Back Pain and Falls during Incliment weather

You may want to use extra caution during snow days to prevent falls and subsequent trauma to spine and extremities. Over the last 3 days, the northeastern U.S has weathered varying amount of snow, falls, stalled vehicles and accidents were evident. in this issue, we urge all to take extra precaution with all movements to prevent falls, accidents and injuries. In the event of any traumatic injury, EZ Rehab is here to evaluate, treat and educate you on caring for your injury.
Click on the link below to learn about falls and back pain...........a free read to nurture your knowledge appetite on this issue.
http://www.ptclinic.com/pdf/294/43.pdf

Dr. Diallo

The work injury dilemma and benefit for a transitional retun to work program

The link below provide you some information on why you should consider a RTW program. So employers intersted in saving thousand and millions of dollars in employee work injury and medical benefits, a must read........


http://www.workerscompensation.com/compnewsnetwork/blogwire/simplifying_the_return_to_work.html

Occupational injury and low back pain

You may suffer incidents of back pain while at work that probably is triggered from repetitive lifting or sustained posture in poor and awkward positions. In any event, most pain triggered while at work is attributed to a work injury based on OSHA and workers compensation rules, regardless of the etiology. Thus, to prevent onset and recurrent back injuries at work, it is important that employers introduce and urge employees to perform 60 second stretches, routinely and to reverse positions of static and sustained postures. Of course you should consider and seek a consult with your doctor or therapist for instructions on proper back care and safety before triggering pain and or injury to your spine. As always, EZ Rehab is here to answer your questions and help keep you safe and healthy.

Below, please see the abstract on occupational lifting and back pain by Waj, et. al

Dr. Diallo, MPT, DPT
http://www.ezrehabsolutions.com/
Tel: 301.446.1724

Causal assessment of occupational lifting and low back pain: results of a systematic review.

Wai EK, Roffey DM, Bishop P, Kwon BK, Dagenais S.

Division of Orthopedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada. ewai@ottawahospital.on.ca

Abstract

BACKGROUND CONTEXT: Low back pain (LBP) is a disorder that commonly affects the working population, resulting in disability, health-care utilization, and a heavy socioeconomic burden. Although the etiology of LBP remains uncertain, occupational activities have been implicated. Evaluating these potentially causal relationships requires a methodologically rigorous approach. Occupational repetitive and/or heavy lifting is widely thought to be a risk factor for the development of LBP.

PURPOSE: To conduct a systematic review of the scientific literature to evaluate the causal relationship between occupational lifting and LBP.

STUDY DESIGN: Systematic review of the literature.

SAMPLE: Studies reporting an association between occupational lifting and LBP.

OUTCOME MEASURES: Numerical association between different levels of exposure to occupational lifting and the presence or severity of LBP.

METHODS: A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, OSH-ROM, gray literature (eg, reports not published in scientific journals), hand-searching occupational health journals, reference lists of included studies, and content experts. Evaluation of study quality was performed using a modified version of the Newcastle-Ottawa Scale. Levels of evidence were evaluated for specific Bradford-Hill criteria (association, dose-response, temporality, experiment, and biological plausibility).

RESULTS: This search yielded 2,766 citations, of which 35 studies met eligibility criteria and 9 were considered high methodological quality studies, including four case-controls and five prospective cohorts. Among the high-quality studies, there was conflicting evidence for association with four studies reporting significant associations and five studies reporting nonsignificant results. Two of the three studies that assessed dose-response demonstrated a nonsignificant trend. There were no significant risk estimates that demonstrated temporality. No studies were identified that satisfied the experiment criterion. Subgroup analyses identified certain types of lifting and LBP that had statistically significant results, but there were none that satisfied more than two of the Bradford-Hill criteria.

CONCLUSIONS: This review uncovered several high-quality studies examining a relationship between occupational lifting and LBP, but these studies did not consistently support any of the Bradford-Hill criteria for causality. There was moderate evidence of an association for specific types of lifting and LBP. Based on these results, it is unlikely that occupational lifting is independently causative of LBP in the populations of workers studied. Further research in specific subcategories of lifting would further clarify the presence or absence of a causal relationship.

