Work Injury Solutions and Leadership Forum

Work Injury Solutions and Leadership Forum: Acute Low back Pain

2011-02-01T10:12:00.000-05:00

Work Injury Solutions and Leadership Forum: Acute Low back Pain: "A must read information for caring for your back. Click below on the link, learn how to care for your back in acute back pain. http://www.pt..."

Acute Low back Pain

2011-02-01T09:35:00.000-05:00

A must read information for caring for your back. Click below on the link, learn how to care for your back in acute back pain.
http://www.ptclinic.com/pdf/294/12.pdf

Back Pain and Falls during Incliment weather

2011-01-28T12:04:00.000-05:00

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

2011-01-24T12:16:00.000-05:00

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

2010-09-29T12:55:00.002-04:00

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

2009-09-15T12:25:00.000-04:00

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

WC Handling

2009-07-13T09:59:00.001-04:00

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

2009-06-08T23:28:00.006-04:00

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

2009-06-07T20:46:00.004-04:00

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

Managing Risk at Work

2008-12-14T16:29:00.000-05:00

A friend recently called me on her experience at a local Maryland hospital, supposedly noted to be excellent and customer friendly. After she explained her experience at the hospital ER, where she was seen for over 7 hours for blood work and IV fluid administration; I was uphauled as to the experience she reported and what caregivers perceive when they see patients. That gets me to think and raise the question to our forum members and guest, What do you see when you approach your clients in your various field of work? Why companies fail? How did we allow our ER quality care to fall bismally in this country with the highest cost in the world? Why are CEO's and managers failing their organization? What changes do we need to make at the personal, professional and corporate level to alter this direction?
My issue is that many good people may need to stop surviving and sacrifice some to position themselves in areas of passion to ease the process to their calling. Many of us are just coping and surviving in jobs just to earn a living and never materialize to meet the daily expectations, demands and uphold necessary values and rules that defines the job. Therefore, performance become substandard, customer relations are poor, and organizations struggle meeting benchmarks because of poor and underperformed employees. Suffice to say, my friend experience at this hospital was very unsatisfactory in all performance measures ranging from admissions to nursing, tech support, physician services and medical care.
My contention is that we can do better if we start thinking as to the reasons for our organizational existence, vision, act compassionately, show humility and develop confidence, respect for our clients, respect yourself and your chosen profession. In a time of economical hardship were organizations are closing doors and handing out pink slips, I hope we all begin to take the role we play in our various field of work seriously; become an asset to your organization and save yourself from the first in line to be handed the pink slip or sued for negligence, descrimination and malpractice. Start by taking things a little seriously, give 125% to your job and ask for more responsibility, treat your clients as you would like to be treated and be compassionate; remember you are paid at the end of every two weeks as a commitment to stay in line with company vision and policies. And so, see others as person's with need, someone in need of your service, someone as important because they are and so are you.
Of course, you know I have to do my rightly civil, community and personal duty to drop a letter to the CEO of that hospital as a warning for a stormy weather in their future in the shadow of poorly and unsatisfactory care standard, insurance fraud, patient negligence and malpractice; simply because the organization and its employees failed to deliver at the minimum standard of care expected and promise to their clients. Part of managing risk is that every employee and manager develop the awareness of what their role is, what is expected of them and avoid going outside of corporate policies and procedures.

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

The Employee Responsibility

2008-12-01T21:12:00.003-05:00

According to compnewsnetwork, employees have a responsibility in a workers compensation program to promote efficient and effective program management. The following 10 responsibilities are highly recommended,

Employees must participate in the program as follows:

1- Know what to do if you are injured on the job
2- Sign an acknowledgement of these responsibilities
3- Seek medical care from the employers medical provider (or their own primary treating physician as allowed by law)
4- Keep the employer informed and updated of their condition/status
5- Complete forms required by the employer truthfully.
6- Attend weekly meetings to keep the employer informed of their condition and any obstacles to return to work full duty
7- Participate in transitional duty (this must be a condition of employment).
8- Attend all medical and rehabilitation appointments.
9- Return to work in either transitional duty or full duty as soon as medically able.
10- Other tasks as required by the employer and allowable by law

Each state is different.
For more cost savings tips go to WC Cost Reduction Tips.Show the REAL cost of workers comp with the Real Cost Calculator.Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Imailto:Info@WorkersCompKit.com

Dr. Diallo
www.ezrehabsolutions.com

Work Injuries Among Nurses: Review of Prevalence

2008-11-04T18:23:00.001-05:00

Employers will best serve their organizations by investing in preventative programs and processes to curtail the incidence and prevalence of MSDs as a result of either traumatic and or repetitive work injuries. Reviews of several research studies conducted by international and national authors, showed compelling associations and correlations of work related injuries among nurses working in various settings and shifts.

