Skin, Joint, and Back Problems Most Common Causes of Physician Visits

physicians visits for back painA new study from the Mayo Clinic reveals that almost a quarter of visits to physicians are related to back pain, with other major concerns including skin problems and joint disorders. More than 140,000 patients in Olmstead County, Minnesota, agreed to have their medical records including in the analysis as part of the Rochester Epidemiology Project and the results offer public health officials greater insight into how medical resources are being used and how patients with back pain from spinal stenosis may be better cared for.

Classifying Disease – ICD-9 and Spinal Stenosis

It may come as a surprise for some that patients were not seen to be consulting their physician (for non-acute conditions) with concerns over diabetes, heart disease or cancer, three of the major causes of ill-health in the US. Instead, the researchers, led by Jennifer L. St. Sauver, PhD, MPH, found that almost half of the patient population (42.7%) had at least one ICD-9 code for a skin condition within the five-year study period.

The International Classification of Diseases, Ninth Revision (ICD-9) was used to categorize all the patients’ recorded ailments, with this latest edition making a distinction between symptomatic and asymptomatic spinal stenosis for improved analysis. The researchers did note, however, that some patients may have been wrongly classified or missing a classification under this system.

Top Four Reasons for Visits to the Doctor

After skin conditions, osteoarthritis and joint disorders accounted for a significant number of visits (33.6%). Back problems accounted for some 23.9% of visits, followed by lipid metabolism disorders (22.4%) and upper respiratory tract disease (22.1%). The researchers also looked at the variation in incidence between different age groups and ethnicities and found that black patients visited their physician more often for back problems than white patients (who were more likely to seek help for skin conditions).

Public Health Policy

Chronic conditions, such as spinal stenosis and back pain, account for the majority of health care costs in middle-aged and older adults but the research serves to highlight how conditions that are not major causes of disability or death (such as many skin conditions) still account for a large percentage of health care expenditure. This kind of research then allows public health officials to more effectively plan public spending and fund new initiatives, such as counselling for back pain over the phone, to reduce costs and improve patient health.

Prioritizing Health Care – Skin Problems and Back Pain

The Mayo Clinic researchers concluded, “Finding that skin and back problems are major drivers of health care utilization affirms the importance of moving beyond the commonly recognized health care priorities such as diabetes, heart disease, or cancer.” We could see a raft of new public health initiatives for back pain from conditions such as chronic spinal stenosis on the basis of this latest research.


Jennifer L. St. Sauver, David O. Warner, Barbara P. Yawn, et al, Why Patients Visit Their Doctors: Assessing the Most Prevalent Conditions in a Defined American Population, Mayo Clin Proc. 2013;88:56-67.

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