LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

work injuries

Is Your Job Giving You Low Back Pain?

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occupational back pain
Is your job giving you back pain?

There are many factors that contribute to low back pain.  Some obvious, some not so.  But in many cases, these factors are under your control.

However, without some serious reworking of your life, you occupation is not easily changed.  But does your job contribute to your back pain?  Sometimes.

I hear it almost daily.  “If I just had a job that I didn’t have to sit all the time.”  “If I just had a job where I could sit down.”  The truth is that we are designed to be out hunting boars and gathering berries.  Not a whole lot of job openings for these positions, however.

I consider myself very lucky because my job has me up and down, sitting and standing, bending and straightening, pretty much all day long (unless I happen to be doing a blog post at my computer, of course).

There has been no real clarity in studies over the years looking for factors that predispose to the development of back pain.  Nothing can be clearly identified in a pre-employment physical that would indicate that a worker is more likely to suffer injuries.

However, there has been a consistent pattern over the studies on workman’s compensation injuries; those who are not happy with their jobs or feel unempowered are more likely to suffer an injury.  Not that anyone is faking an injury because he or she does not like his or her job; rather, this reflects the complex interplay between the mind and the body when it comes to pain.

This particular study, however, seems able to add some insight.  In it, researchers looked at 2,161 men working in various occupations across France who were followed across 5 years.  Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey.  Five years later, in the second survey of these workers, they were asked about low back pain during the previous week.

Here’s what they found:

  • 394 (30.0%) men had low back pain in the second survey.
  • Frequent forward-only bending increased the risk of low back pain by 45%.
  • Frequent forward-and-sideways bending increased the risk 213%.
  • Driving industrial vehicles increased the risk 35%.
  • Working more hours than officially planned increased risk 38%.
  • Reported low support from supervisors increased risk 35%.

Notice that psychological factors showed up on this list again (low management support and working longer hours than planned).

There are other, general factors that play a role in low back pain.  Things like smoking and a sedentary lifestyle play a role in back pain, but these are easily modifiable.  If your occupation requires any of the behaviors or movements noted above, there is going to be a challenge.

The best you can do is manage your workstation, using back posture support devices when possible or lumbar support cushions if your job requires prolonged sitting or driving.  If you happen to own a company that uses team members who have to perform these repetitive movements, it might be well worth your while to invest in an ergonomic evaluation to see if any changes can be made to the workstation to minimize your team’s risk of low back pain.

 

Chiropractic Care in the Workplace: Money Extremely Well Spent

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Employers have been getting hip on ways to increase worker productivity and jazz up the workplace.

Some have added full gyms and relaxation areas.  One large, local employer that I’m aware of now has an on-site nurse practitioner.  Overall, the addition of some level of urgent-care-ish care is becoming more and more common.  This saves the employee from having to leave work for routine visits to his or her doctor for things like ongoing prescriptions.

It also means that they don’t have to spend hours going to the doctor for urgent care stuff like sore throats, upper respiratory infections and coughs.  It works out well for everyone involved.  The employer is happy because productivity is preserved and the employee is happy because they waste less time running around to doctors’ offices.

What is notoriously, glaringly absent from these relationships is an on-site chiropractor.

Now maybe my opinion is biased (OK, OK…it’s clearly biased…), but given that the typical office or industrial worker is particularly prone to overuse injuries, it just makes sense to have a provider nearby who can most aptly handle these complaints.  And handle these complaints quickly to get the employees back to working as comfortably as possible.

It is has already been solidly shown that outside of the workplace, whether within an injured workers / worker’s compensation environment or among patients experiencing most types of musculoskeletal pain, chiropractic care is extremely cost-effective, safe and clinically effective.

In this particular study, researchers took a look at what happens when chiropractic care is offered inside of the workplace.  They looks at the claims from a single employer health plan that had employers who received chiropractic care on-site or off-site over the course of two years.  Here’s the details:

  • There were 876 on-site and 759 off-site participants.
  • The off-site group received more radiology services overall (55.5% vs 38.2%) including MRI, ultrasound, and X-rays.
  • The off-site group also had higher outpatient and ER visits.
  • The off-site group also has greater use of chiropractic care and physical therapy.

Given how darn effective chiropractic care is at already reducing imaging, outpatient visits and ER visits, to see that these numbers were EVEN less when a chiropractor was on-site gets me pretty darn excited.

If you happen to be an employer that does not yet have an on-site chiropractor (even if it was just a day or two per week) this should certainly give you cause to think that you’ve been missing an excellent opportunity to do something wonderful for your employees that is going to SAVE you money, not cost money.

So what are you waiting for??

 

Chiropractic: The Red-Headed Stepchild of Injured Workers’ Care

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chiropractic care for injured workers
Photo courtesy of https://www.flickr.com/photos/pamhule/

As a practicing chiropractor here in sunny Mesa I can tell you that seeing injured workers in my office is a rare event.

Even rarer is a patient who was injured at work who was sent in by his or her HR department to my office for care.  Almost always it is a current patient who was injured at work and wants to be seen in our office for care because they know how effective we are.