M. Shayesteh Azar et. al emphasized the magnitude of LBP among nurses, citing lifting as a primary injury mechanism with prolonged standing and rest as been aggravating and relieving factors, respectively. The impression is that repetitive lifting and poor lifting training and mechanics probably needed to be studied more elaborately to specify cause and effect relationship. Also, Hasnat Alamgir, et. al, cited full time direct patient care occupations as having a greater risk for work injury compared to part-time and casual health care workers, suggesting an apparent need to evaluate work demands and work hours. The functional issues of significance here is addressing the work capacity demands and the worker relationship in order to identify stressors and improve safety as a mean to proactively prevent injuries. As emphasized by Shoko Ando et. al, focusing on associated perceptions of job demands and MSDs among hospital nurses, suggested a likely association with actual work tasks , postures, condition of work and work organization. Also, Yassi A et. al, dissecting through epidemiological research on back injury in hospital nurses, suggested an increased prevalence among young and Junior level nurses working in orthopedic, neurology, medicine, spinal and surgery wards with lifting and patient transfers reported to be highest risk mechanisms, and inadequate training and staffing as risk factors. As health care system evolves, a positive correlations with neck, shoulder and back injury complaints are shown, suggesting a revisit to current health care changes to reduce adverse impact on the health of workers. In summary, the volume of evidence in regards to matching the work to the worker is compelling in realizing an effective work injury prevention and management program. It is clear that work injury is evident in routine work without a management process that comprises of an education, ergonomic and functional testing components. The key is for the employer to implement a process with both employee's and management ownership and active participation in a vision of a safe working environment.

As employers begin to realize the impact of health care and workers compensation costs to the organization bottom-line, it is compelling the outstanding adverse effect of an uncontrolled and poorly managed cost on growth, and profit at a crucial time of global economical slow-down. However, organization's still have an opportunity to reevaluate their system and implement a process to promote health, wellness and safety at the work place.

Dr. Diallo, PT, DPT

The Reality

2008-10-31T21:48:00.005-04:00

Basically, every business organization is formed to answer the call to a market need, a value, and desire, be it for profit or non for profit. As such, making profit is the key to organization survival, development and existence. Therefore, every aspect of a business, HR, Finance, Accounting, Marketing and Sales, Management, labor, collections and safety collaborate to effectively produce and realize a corporate vision, goals and objectives, periodically(quarterly and annual benchmarks). When corporations become callus and risk safety without an implemented effective, and adequate process for RTW, the effect is a negative consequence on net financial bottom-line, an idea contrary to the strategic management plan for growth and profitability. Corporations can avoid such expense and dent to bottom-line financials by implementing effective risk management process to prevent and immediately follow up with injured workers by promoting a direction toward excellence in necessary medical and rehab care, open communications, benefits, testing and through effective and efficient process implementations to prevent and monitor work injuries and unhealthy employee risk habits with rehab that address functional deficits within a comprehensive return to work focus plan of care. These are possible and necessary to industrial survival and profitability during these crucial economical and business slow-down. It is high time that corporations and industries reevaluate their business culture and risks as a means to manage spending and improve productivity as sales a not evident to continue to soar as in the 1990s and early 2000.

Ibrahima

Key Points

Policies and procedures for management of injuries

Safety personnel and preventative training

Development of functional tests, Job Descriptions and functional tests

Early effective and efficient medical-rehab interventions as appropriate

Early functional testing and job placement, lift or full duty

Onsite training, early intervention, stretching and Ergonomics

When the above steps and process are employed, small and large corporations can successfully, realize opportunities to save and a cost effective return on their investment from both direct and indirect costs from loss time work, wages, and medical -rehab expenses.

Dr. Diallo
www.ezrehabsolutions.com

Where Do We Start

2008-10-29T20:55:00.001-04:00

The steps below is an introduction of EZ Rehab Solutions complex and perplexing work injury paradoxes. It is grounded on fair, objective functional testing with excellent job specificity and relatedness with a legal validation process to bring cost savings investment opportunities to employers worker's compensation cost by using effective leadership tools combined with preventative measures. The objective is to have employers focus resources at the heart of the problem where a difference can be realized by prevention and controlling wastes from medical-legal abuse, poor and substandard medical-rehab care from incompetent providers; the lack of an effective RTW program, and bad ineffective case management. Employers can realize significant control and cost savings from worker's comp direct and indirect costs (usually 3-4x of direct cost), using a very simple process.

Develop and implement effective return to work process

proactive and Benevolent

Fair and Objective

quantifiable and Job Related

tested and validated

Implement ongoing preventative education programs

Body Mechanics training and Ergonomic consultation

Post offer screens

Contract On site services for ongoing safety monitoring and Early intervention

On site Rehab intervention for sprain, strains and repetitive injuries

Functional testing and job modification, job matching programs

On site rehab and work conditioning program

On site stretch program

Further info can be found at http://www.ezrehabsolutions.com/

For info on exercise, on site training and work injury refer to

www.biomedcentral.com/1471-2474/8/9

Dr. Diallo, PT,DPT

www.ezrehabsolutions.com

A visit to a PT clinic: A lift injury

2008-10-27T21:34:00.000-04:00

I had the pleasure of meeting Mr. Y 2 months ago for his first PT visit following a back injury sustained during an attempt to lift a 30 pound box from floor to center to be placed on his desk. Mr. Y is a 56 year old male police officer with 30 year of service track with the metropolitan police department. He reported pain to his lower left quarter of his back shooting down his leg which he rated as a 8 on a 0-10 pain scale with complaint of burning and numbness along the posterior L thigh. He is concerned that the pain has worsen since the onset, one week before his evaluation and he continued to work on light duty, sitting at a desk which is not his preference but was grateful for the opportunity to be around his job.

