Study Finds Integrative Care Reduces Disability Due to Chronic Low Back Pain

People with chronic low back pain that keeps them sidelined from work can recover an average of four months earlier if they take part in a specific type of rehabilitation program, a new study suggests. 

According to The Times of India, researchers based in The Netherlands and Canada evaluated the effectiveness of an integrated care program in 134 patients with chronic low back pain. All patients were aged between 18 and 65 years and had been absent from work due to low back pain for almost half a year on average. 

Patients were randomly assigned to either usual care or integrated care. Integrated care consisted of adjustments to the workplace and a graded exercise program to teach patients how to move safely while increasing activity levels. The main aim of the program was to restore occupational functioning and to achieve lasting return to work for patients in their own job or similar work. 
The usual care group received normal pain treatment with usually little or no workplace involvement. 
Patients completed questionnaires at the start of the study and after three, six, nine and 12 months. Sickness absence data was collected every month. 
Over the 12-month study period, patients who received integrated care returned to sustainable work after an average of 88 days compared with 208 days for patients receiving usual care, an average reduction of 120 days. 
After one year patients in the integrated care group also reportedly improved significantly more on functional status compared to patients in the usual care group. No statistically significant differences in pain improvement were found between the two groups. (workersxzcompxzkit)
The integrated care program was reported to reduce substantially disability due to chronic low back pain in both working and private life, according to the authors. 

Author Robert Elliott
executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers' Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: or 860-553-6604.

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@

Chronic Pain Management Matters

In 2006,  The Center for Disease Control and Prevention (CDC) released its 30th annual report on the health status of America, “Health, United States, 2006” which found that the overall health of the nation seemed to be improving or holding steady, but highlighted one particular condition as needing further attention: pain.   

Pain is a common  and troubling condition around the world. In a 2005 European study, it was estimated that 20% of the world’s population deals with some form of chronic pain. In Europe, chronic pain accounts for over 30 billion euros in lost productivity. In 2002, an American study found common pain conditions caused 13% of workers to experience a loss of productivity over a two-week period. The estimated cost to corporate America was $61.2 billion dollars that year. In fact, pain has been such a prominent health care issue that the 106th U.S. Congress passed Title VI, Sec. 1603, of H.R. 3244, declaring the period between January 1, 2001 and December 31, 2010 the "Decade of Pain Control and Research."


 Conventional treatment  of chronic pain is time-consuming and often very expensive, particularly for those claims that continue without resolution over the course of several years. For this reason, it is important that employers and payers understand the dynamics and drivers of the costs associated with chronic pain.  By employing a focused, multi-disciplinary clinical approach very costly segments can be targeted.  It is then possible to manage effectively chronic pain from the overall costs associated with medical care and treatment as well as loss of a productive workforce.

Using evidence-based  medicine to create a plan of action for those individuals with inadequately managed chronic pain promotes the achievement of optimum results.  Medical management programs can provide information and resources to the claimant's current treating doctors, clinics and hospitals. These types of consultations with providers help achieve the following objectives:

1.     Safe, rational and effective management of the chronic pain population

2.     Maximized functionality and return to work

3.     Management of medical costs

4.     Focused and designated processes/people to reduce internal duplication of effort

5.     Document measurable results and ROI metrics


How It Works

A Chronic Pain Program, for example, uses a defined and rigorous process. After an initial eligibility assessment, a highly skilled and experienced medical team of specialty physicians and nurses reviews the medical and psychosocial aspects of each case. The team establishes a list set of customized strategies in the form of recommendations to achieve ultimately the goals and objectives for each case. The team then monitors the impact of interventions during subsequent meetings and follows the case through to timely resolution.


The key to the program  is the expertise clinical and claim professionals bring to each claim. A highly experienced staff performs the data analysis, oversight and management of the process. An expert panel of specialized pain physicians (anesthesiologists, physiatrists, orthopedists, and psychologists or psychiatrists) provides guidance. Other contracted resources such as selected, accredited pain management facilities and urine drug monitoring labs help ensure that patients are compliant with prescribed regimens. 


A Chronic Pain Program  has the power to make a sizable difference. With proven methods, resources, and expertise it can provide the support and control to help employees beat pain back and return to productivity.


Guest Authors:  Candy Raphan, RN, BSN, ARNP, MAOM and Dr Jacob Lazarovic, MD, FAAFP.  For more information contact us at 404-300-1602.

Podcast/Webcast: Claim Handling Strategies
Click Here:  Claim_Handling_Strategies/index.php 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@

Head Injuries are the most costly workers compensation claims

Head injuries are the most costly workers’ compensation claims. According to NCCI, the average incurred cost per claim for a head injury in a work-related injury is $46,898 in 2004-2005 (the most recent statistics I could find)(page 55 of National Safety Council’s 2008 Injury Statistics).

More than 5 million Americans suffer with traumatic brain injury (TBI), mostly the result of car accidents and falls — many of which are work-related. TBI is more disabling than most realized. The typical presenting symptoms are memory loss, decreased concentration, difficulty staying on task, fatigue and other, often vague complaints. Because little is seen on MRI or CT scan, symptoms seems “psychological” or even exaggerated, and it is not difficult to dismiss complaints as psychological or such a person as a symptom magnifier.

Until recently there has been no effective treatment. There is an emerging technology called EEG biofeedback, or neurofeedback that is unusually effective in helping with this very real problem. Neurofeedback looks at the brain as a bioelectric system; large neural networks firing in a coordinated manner. Problems are analogougs to the spark plugs in a car not firing properly. A “disregulation” occurs, and the brain does not function properly.

Neurofeedback helps the brain balance and self-regulate. Physiological changes are seen in the brainwaves, which are electrical recordings of the brain function analogous to an electrocardiogram (EKG), which is an electrical recording of the heart.

Neurofeedback technology has been found very effective for certain pain syndromes, ADD (as effective as Ritalin, making continued medication unnecessary), acute anxiety, and PTSD. There are also reports of effectiveness in some RSD (reflex sympathetic dystrophy).

Neurofeedback is a rapidly emerging technology. Not all neurofeedback systems and programs are equally effective even when you can find a practitioner. For further information you can contact Dr. Dubin at

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