Cause of Chronic Low Back Pain
Budget: $50 – $0 USD
I am a board-certified workers' comp attorney in Texas who represents doctors and injured workers but at 79 years old, would rather have someone else do the hard work!
American Airlines is in a network that does not contain a legitimate multidiscipline program that treats chronic pain. I am counsel for such a program but cannot get an out-of-network exception so they can treat one of my clients.
In any event, my case with this client is in civil court and I need an expert report covering several topics to provide to the treating doctors to give them a starting point for their own written opinions. They and I are doing this pretty much pro bono so I don't want them to have to work too hard. I did a literature search and can email the results to whoever wants to work on this project.
To provide some background, in Texas, a treating doctor will provide medical management and PT to a sprain/strain patient for three months or so. Most patients heal and go back to work. 10 to 15% do not.
The insurance carrier gets a peer reviewer to look at these cases and he opines that all back sprain/strains heal in three months and that the back pain is now caused by DDD. Then the carrier asks for a state doctor, called a designated doctor, to examine the injured worker. He or she is generally a chiropractor and he or she generally agrees with the peer reviewer and says that the injury healed and now the pain is from DDD.
The project is to write a report citing medical studies making the following points:
1. About 10% of sprain/strain patients do not heal within the expected healing time.
2. There is no necessary correlation between pain and DDD.
3. Early intervention in a multidiscipline program provides the best chance for a successful outcome.
4. There are many theories explaining why back pain becomes chronic but no good evidence that any of them is correct. One theory involves ligament subfailure, ie, that damage to the spinal ligaments, disc annulus, and facet capsules causes chronic low back pain. I like that theory.
American Airlines is in a network that does not contain a legitimate multidiscipline program that treats chronic pain. I am counsel for such a program but cannot get an out-of-network exception so they can treat one of my clients.
In any event, my case with this client is in civil court and I need an expert report covering several topics to provide to the treating doctors to give them a starting point for their own written opinions. They and I are doing this pretty much pro bono so I don't want them to have to work too hard. I did a literature search and can email the results to whoever wants to work on this project.
To provide some background, in Texas, a treating doctor will provide medical management and PT to a sprain/strain patient for three months or so. Most patients heal and go back to work. 10 to 15% do not.
The insurance carrier gets a peer reviewer to look at these cases and he opines that all back sprain/strains heal in three months and that the back pain is now caused by DDD. Then the carrier asks for a state doctor, called a designated doctor, to examine the injured worker. He or she is generally a chiropractor and he or she generally agrees with the peer reviewer and says that the injury healed and now the pain is from DDD.
The project is to write a report citing medical studies making the following points:
1. About 10% of sprain/strain patients do not heal within the expected healing time.
2. There is no necessary correlation between pain and DDD.
3. Early intervention in a multidiscipline program provides the best chance for a successful outcome.
4. There are many theories explaining why back pain becomes chronic but no good evidence that any of them is correct. One theory involves ligament subfailure, ie, that damage to the spinal ligaments, disc annulus, and facet capsules causes chronic low back pain. I like that theory.