Non-Pharmacologic Solutions for Pain Management in Workers’ Compensation – a Research Study
The Workers Compensation Research Institute (WCRI) came out with a 5th Edition Report on Interstate Variations in Dispensing of Opioids earlier this year. It examines the trends in dispensing opioids between 27 state workers’ compensation systems and notes the changes in prescribing patterns of both pain medications and non-pharmacologic pain treatments.
Although opioid dispensing to injured workers has decreased in recent years, the increase in non-opioid pain medications has not fully offset these decreases. This study by WCRI suggests that providers have switched to more comprehensive treatment protocols which involve a number of therapies and a focus on non-pharmacologic solutions.
In order to analyze these non-pharmacological services, the study looked at nonsurgical claims with more than 7 days of lost work time, between October 2015 and September 2016. The most frequent services billed and paid were:
- Physical medicine evaluations (more than 50% of claims)
- Active Physical Medicine (most frequent in all 27 states) – exercises and movements done by the injured workers such as stretching, strength training and stability training
- Passive Physical Medicine Modalities (2nd most frequent in 18 states) – such as electrical stimulation, and hot and cold therapy
- Passive Manipulations (relatively frequent in claims 24-58% range) – usually performed by a therapy provider, such as massage and chiropractic manipulations
- Interventional Pain Management (4th most frequent in pain treatment 16-27% range in claims) – include epidural procedures, facet and sacroiliac joint interventions, tripper point injections, and nerve blocks
The 27 states in the study are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. You can access the full report here.
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