According to a survey conducted for the Center for Disease Control, 51.5 percent of adults reported a chronic musculoskeletal condition in 2009, twice the rate of chronic heart or respiratory conditions. This issue is so pervasive it is the third most common reason that Americans seek medical attention.

A U.S. Department of Health study showed that from 1996 to 2004 managing musculoskeletal disease, including lost wages, cost an average $850 billion annually, making it the largest workers' compensation expense. For employers paying workers' compensation claims, the economic strain has reached a tipping point. How significant is this specific category of injuries? Consider:

• 80 percent of all claims under workers' compensation are musculoskeletal sprain/strain injuries, with lower back injury consuming more than 33 percent of every workers' compensation dollar.
• Back pain causes more than 314 million bed days and 187 million lost work days yearly (data from the U.S. Department of Labor, 1998 to 2005).
• Employers lose 5.9 hours of productivity per week from those suffering from musculoskeletal pain who continue to be on the job (referred to as presenteeism).

The statistics surrounding musculoskeletal injury clearly define it as the primary threat to employers' risk programs. The magnitude of this problem is related to three principal problems with the delivery of efficient, effective care: 1) Lack of reliable or precise diagnoses; 2) Ongoing use of ineffective treatment methods; 3) Poor application or emphasis of self-care and preventive strategies.

Patients, employers and insurance providers assume that the current model of care is driven by evidence-based standards that dictate treatment methods. However, the reality is that determination of treatment protocol is rarely based on a precise or reliable diagnosis as supported by the medical literature. Instead, most clinicians assign treatment based on the specific training within their medical discipline:

• Pain management physicians apply injection therapy
• Chiropractors manipulate most patients with joint pain
• Physical therapists apply general exercise and modalities
• Surgeons recommend surgery.

These inherent biases towards delivering care based upon training result in over-utilization of services, inefficient treatments, and regular recurrence of pain due to the lack of emphasis on prevention. It is the “I seek what I know, therefore I find what I seek” mentality that creates these clinical biases. In short, employers are funding an outdated system of treatment that is ineffective and costly.