Articles Posted in Medical News

Regardless of whether we are seeing an injured worker suffering from a trauma to his or her arm, leg, neck, back, shoulder or any other part of the body, the common thing we are seeing is pain. Often, this is a chronic, unrelenting, pain. These are usually the cases when surgery either has been attempted and has not been successful, or when the doctors do not feel surgery would relieve the pain. Frequently, the only way to even take the edge off this excruciating pain is by taking pain-relieving medications, often narcotics.

One of the more “popular” narcotic medications used in Pennsylvania workers’ compensation matters is OxyCodone (OxyContin). The manufacturer of OxyContin, Purdue Pharma, has recently developed three new dosage strengths. These three new dosage levels now make a total of seven dosage strengths of OxyContin. In theory, this makes prescribing the proper dosage for every injured worker much easier.

With more usage of OxyCodone, and OxyContin, comes more abuse. Unfortunately for those injured workers who actually need this type of pain medication for relief, many people are using such drugs recreationally. Purdue Pharma has attempted to change the type of the OxyContin tablet, to make it less “useful” for recreational use, but so far, the FDA has not approved the changes. According to this article, there were 42.2 million prescriptions written last year for Oxycodone.

It seems like such a basic thing. An injured worker goes to the doctor and gets a prescription. Big deal, right? What is there to think about? Well, maybe it isn’t so simple after all. Maybe there are some questions an injured worker should be asking when getting a prescription. When I came across this article, I started thinking that some of these ideas make a great deal of sense. The article seemed like a valuable resource to both my injured clients and the general public. I guess you could sum up some of these hints by reminding yourself to know what medication you are taking, why you are taking it, how to take it and how your body reacts to the medication. I would suggest anyone getting a prescription filled review this article.

Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS) is a horrible condition we see all too often resulting from work injuries. This condition can develop from a traumatic work injury, even what previously seemed to be a relatively minor one. Scientists still do not seem to know why RSD or CRPS develops.

The hallmark symptom of RSD or CRPS is unrelenting, often burning, pain. This character of pain, called “neuropathic” pain, is caused by irritation of the nerves in the affected area. Frequently, there are also changes in the skin or fingernails of the area as well (known as “trophic” changes). Sadly, there is no cure for RSD or CRPS, and doctors simply try to manage the symptoms of the patient as best they can.

Research is continuing in this area, and there are some promising things on the horizon. A recent study, led by local RSD/CRPS specialist Dr. Robert Schwartzman, found that the drug ketamine, given in an anesthetic dosage, may relieve pain in RSD/CRPS patients who have failed with other treatments. Administration of ketamine while the patient is placed in a five-day coma has been successfully performed in other countries, but has not been approved as yet in the United States. Obviously, in the workers’ comp setting, treatment not approved by the FDA probably does not need to be paid for by the PA workers’ compensation insurance carrier.

Though the reasons for the dramatic increase are not clear, it appears total knee replacements and total hip replacements are much more frequent now than in the past. According to an article on the American Medical Association website, total knee replacements increased 63% from just 1997 to 2004. Over that some period, total hip replacements were up 48%.

One of the potential reasons for the striking increase is the trend of the population to generally be both older and heavier, putting greater strain on these joints. Better technology in performing the total joint replacements has also been said to have increased the frequency with which the procedures are recommended by doctors.

From the perspective of patients, the total knee replacement or total hip replacement may appear to be a safer long-term way to treat their chronic pain than continued use of medications. This is especially true given the controversy, and apparent side effects, of the class of medications including Vioxx, Bextra and Celebrex, known as Cox-2 Inhibitors. An increase in the amount of advertising by the manufacturers of the artificial joints may also make patients more interested in having the total joint replacements done

Though workers’ compensation insurance companies routinely deny that carpal tunnel syndrome is caused by work activities, a recent article suggests that about half of all cases of carpal tunnel syndrome are, in fact, related to work activities. According to the article, Carpal Tunnel Syndrome Treatment, approximately two million people in the United States suffer from carpal tunnel syndrome. An estimated 260,000 surgeries are performed each year to address the condition.

“Carpal tunnel syndrome . . . tends to affect people more frequently who use their hands excessively, such as pianists, concert violinists, hairdressers, computer operators, manual laborers, artists, sculptors, dentists, and even neurosurgeons,” says James R. Bean, MD, American Association of Neurological Surgeons president-elect.

One of the common injuries we see in workers’ compensation cases is to the neck. A recent study published on Spineuniverse, a website dealing with neck and back pain suggests that acupuncture relieves neck pain as well as injection therapy does, without the use of any medication. Unfortunately, though, neither of these methods seems to work for even half of patients. According to the study, 43.6% of acupuncture patients described themselves as being at least satisfied with their treatment, as compared to 41.3% of injection patients. Since surgery is a last resort, acupuncture can at least be considered as an option to relieve neck pain.