Collaboration and consistency: The keys to low-back pain care?


Back pain is not like a common cold. When you get the sniffles, you drink plenty of fluids, take some medicine and, before too much time passes, you’re back to feeling well again. With low-back pain, there’s a wide range of experiences — from physical therapy and education all the way up to surgeries and chronic pain treatment. So how can reliable care be provided or suitable accommodations be made when treating back pain isn’t a cut-and-dried approach?

Recently, I learned about the Inland Northwest Back Pain Collaborative in Spokane, Washington. This community of motivated members — public and private organizations, health care professionals and insurers — is getting together to come up with communitywide best practices for managing back-related pain. Best practices should lead to consistent care and lowered costs related to low back pain while increasing other positives, such as earlier return to work.

While there are opportunities for change in health care protocols, employers and disability carriers can play a role in better assisting those living with low-back pain today. The main takeaway is this: Provide assistance as early as possible because early intervention can have a major impact on an employee’s outlook and potentially lead to better outcomes for everyone involved.

Let’s break that down:

Provide assistance as early as possible …
The goal is rapid treatment and rapid recovery. Through early diagnosis and treatment, surgery may be avoided. Similarly, through early intervention in the workplace, lost productivity may be avoided. Often, by the time a disability carrier learns about a low-back pain case, it’s often far progressed — but this doesn’t have to be the case.

Everyone plays a role in being proactive; the employee sees a primary care doctor in a timely manner, the doctor makes the appropriate referrals and the employer reaches out to a disability carrier for accommodations assistance. A more preemptive approach can help decrease use of high-cost procedures, lessen the chance of an employee being prescribed narcotics and much more.

… because early intervention can have a major impact on the employee’s outlook …
Simply put, whether employees are motivated to stay at work or return to work can be greatly influenced by how they view the situation and the support they receive from their employer. As our contributor Bryant Millan has mentioned, emotional support on the job also is often necessary to eliminate setbacks, maintain expectations and promote a positive attitude.

For example, if employees with low-back pain see a physical therapist, receive assistance from a disability consultant who completes an ergonomic adjustment on their workstation and receive encouragement from the employer, they may have a more positive perspective on staying at work.

… and potentially lead to better outcomes for everyone involved.
It’s quite unfortunate, but I’ve seen situations in which an employee who starts with back pain ranked 4 on a 10-point scale will report worse pain after undergoing multiple surgeries that possibly could have been avoided. When you factor the cost of the treatment, loss of productivity at work and the decrease in income for the employee while off work, it can be a lose-lose situation for everyone. With more proactive, rapid and consistent care and accommodations, however, these unsuccessful outcomes may be avoidable.

There’s no one-size-fits-all approach to caring for back pain, but it’s promising to see a dialogue begin among organizations, providers and insurers to set a precedent for providing injured employees with rapid, appropriate and cost-efficient care so they can return to the workplace as soon as possible.

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