It is rare for me to get frustrated over anything, but having a representative for a patient’s workman’s comp insurance tell me “we don’t refer to chiropractors” just irks me to no end.  Even worse is an existing patient who comes in for care of a work injury and then is told, ILLEGALLY, that they can’t come into our office for care.  The worker is scared to go against his or her employer, even after assurances by us that they can see us for treatment.

Here in AZ, with a few self-funded exceptions, patients all have a right to see the provider of their choice.  They may be required to make a single visit to a provider that is chosen by the employer, but that is all they have to do.  However, once they have seen a provider twice, that provider controls all care for the course of the injury.

So the patient sees the provider that the employer requires.  That provider (which is almost always one of the two larger occupational or urgent care clinics that use PTs for treatment) then coerces the patient to come back for another visit under one pretense or another and they get them back in quick.  Frequently the next day.

The patient ends up falling into the scheme and is NEVER given his or her rights, which would be to see a chiropractor if he or she chose to.

I would just be whining and complaining in this article if it weren’t for one important fact…

It’s a very, very bad idea to NOT see a chiropractor first or at least have one on the care team as soon as possible.  Why?  Here are a few of the reasons:

  1. The alternative is far more costly.
  2. Patients take longer to get back to work and are more likely to become disabled.
  3. Medications that actually promote chronicity are more likely to be used.
  4. Patients are generally not as happy with the care they receive.

As a chiropractor one would think that I’m just being petty and biased.  But regular readers of the Rantings know that I can back up everything that I put in writing.  This is no exception.

In this particular study, researchers looked at 14,787 injured workers over the course of 8 years to evaluate care patterns for low back pain.  They identified 5 distinct patterns of care for the injured workers:

  1. Information and Advice (59% of injuries): The first 6 weeks basically consisted of information gathering or advice seeking but no overriding pattern.  This included simple office visits, laboratory tests, emergency department or hospital visits, talk therapy, or visits involving imaging (x-ray, ultrasound, CT, or MRI) but no other procedures.
  2. Complex Medical Management (2% of injuries): Included more than a single visit to a physician for nerve blocks, surgeries, or comparable procedures.  This is expensive and fragmented care and runs completely contrary to the way low back pain should be managed.
  3. Chiropractic (a paltry 11%):  Self-explanatory.  Used by the most intelligent injured workers (ok…so I made this part up).
  4. Physical therapy (11%):  Self-explanatory.
  5. Dabble (17%): Workers who had one visit to a non-chiropractic physician, chiropractic physician or PT, or at most one visit to two or more of these categories.

Overall, being good at math, it looks like 89% of the injured population were not under the care of a chiropractor.  Keep this in mind as we go through the rest of the study.  I know that here in AZ, this low percentage is likely a result of steerage by the insurance company, HR employees who do not understand how effective chiropractic care is, as well as the schemes played at the patient’s expense by other providers that treat injured workers.

After identifying the 5 patterns, researchers looked at well accepted guidelines for the treatment of low back pain that is backed up by medical research.  There were 11 guidelines that were used to evaluate the 5 treatment patterns, but here are some snippets to think about:

  • Early use of (MRI) has been linked to prolonged disability, higher medical costs, and greater use of surgery at the same time finding no benefit on health or disability outcomes for low back pain.
  • Chiropractic has been shown to lead to lower likelihood disability recurrence over non-chiropractic physicians and physical therapists.
  • In addition, chiropractic care with shorter duration (likely meaning more effective chiropractic care that seeks to get the patient better ASAP) also leads to shorter disability duration.
  • More frequent and stronger dosages opioids leads to longer claim durations.  Worse, the likelihood for a catastrophic claim (total cost of $100,000 or more) when spinal surgical procedures were performed increased 10-fold when treatment included opioid use.

It goes without saying that chiropractic care is the antithesis of opioid use.

With all this in mind, here are a few snippets from the study:

  • Care to injured workers that was in line with 10 of 11 guidelines led to lower total costs.
  • Of the five patterns, complex medical management followed the guidelines the worst in regards to imaging, surgeries, and medications as well as having the highest total costs.
  • Complex management was also linked to the highest rates of prescriptions for four of the seven drug classes—opioids, other pain medications, SSRI/SNRI/tricyclics, and anxiolytics/sedatives/hypnotics.
  • The PT group was highest in NSAIDs, muscle relaxants, and oral steroids.
  • Chiropractic care was on the opposite end of the spectrum, leading to the most alliance with accepted guidelines, lower total costs and the lowest prescription rates in all seven classes of drugs.
  • Previous treatment choices by injured workers influenced future choices for another injury.  This means that, if someone did NOT choose chiropractic care for an initial work injury, if they got injured again they were not likely to seek chiropractic care for the second episode.

There is really not much more to say.  Except that maybe all of this information is not new and is consistent with the findings from a large handful of other studies.  Hopefully you can understand my frustration with the care of injured workers here in Arizona, as well as the extreme confusion when it comes to chiropractic care being treated as the red-headed stepchild of healthcare when, in reality, we really rock when it comes to doing what we do.

By avoiding or discouraging chiropractic care for injured workers here in AZ, workers are not getting the best and most cost-efficient care possible.  That, quite frankly, is a travesty.