Return to Work – Back Problems, Back Solutions – Back to the Basics

By Bob Cogburn, Vocational Rehabilitation Specialist

By Bob Cogburn,
Vocational Rehabilitation Specialist

In a CDC study, 47.5 million U.S. adults (21.8%) reported having a disability. Arthritis or rheumatism are the most common disabilities, and back or spine problems run a close second.

The older we get, the more susceptible we are to back injuries. With more Americans delaying retirement, well, you get the idea.

As disability managers, what do we do when a 50-something employee submits a back claim? I certainly don’t have all the answers, but here are three tips I’ve found helpful: 1. Understand the likely course of treatment. 2. Learn to anticipate return-to-work opportunities. 3. Manage the injured worker’s expectations.

Most back pain is caused by soft tissue strain. At an older age, just a minor twisting motion can over-stretch a low-back muscle, and there you go! Fortunately, back pain originating in soft tissue responds well to conservative, nonsurgical treatment.

Look for the treating doctor to start with non-steroidal, anti-inflammatory medications, like ibuprofen. Then, expect heat or cold therapy to increase circulation and reduce swelling.

Physical therapy (PT) will likely be part of the treatment mix. It’s good for stretching muscle groups and preventing spasms. The PT specialist will usually introduce specific exercises to strengthen weak back muscles. This is when we can get a modified duty release and allow PT trips while continuing employment – no problem!

Your vocational case manager can spot the good progress, such as lifting going from 20 lbs to 45 lbs during PT sessions. Then, he or she will update the treating doctor. The next thing you know, we have a work release, and we’re off to the races.

Many back patients, especially older ones, have minimal experience with fitness training. That may be why they hurt their backs in the first place. People respond to different methods of treatment with different motivation.  Some respond well to “sports medicine,” while others plead for chronic pain management, or both.  It is critical that we manage the injured worker’s expectations.

In other words, do not promise to get them pain-free and back to their pre-injury condition. If you do, you’re setting them up for failure and yourself up for a large-loss claim.

On the other hand, if you, your employee and vocational case manager establish a new level of functioning, of learning to cope with limitations and discomfort, you’re on your way to successful RTW. Keep the emphasis on functional capacity instead of symptomatic complaints.

There’s more to learn about back pain. Let’s talk!

About the author

Bob Cogburn has nearly 25 years’ experience in vocational case management. Since 1997, he has been helping injured workers covered by a Texas Mutual policy rehabilitate and return to productive employment. Prior to joining Texas Mutual, Bob served as a vocational rehabilitation counselor for the Department of Assistive Rehabilitation Services. He also spent time as a job placement counselor for Goodwill Industries and El Centro College. At El Centro, he managed a job club specializing in placing students with disabilities back into the workplace. Bob holds a bachelor’s in rehabilitation science from the University of Texas Health Science Center and a master’s in counseling from Amberton University.

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