Low back pain is one of the most common conditions that sidelines the American employee—and pain medication has been a standard feature of its treatment for a long time.
That may soon change. Many doctors are suggesting new methods of dealing with low back pain and chronic pain in general that only look toward pain medications, particularly opioids, as a last resort.
According to new treatment guidelines publicized by the American College of Physicians, people should attempt non-drug treatment options early and investigate other options before resorting to either over-the-counter or prescription pain relief.
The new guidelines aim to be as non-intrusive as possible:
-- Recent pain recommends using heating pads, massage, acupuncture and spinal manipulation.
-- The first medications introduced should be non-steroidal anti-inflammatory medications, like ibuprofen, or muscle relaxants.
-- If the back pain continues for more than 12 weeks or radiates into the lower legs, more investigation is needed to determine an appropriate course of therapy.
-- Exercise, acupuncture, stress reduction techniques, yoga, biofeedback and spinal manipulation.
-- Opioid prescriptions should be used as a last resort and only after patients fully understand the risk of addiction.
In Pennsylvania, legislators are considering a bill that was prompted by the fact that workers' comp patients in Pennsylvania are prescribed opioids far more often than other patients, which added to the general concern over a national epidemic of opioid abuse, addiction and drug-related deaths. The bill would completely change how pain medication gets prescribed to those on workers' comp.
There would be a drug formulary for the workers' comp program that recommended drugs based on the Food and Drug Administration's approval status and medical evidence. It would also require authorization for certain medications. While the guidelines would include all drugs, not just opioids, it's likely that those on opioids or needing them would see the biggest effect from the changes.
Critics warn that the new approach may be taking things too far the other direction—turning prescribing medication into a "cookie cutter" approach to those on workers' comp. That could leave people in unnecessary pain simply because they fall between the cracks of the formulary or don't respond the way the medical literature says they should respond to other methods of treatment.
Are you having trouble getting treatment for your work-related back injury covered by workers' comp? An attorney can help you file an appeal.
Source: newsworks, "Pa. may change drug-prescribing guidelines for those on workers' comp," Feb. 15, 2017