A thorough and comprehensive evaluation was completed with a targeted plan of care to address Mr. Y's pain, functional deficits and employment demands and abilities. Mr. Y's pain was typical of discogenic pain with a sciatic radicular component. Following the evaluation, Mr Y was given complete information of his injury, and the expected management and prognosis with instruction on appropriate exercises to reverse his injury. Mr. Y was seen at 3x/week x 4weeks with specific instructions on progressive exercises, McKenzie derangement training focus, to restore spinal lordosis and centralize symptoms; then graded stabilization exercises to develop the core spinal and abdominal muscles while introducing function and abilities necessary to return to full time police work ensued in a systematic progression.

Mr. Y met his goals and happily returned to his normal work within five weeks without waste, abuse, loss time and indemnity cost to the police department and the tax payers of his city.

In my opinion, the success of Mr. Y's case is that the system worked because the key players did the necessary steps to supervise and direct the process with accountability and communications at all levels. Employers have the choice to play fairly and be accountable by developing and implementing a process that works. When a process is in place, employers will realize great savings and positive response from injured workers with significant return to work percentage. Employers must also make it a priority to invest in programs to prevent work injuries and realize ultimate savings from work-comp direct and indirect costs.

For more info visit http://www.ezrehabsolutions.com/

or comment as appropriate

Ibrahima

The Work Injury Problem

2008-10-26T23:01:00.002-04:00

Everyday, injuries with minor and major catastrophe's are reported costing the system and employers at large, in the excess of ------ billions, from profits drained from the net income of small and large U.S businesses, government and municipalities. While most of the cost are usually computed to include the cost of direct cost of medical, rehab lost wages, and indemnities; a significant aspect of work injury expenses are normally indirect costs to the employer from lost time, light duty, rehire and training of a temporary worker, low work morale and decrease productivity. While most work injury cases are valid and required medical attention; a significant number of cases are mismanaged for lack of a comprehensive process. Most employers in good faith invest in programs to manage their work injury cases. However, a substantial amount of programs are reactionary and lack comprehensiveness, leadership, effective policies and procedures to have the impact other than keeping up with paper trail.

The problem lies in the disconnect with key players that are necessary to drive the system as part of the organization culture; a way the organization does business. Until it is openly accepted from top to bottom and nurtured with priority, giving it life to live on, a program is considered to be reactionary and ineffective.

Organizations should be rest assured that a simple cost effective investment on such a process is tantamount to an ounce of prevention; an invaluable measure for companies with high turn over rates and aging population with moderate physical demand jobs. Why not?
Dr. Diallo, PT,DPT
www.ezrehabsolutions.com

Back Pain-The employer cost

2008-10-24T21:40:00.001-04:00

On a daily basis, I have the pleasure of treating workers from all backgrounds with complaint of low back pain from an injury sustained while at work. It is apparent that a substantial amount of the cohort of injured workers are confused and uninformed of a process and their entitlement under the law either because of a lack of work injury management process or uneducated of a process already in place. Most back pain injuries are minor musculo-skeletal disorders that are not effectively managed or allowed to fester for over prolonged periods due to unnecessary red taping and poor communication amongst key players.

Empirically, a significant number of work injury associated low back pain complaints involves soft tissue sprain and or strains from lifting, reaching out of one's base of support while lifting, combined twists with a bend, falls and or whiplash acquired disorders. Mostly, the complaints are of mild to moderate localized pain described as ache, throbs, spasm, and usually without a neurological component. Also, in severe cases, neurological observations are noted with radicular symptoms to the extremities, unilaterally or bilaterally with complaint of numbness, burning, spasms that is influenced by movement; signifying a disc involvement, nerve entrapment, vertebral displacement, and or instability. It is not unusual that prior existing condition may have been present and or exacerbated. Appropriate and comprehensive diagnostics may be necessary and indicated to effectively complete the differential diagnosis process and determine the appropriate level and course of care.

It is suffice to note that early intervention in work injury cases is primary and an effective process already in place will assure the right course of treatment. It is important to note that a process that is focus on early return to work goals will assure effective goal oriented medical and rehab care, open communications amongst key players to discourage abuse and over utilization, may not be overemphasized.

Employers that implement a validated return to work programs will have the advantage over those lacking such a program, the assurance of increase job morale, and a decrease in indemnity costs, direct and indirect costs to the employer. At a time when the bottom line is in the red (company profits) for most companies, it is crucial that self insured organizations assess all expenses to keep their boat afloat. Why not?

Dr. Diallo, Pt, DPT