Treatment Guidelines Help Reduce Amount of Services Used for Low Back Injuries: WRCI

By Sheena Harrison

Sep. 6, 2012

Medical treatment guidelines can help reduce the amount of medical services used for lower back injuries, but produce mixed results for helping to treat other types of injuries, according to the Workers Compensation Research Institute.

In a report released September 5, Cambridge, Massachusetts-based WCRI studied Texas medical treatment guidelines that were implemented by the state in 2007. The study looked at how the guidelines affected workers with injuries of the upper back, lower back, neck, knee and shoulders.

WCRI found that medical guidelines decreased the number of surgeries for all of injuries studied, including a 9.3 percent reduction in surgeries for shoulder injuries.

Lower back injuries saw decreased utilization for several types of treatment, including physical medicine, chiropractic manipulation, radiology and injections.

However, some injuries experienced increased medical utilization under the Texas medical treatment guidelines, WCRI said. For instance, the report showed a 9.7 percent increase in physical medicine treatments received by workers with neck and upper back injuries, and a 10.6 percent increase in MRIs and CT scans for workers with shoulder injuries.

Injured workers with knee injuries saw a 3.1 percent increase in the number of physical medicine treatments. There was also a 4.4 percent increase in workers with knee injuries who needed more than 12 physical medicine visits in the nine months after their injury.

“A consequence of these findings might be that it is too simplistic to expect that a set of treatment guidelines has a common effect across all injury groups,” the report reads. “Rather, it is more likely that, for a given set of treatment guidelines, the impact on the medical and lost time outcomes will be different across injury groups.”

Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management. To comment, email

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Sheena Harrison writes for Business Insurance, a sister publication of Workforce Management.

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