In most cases, recovery from an injury is a straightforward and relatively inexpensive process. However, in a small number of cases, the costs are extremely high. Frymoyer (1988) reported that about 5% of back pain cases accounted for about 75% of all medical costs. Similarly, the Boeing studies found that about 10% of back pain cases accounted for around 80% of the costs (Bigos, et al, 1992). We will refer to this 5% to 10% of more expensive patients as being "slow recoverers".
If we compare the medical costs for slow recoverers versus the other patients using Frymoyer's statistics, we will find that the average slow recoverer is 57 times more expensive to treat than the other patients. In some cases, this is because the slow recovery patient simply has a more complex medical condition. However, in many cases these slow recovering patients with have no objective medical findings. As far as the best objective medical tests can discern, there are no objective reasons as to why this person should be feeling pain or loss of function. Under such circumstances, there is an increased possibility that psychosocial factors are causing a delayed recovery to injury.
The role of psychological factors would seem to be as important in illness as it is in injury. The government publication New Frontiers in Behavioral Medicine, published by the National Institute of Health, gives an extensive overview of research documenting how mental health interventions offset medical costs. There is also a large body of medical studies support the notion that psychosocial factors play an important role in medical conditions. This information is reviewed elsewhere in this site:
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