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Taking the pain out of back injuries

According to a December 2006 study in the international journal, Spine, back pain results in productivity losses of $7.4 billion a year for employers. Moreover, back pain is incredibly common – studies show that 80% of people will report having back pain during their lifetimes and lower back pain is the No. 2 reason Americans visit their doctor.

While there has been much research over the past 50 years about treatment for back pain, there has not been much progress in terms of the incidence of back pain or the resulting lost time. That may be changing, according to article in HR Magazine, “Easing Back Pain” by Nancy Hatch Woodward. Woodward notes that medical treatments, new prevention approaches, and return-to-work programs are showing promise.

For some types of back pain, experts say adopting a conservative course of care produces outcomes that are as good as, if not better than more aggressive measures. The New England Journal of Medicine reports that 90% of people with acute lower back pain recover within six weeks, while two to seven percent will develop chronic pain.

Because the majority of back pain patients recover within six weeks, the National Committee for Quality Assurance (NCQA) recommends using over-the-counter inflammatory and pain-easing medications. Patrick Leary, director of external relations notes, “Doctors should not rush X-rays, computed tomography scans or surgery because less than one percent of premature imaging studies find the cause of low-back pain.” The NCQA also recommends that physicians incorporate mental health examinations, when appropriate. Addressing the behavioral health component will help increase the speed at which the patient recovers.

Furthermore, a recent study in Spine concluded that the early use of opioid medications in low back injuries might mean an increased risk for disability a year later. More than one-third of the 1843 back-injured employees studied, received an opiate prescription within the first six weeks of the injury. The study found that workers receiving opiates for more than seven days and receiving more than one opioid prescription were more likely to still be out of work one year later.

The prescription of opiates should trigger a response from the employer for early intervention to determine if there are alternatives to provide improved outcomes.

Wood notes that Fed Ex, where employees need to be able to lift 75 pounds, has found that new workers tend to have the most back problems. The company trains workers how to stretch prior to shifts, how to properly lift and how to organize their trucks to prevent back strain. In addition they have a temporary Return-to-Work program where operation managers stay in touch with injured workers to prevent the development of a “disability mentality”.

In addition, general health and wellness programs can help. Obesity and smoking can contribute to longer and more difficult episodes of illness.