TUESDAY, Feb. 12 (HealthDay News) -- Americans are spending more money trying to ease back and neck pain, but new research suggests those extra dollars aren't buying more relief.

The increased expenditures were expected, said the authors of a study in the Feb. 13 issue of the Journal of the American Medical Association, but the lack of results weren't.

"This calls into question whether we're providing treatments to people who aren't going to benefit," said study author Brook Martin, a research scientist in the department of orthopedics and sports medicine at the University of Washington, in Seattle. "This calls for a need for more effectiveness studies and looking at which patients would benefit from treatments and diagnostic tests."

"Spine problems are the most common reason why people of middle age have pain and disability, and we need to continue to search for better solutions because, although we have come up with newer techniques of treatments, we still have a large percentage of the of population with spine problems who are still disabled," added Dr. Andrew Sherman, head of medical rehabilitation at the Spine Institute at the University of Miami Miller School of Medicine.

That said, Sherman continued, "just because [the study authors] did not find improvement over the entire group doesn't mean that many individuals are not deriving benefit from treatment. There are many individual patients who do see improvements."

According to background information in the article, 26 percent of U.S. adults in 2002 reported lower back pain, and 14 percent reported neck pain during the previous three months.

Low back pain alone accounted for about 2 percent of all doctor's office visits, exceeded only by routine exams, hypertension and diabetes. At the same time, there have been increases in the rates of imaging, injections, use of opiates and surgery all related to spine pain.

But have these expenditures resulted in any actual improvements for the patient?

The authors sought to answer this question using data from the Medical Expenditure Panel Survey, which sampled individuals around the nation aged 17 and older from 1997 to 2005.

In 1997, 23,045 individuals were sampled, including 3,139 who reported spine problems. At this time, medical costs for those with spine problems was $4,695 compared with just $2,731 for those without spine problems.

In 2005, the survey included 22,258 respondents, including 3,187 with self-reported spine problems. Medical expenditures for those with spine problems was now $6,096 versus $3,516 for those without back and neck problems.

During that period, expenditures increased 65 percent from 1997 to 2005 for those with spine problems, which was more than for overall health expenditures during the same time period. There was only a small increase in the estimated number of U.S. adults with spine problems.

The estimated proportion of people with self-reported physical disabilities resulting from spine problems also increased, from 20.7 percent to 24.7 percent.

Most of the cost difference came from outpatient and inpatient services, with a smaller proportion accounted for by prescription medicines. However, the percentage of expenditures related to prescription medications went up more rapidly than expenses for other services.

"That includes a 423 percent increase in expenditures related to narcotic analgesics over that time," Martin said.

In addition, "there's been a steady stream of new devices and surgical techniques and imaging methods being used over time," he pointed out. "There's also been a moderate increase in people with back problems."

The annual expenditures for spine problems are comparable to the amount spent annually on arthritis, diabetes and cancer. All of those figures are dwarfed by the enormous sums spent in this country on heart disease and stroke.

More information

The National Institute of Neurological Disorders and Stroke has more on back pain.

THURSDAY, Feb. 7 (HealthDay News) -- A gene called HLA-DRB1 that's associated with an increased risk of developing inflammatory arthritis may also increase the chances of premature death from cardiovascular disease (CVD), a British study finds.

People with rheumatoid arthritis (an autoimmune disease) tend to die younger, and largely from CVD, according to background information in the study, which looked at 1,022 people with inflammatory polyarthritis, including 751 people with rheumatoid arthritis (RA).

During the study period, 242 (24 percent) of the patients died, and CVD was the cause of death in 76 (31.4 percent) of those patients.

The researchers, led by Dr. Tracey M. Farragher at the University of Manchester, investigated whether genetic variants associated with increased risk of RA might also increase the risk of death from CVD. Their report was published in the February issue of Arthritis & Rheumatism.

They found evidence that implicates HLA-DRB1 genotypes, already associated with RA susceptibility and severity, as a predictor of premature death from CVD in patients with inflammatory arthritis.

The researchers said that, for RA patients in particular, having the shared epitope (SE) -- a group of HLA-DRB1 alleles with kindred amino acid traits -- plus anti-cyclic citrullinated peptide (anti-CCP) antibodies and being a current smoker is an especially lethal combination.

This is the first study to link the HLA-DRB1 genotypes with premature death, particularly from CVD, among people with inflammatory arthritis. Farragher said the findings "raise the possibility of a targeted strategy to prevent CVD in these patients" and reinforces the danger of smoking for people with a genetic predisposition for arthritis.

More information

The Arthritis Foundation has more about rheumatoid arthritis  .

MONDAY, Jan. 14 (HealthDay News) -- Low testosterone levels may boost the risk of fractures for men over 60, an Australian study finds.

The researchers tracked 609 men (average age 72.6) between 1989 and late 2005.

The University of Sydney researchers collected information about the men's bone mineral density, lifestyle habits, and blood levels of testosterone and estradiol (an estrogen).

During the study period, 113 men suffered low-trauma fractures (caused by a fall from standing height or lower). Of those men, 25 suffered multiple fractures.

There were a total of 149 fractures, including 55 vertebral, 27 hip, 28 rib, six wrist and 16 upper- and 17 lower-extremity fractures.

The risk of fracture was much higher among men with low testosterone levels, the team found.

Even after adjusting for a variety of potential risk factors, low blood levels of the two hormones "were associated with overall fracture risk," the study authors concluded. Fracture risk was associated "particularly with hip and non-vertebral fractures," they noted.

The findings are published in the Jan. 14 issue of the journal Archives of Internal Medicine.

"While testosterone may affect fracture risk via skeletal and non-skeletal mechanisms, the present findings suggest that measurement of [blood] testosterone provides additional clinical information for the assessment of fracture risk in elderly men," the researchers wrote.

More information

The U.S. National Institute on Aging has more about falls and fractures  .