or nothing “.

Although we have focused on back pain, similar statements can be made for other chronic conditions like peripheral neuropathy and chronic joint pain. While surgery is not used as frequently for these conditions, the treatments that are recommended come with their own list of problems.

Chronic joint pain

Chronic joint pain is more likely to be treated with steroid injections and prescription medications for inflammation and pain. Steroid injections can dramatically reduce pain and inflammation. Unfortunately, for most chronic conditions the relief is short lived and the pain returns.

Steroid Side effects

We believe this is like what we described earlier about low back pain returning after surgery. If the underlying cause has not been corrected, history is likely to repeat itself. In addition to offering limited relief, steroid injections can have the following side effects:

• Weaken tendons and ligaments
• Suppress immune function
• Increase the risk of fracture

Peripheral neuropathy

Conventional medical treatment for peripheral neuropathy usually includes medications like Gabapentin, Lyrica, Cymbalta or opioids like Tramadol or Oxycodone. Some of the side effects for these medications are as follows:

Medication Side Effects

• Dizziness
• Blurred vision
• Constipation
• Impaired cognitive function
• Addiction

Most patients that come to us with peripheral neuropathy are looking for an alternative to these medications. The majority tell us the benefit they got from the medication wasn’t worth the price they paid with the side effects.  Additionally, one of the greatest concerns patients with peripheral neuropathy have is the progressive loss of their independent mobility. Having to rely on a cane is inconvenient, a walker has significant limitations and a wheelchair requires major lifestyle revisions.

What About The Cost of Lost Quality of Life?

The financial costs we’ve discussed are easy to add up. The loss of quality of life is far harder to calculate. What dollar value do you place on:

• Suffering from chronic pain?
• Not being able to sleep soundly?
• Straining relationships because you are irritable and on edge?
• Not being able to do the activities you enjoy?
• Not being able to participate in social/family activities?

One Patient’s Story

I would’ve written a check for $100,000 if I had known I could get this much relief I haven’t slept for more than 2 ½ to 3 hours at a time in 10 years because of the pain. I tried medication, massage therapy, chiropractic, physical therapy, and injections. I am a small business owner; my plan is to retire in five years. My concern was retiring with constant pain, being limited in what I can do, and not being able to enjoy time with my family. The treatment is expensive, but honestly, I would’ve written a check for $100,000 if I had known I could get this much relief. My life is so much better. Now I can work a full day and sleep through the night! I rode a bike 20 miles and played softball with my kids. In addition to the treatment, it’s an education. I’ve learned how to sit and move properly. I always get an explanation to my questions, not a short “move along” answer. The staff is exceptional, they’re all invested in the patient’s results.

Travis G.

Often, patients pay the highest price in these non-monetary costs. Only you can set a dollar amount on your quality of life. As the saying goes: “you can’t take it with you!” Travis is one of the thousands of patients we have helped to experience less pain, have more mobility, and reclaim activities in their life. We have helped them accomplish this without the use of drugs or surgery.

Our hope is that this information gives you a more complete picture of the true costs of treatment for chronic conditions. We believe the best treatment for a patient, is the treatment that is the safest, most effective, and most economical.  We also believe the doctor should work with the patient to determine what that treatment is on an individual basis.