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What’s the Use of Physical Therapy in a Work Comp Claim

Posted Oct 08 2010 12:00am

Many workers compensation injuries involve the .  Strains and sprains are common and sometimes result in longer claims than those who suffer fractures or tears which require surgical intervention.  The treating physicians will often use or physiotherapy to develop, maintain, or restore the body’s normal motion.

Signs that physical therapy may be in order include:

  • decreased
  • pain
  • decreased strength
  • gait disturbances

When range of motion is limited, function of the limb or joint is decreased which in turn makes it difficult for one to perform tasks in a normal fashion.  This decrease in range of motion often occurs secondary to pain.  The patient limits their motion because the motion causes pain and soon their overall range is diminished resulting in a vicious cycle.

Physical therapists specialize in working with the body’s muscle, tendons, ligaments, bones and joints.  Some therapists work with skin secondary to burns, or wounds.  Others work with breathing and lung problems secondary to respiratory issues.

A case manager typically has relationships with different therapy providers in the area and may be knowledgeable about the best facility for the particular body part or condition involved.  Therapy is typically performed in an outpatient setting for the workers compensation patient.  The physician will indicate the frequency and duration of the therapy.  The case manager stays in touch with the therapist and reviews the records to determine if the patient is compliant with therapy and making progress.

The initial visit with the therapist will be an evaluation to determine what treatment plan would be best for the individual.  Measurements are taken and pain level identified.  The treatment plan can include items for improving flexibility, endurance, strength, coordination and balance.  Other treatments are used to reduce swelling, stiffness, and pain.

The treatments by the therapist include multiple modalities.  These include items such as:

  • ultrasound
  • hot/cold packs
  • aqua therapy
  • hydrotherapy
  • electrical stimulation
  • stretching
  • walking
  • weight lifting
  • exercises

The therapist is also responsible for educating the patient.  Education is directed at proper body mechanics, avoiding re-injury, minimizing the effects of repetitive motion, etc.  Therapy a couple of times per week is not enough.  The patient must take some responsibility for their own musculoskeletal health.  Many therapists will provide the patient with a home exercise plan.

Physical therapy treatments couple with rest and medication are considered conservative care.  This conservative care is traditionally less expensive than the surgical alternative.  By educating the patient, future injury might be avoided as well.

I promote the use of formal physical therapy in my practice.  However as a case manager my job also consists of reserving resources.  I evaluate therapy on a frequent and on-going basis.  If my client fails to make progress with multiple therapy attempts, I do not continue to authorize the treatment.  Staying in touch with the patient and their therapist as well as reviewing the medical records is key to determining if additional therapy is warranted.

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