While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
Growth of Managed Care
Managed care enrollment in the United States is growing at an unprecedented rate. The number of Americans enrolled in preferred provider organizations (PPOs) increased by more than 32 percent in 1993. The number enrolled in health maintenance organizations (HMOs) increased by over 9 percent.
HMOs
1992 -- 38.8 million enrollees
1993 -- 42.3 million enrollees
PPOs
1992 -- 58 million eligible enrollees
1993 -- 76.6 million eligible enrollees
SOURCE: 1. InterStudy
2. American Association of PPOs