PMID: 20494816 [PubMed - indexed for MEDLINE]

Effect of lordosis on the position of the nucleus ...[Spine (Phila Pa 1976). 1994] - PubMed Result

Effect of lordosis on the position of the nucleus ...[Spine (Phila Pa 1976). 1994] - PubMed Result

WC Handling

Here is a good information for employers to use in establishing effective relationship with their TPA to ensure effective handling of claims and ensure good communications with stakeholders.
http://blog.reduceyourworkerscomp.com/?p=39

Diagnostics and Work Injury

Three weeks ago, I evaluated a 24 year old male worker from a heavy labor construction company following a lifting injury while in a dynamic flexion and rotation position. While the patient complaint of back pain with mild spinal deviation to left, he reported no neurological nor radicular symptoms. Physical exam following history reveals muscle strain to lumbar paraspinals requiring physical therapy and possible degenerative disc without any neurolical symptoms. However, the adjuster wanted to hold off treatment Pending MRI report. Spinal MRI reveals multiple spinal disc dessications and disc bulges in all three regions of the spine.

Should third party claims administrators, persons with non medical credentials dictate treatment with authority to stop or delay recommended treatment based on pending diagnostics?

Does diagnostics lead or determine the course of treatment or should they be used as tools within the differential diagnosis process?

In my opinion, No. Because the presence of asymptomatic disc bulges does not comprise nor represent the cause of the pain. In any sample of normal adults MRI report studies, there will be a significant number of normal persons in any given population with positive asymptomatic, dessicated, and bulging disks. However, we do not treat patients without symptoms or complaint(s). As such, MRI reports help to confirm and guide treatment plans when a thorough evaluation determines that the complaint is of a direct cause to the pathology, thus a cause and effect relationship with a significant postive likelihood ratio exists.

As in the present patient, because of his high labor demand, repetitive bending, he showed multiple discs and joint degeneration throughout his spine; but because of his physique and youth, they are presently asymptomatic. What this patient needs is improvement of his dynamic posture, good lifting strategy and a proactive ongoing conditioning program. of course, he needs to gradually change his occupation to a light to moderate labor demand job from his present high labor and repetitive bending demands. Although therapy was then authorized following the result, mainwhile the patient had wasted two weeks doing absolutely nothing. Treatment was initiated and patient continue to function with less pain everyday. The patient is cautioned of positioning, lifting techniques and body mechanics.

This was an amazing observation, a significant number of asymptomatic disc bulges were seen in this young construction worker's spine. A worker with such involvement is a work liability if the worker is not matched or properly fitted to the work and encouraged to stay conditioned. Today, this worker was asked by his supervisor to work in the field even though he is supposedly on light duty. Such risks taken by employers against the doctors recommendation are of poor judgement, wrong, risky and unethical. Employers must use good judgement and good faith to protect their employees from harzardous and unsafe conditions in order to avoid risky actions when the result is catastrophic. Patients are to be allowed the necessary time to heal and must not be subjected to conditions that are harmful and in contradiction to their dctors orders and recomendations.

EZ Rehab over the years have helped significant amount of employees and employers realize a balanced process of returning the worker to the work, safely and cost-effectively. We can help, the EZ rehab process is comprehensive, fair, practical and effective.

Dr. Diallo
http://www.ezrehabsolutions.com/

The Ethical Practitioner

Following a work injury, workers, case managers, and employers contemplate a worker's ability and safety to return back to prior work. Mainwhile, the injured patient await their appontment with a physician to decide on their return to work verdict. However, the situation is usually gaurded as physicains are wary of sending a patient back to their job when they are not quite sure of the job functional description and demands. On the other hand, the patient is wary of what his employer might just be thinking and also scared of reinjuring himself. At the same time, case managers contemplate the reliability of the injury and credibility of the worker. These are varying prospectives that slows down the effectiveness of the system. Many injured patients spend significant amount of time doing absolutely nothing while waiting for the system to sort it self. When such dynamics persist and fester over a significant duration, it becomes a burden on the employee, the system and an unnecessary expense on employers.

While all involved stakeholders focus their effort to helping the injured worker, the means to get the worker back to work should be focus on the worker and the work. Most practitioners focus their attention and decision on pain rather than function, making it difficult to start focusing on functional performance. The ethical employer and practitioner will think of the most beneficial process, an effective treatment course with least consequencies to safely return the worker back to his prior work. Employers must be willing to provide modified and transitional work to bring the employee back to the work environment. It is a win-win for all stakeholders and cost effective for the employer to have workers at the work site immediately, when it is safe to do so. Also employers should grant the injured worker time to access good medical and rehab care until it is medically necessary to be discharged.

At EZ Rehab Solutions, we are committed to making this process as smooth and efficient by rightly focusing on the most effective treatment techniques with work demands and function early on in our treatment. The result is increase patient confidence, decrease fear, better conditioning and awareness of their condition to return back to work at the earliest time possible. Our patients are happy and always greateful for our comprehensive rehab program and education on preventing work injury incidents.

Dr. Diallo