How to Get Employees Back to Work Quickly

By Dr. John R. Anderson, DO, FACOEM Chief Medical Officer | 04/21/2016

Nearly two million American workers per year suffer from Musculoskeletal disorders (MSD), with 600,000 experiencing lost time from work. Direct cost estimates run from $15 to $20 billion, with total MSD-related costs (such as lost production and employee replacement costs) averaging $45 to $54 billion annually. One out of three work injury claims in 2011 were caused by musculoskeletal disorders (MSDs).

Some of the most common musculoskeletal work-related disorders are lower-back pain, tennis elbow, carpal tunnel syndrome, plantar fasciitis, rotator cuff strains, and hamstring injuries. While the costs for these conditions vary, indemnity and other indirect costs often cost more than direct medical care. In recent years, new evidence has emerged supporting a change in the way we treat injured workers reduced use of pain medication, injections, and imaging therapy instead of surgery. This aggressive, evidence-based treatment is designed to minimize disability and prepare the worker to return to work. Concentra calls this this an early intervention and integrated care model.

An early intervention model consists of 4 parts:

1. Functionally-Based Treatment

Our functionally-based treatment helps the patient grow stronger and take an active role in their own recovery. Our clinicians use therapeutic exercise that helps a patient build strength, improve balance and coordination, increase flexibility, stimulate the cardiovascular system, and relieve musculoskeletal stiffness, fatigue and pain. Evidence supports MSD recovery strategies that encourage workers to participate in the strengthening, conditioning, and neuromuscular activities. 

2. Communication and Collaboration

Successful recovery requires collaboration between therapist, physician, payor, and patient. The ability to work together and ensure quality MSD outcomes for each patient is achieved with this close communication and team approach. Regular communication lets the therapist adjust care to changes in patient status, expedite changes to work restrictions as workers show functional improvement, and enhance opportunity to discuss concerns or issues with the course of care. 

3. Early Intervention

Muscle atrophy and nerve changes can begin within 24 hours of injury. The goal of early intervention is to prevent these changes by beginning treatment as early as possible. This will help decrease case duration and increase patient healing. 

4. Patient Empowerment 

A positive first experience with the therapist will motivate the patient and create a healing attitude that’s been shown to shorten rehabilitation time. Regular communication between said therapist and the referring clinician on a weekly basis, instead of waiting until the patient completes the full course of therapy, is very important. This helps to build a partnership between the patient and therapist that focuses on collaborative goals and expectations.
 
By utilizing therapy to treat MSDs early in the course of care, outcomes, costs, and patient satisfaction can be improved more effectively than with a ‘wait and see’ approach. Collaboration between the medical and therapy personnel is key to optimizing early referral to therapy. Concentra is focused on getting patients back-to-work in an effective and safe manner. 

 

References

  1. Hebert L. The Injured Worker. APTA Current Concepts Module. 2013 https://www.orthopt.org/store.php?USER_LEVEL=4&type=2
  2. Centers for Disease Control and Prevention Website 2013
  3. Bureau of Labor Standards: incidence and costs of MSD. http://www.bls.gov/news.release/osh2.nr0.htm. Accessed February 6, 2013.
  4. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences [review]. J Bone Joint Surg Am. 2006;88(suppl 2): 21-24.
  5. Bureau of Labor Statistics http://www.bls.gov/news.release/pdf/osh2.pdf
  6. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences [review]. J Bone Joint Surg Am. 2006;88(suppl 2): 21-24.
  7.  Bureau of Labor Statistics http://www.bls.gov/news.release/pdf/osh2.pdf 6. Kromer, T. O., de Bie, R. A., & Bastiaenen, C. H. (2014). Effectiveness of physiotherapy and costs in patients with clinical signs of shoulder impingement syndrome: One-year follow-up of a randomized controlled trial. Journal of rehabilitation medicine, 46(10), 1029-1036.
  8. Wand B., et al. Early Intervention for the Management of Acute Low Back Pain: A Single-Blind Randomized Controlled Trial of Biopsychosocial Education, Manual Therapy, and Exercise. Spine 2004; 29: 2350-2356. Accessed from: http://journals.lww.com/spinejournal/Abstract/2004/11010/Early_Intervention_ for_the_Management_of_Acute_Low.3.aspx
  9. Linz, D. H., Shepherd, C. D., Ford, L. F., Ringley, L. L., Klekamp, J., & Duncan, J. M. (2002). Effectiveness of occupational medicine center-based physical therapy. Journal of occupational and environmental medicine, 44(1), 48-53.