New medical guidelines on back pain say stay active

This could be bad news for workers' comp back injury claims

The epidemic of opioid addiction has caused the medical community to re-think how lower back pain is treated. Rather than prescribing narcotics and bed rest, a growing number of physicians now advise patients to stay active and forego painkillers.

This "grin and bear it" approach represents a major change in the treatment of back ailments. It could also lead to serious conflicts in workers' compensation claims. Employees with disabling back injuries may be denied medical treatment or forced back to work.

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Doctors shifting on treatment of lower back pain

The standard treatment for lower back pain has been to alleviate the symptoms: painkillers, muscle relaxants, anti-inflammatory aids and lots of rest. The unfortunate side effect has been a sharp increase in patients becoming addicted to prescription pain medications such as oxycodone.

Many doctors are now advising the opposite. They say that the quickest and safest path to recovery from back pain is to stay active and go without the pain pills. The American College of Physicians issued new guidelines that advise against prescription narcotics (or even over-the-counter painkillers) as the first recourse. They say that most back injuries will heal on their own in a matter of weeks - and that it may not be necessary to see a doctor at all.

Short-term back pain vs. serious back injury

When you hurt your back at work, there is no way of knowing whether you will heal in a week or a month or a year. Failing to report a back injury to your employer or failing to seek medical attention could undermine your workers' compensation rights. The employer and insurer can challenge whether your injury is work-related. They can challenge your claim for medical benefits or disability pay.

It may be true that minor back injuries heal on their own, and that yoga and other exercise is better than bed rest. But these new medical guidelines work against people with serious back injuries.

  • Insurers may resist paying for prescription medications, surgery and even physical therapy, especially if doctors are telling patients to tough it out.
  • More employees will likely be forced to submit to independent medical exams (IMEs).
  • A herniated disc or severe back strain will not heal from the "walk it off" approach. In fact, staying active and returning to work could cause further injury - maybe permanent damage.

Get medical and legal help

You have to protect your body and your ability to earn a living. If you are in major pain from a work-related accident, the best recourse is to see a doctor - and perhaps get a second opinion. If you get any pushback from the employer or insurance company, contact a workers' compensation attorney who has experience with back injury claims.

Source:  Lower back pain? Be active and wait it out, new guidelines say. (New York Times)

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