Low back pain is a constant companion for many workers compensation injured workers with a serious low back or lumbar injury. Neurogenic or mechanical lumbar, or cervical, pain too often become a problem for injured workers. In general, pain is the primary reason 75 percent of patients seek emergency treatment in hospitals and urgent care centers.
Any pain can be quickly covered with opioids — Percocet and Vicodin pills; intravenous morphine and Dilaudid. The risks of these painkillers are well known. Doctors feel opioid drugs cannot be completely replaced as they provide immediate needed relief in traumatic emergencies such as a broken bone jutting through skin or a bad burn.
Some hospitals have been using opioids only as a last resort. For patients with common types of acute pain — migraines, kidney stones, sciatica, fractures — doctors first try alternative regimens that include nonnarcotic infusions and injections, ultrasound guided nerve blocks, laughing gas, even “energy healing” and a wandering harpist. St. Joseph’s ER in Patterson, NJ has taken the pain alternative efforts to a new level.
As noted in a recent 6/10/16 New York Times article, “St. Joe’s is on the leading edge,” said Dr. Lewis S. Nelson, a professor of emergency medicine at New York University School of Medicine, who sat on a panel that recommended recent opioid guidelines for the Centers for Disease Control and Prevention. “But that involved a commitment to changing their entire culture.”
St. Joseph’s Hospital is trying to change a culture of pain control where opioids are the first option, an attitude held not only by medical professionals, but by patients too.
In order to fight pain medication addiction, it is what happens after patients leave the ER that is most important. Upon ER discharge, patients are often given opioid prescriptions with instructions to follow up for treatment and any medication refills with their primary care doctors. Most pain patients never become dependent, but some do. Although emergency physicians write only 5 percent of opioid prescriptions, it is the starting point on a patient’s path to opioid addiction but it is also the pinch point where most problems can be stopped before they become a problem.
McCormick Law Office in Milwaukee, Wisconsin represents injured workers with significant low back pain and neck work-related injuries. We fight to get our clients the necessary treatment they need under the Wisconsin worker’s compensation rules. Everything we do is consistent with our client’s goals of returning to their preinjury status in medical and vocational terms, free of pain medication if possible. The first step in solving any problem is recognizing it. Fortunately, pain medication problems are much less than they were five or 10 years ago.