Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Displacement, Lumbar Intervertebral Disc Without Myelopathy


Related Terms

  • Disc Protrusion
  • Disc Rupture
  • Herniated Disc
  • Herniated Nucleus Pulposus (HNP)
  • Lumbar Disc Herniation
  • Lumbar Disc Prolapse

Differential Diagnosis

Specialists

  • Anesthesiologist
  • Neurosurgeon
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Preventive Medicine Specialist
  • Rheumatologist
  • Sports Medicine Physician

Comorbid Conditions

Factors Influencing Duration

Length of disability depends on the location and number of the affected discs, the severity of the disc disease, the nature of any neurological involvement, the presence or absence of objective sensory loss and / or muscle weakness, the duration of these neurological deficits (acute or chronic), the presence of other sources of pain (such as facet joint arthritis and mechanical instability), the type of treatment, and the individual's response to treatment. Individuals who smoke tend to have more delayed recoveries and poor outcome.

First lumbar discectomies have the best prognosis. Repeat surgeries are associated with greater disability and longer duration.

Medical Codes

ICD-9-CM:
722.10 - Lumbar Intervertebral Disc Displacement without Myelopathy; Lumbago or Sciatica Due to Displacement of Intervertebral Disc; Neuritis or Radiculitis Due to Displacement or Rupture of Lumbar Intervertebral Disc

Treatment

Based on clinical suspicion of a disc herniation, conservative treatment, which may range from simple rest to elaborate traction devices is recommended initially, except when signs of severe or progressive nerve compression (radiculopathy) are present. The individual is instructed to avoid aggravating activities such as heavy lifting, bending, twisting, or prolonged sitting. A corset may be worn during the day to provide support. For relief of pain and inflammation, treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs) and, if pain is severe, a narcotic or an anticonvulsant for its analgesic effects. Muscle relaxants are frequently prescribed for their sedative effects. Other treatments such as ice, heat, massage, and ultrasound therapy may help relieve pain and muscle spasm.

As symptoms subside, an increase in activity is recommended, including physical therapy and / or a home exercise program to strengthen the lower back and abdominal muscles and improve aerobic capacity (walking). The individual may attend "back school" to learn correct posture and body mechanics. Many individuals recover completely; however, recurrences of back pain and sciatica are common. Therefore, preventive and maintenance measures such as exercise and proper body mechanics may be continued indefinitely.

If little or no improvement is seen after 4 to 6 weeks of treatment, and if the pain is severe and debilitating, further evaluation is appropriate. If imaging studies have not yet been performed, MRI or CT/myelogram are indicated.

Individuals who have leg pain (radicular pain) as the predominant symptom may gain relief through the administration of epidural corticosteroid injections. If non-operative measures are unsuccessful in relieving the individual’s symptoms, surgery consisting of a laminectomy and disc excision or a minimally invasive disc excision, may be considered. Proper patient selection is the key to favorable surgical results, and good outcomes are more highly associated with correlation between clinical findings of radiculopathy and imaging studies. Central disc herniations generally present with low back pain and without radicular complaints; they, rarely benefit from a lumbar laminectomy and discectomy. Individuals who have persistent back pain as the predominant symptom usually do not benefit from surgery intended for disc herniation (discectomy). Individuals with chronic low back pain may benefit from a rehabilitation program, and / or pain management.

Emergent disc excision (discectomy) is indicated in the patient with cauda equina syndrome, which presents with bilateral severe leg pain, saddle anesthesia, and bowel and / or bladder incontinence. Surgery is also indicated in the individual with progressive muscle weakness; severe unilateral leg pain with objective signs of nerve root compression (nerve tension signs and / or loss of neurological function) that has not improved during an adequate trial of conservative treatment, with an imaging study that correlates with the clinical findings for nerve root compression; or recurrent episodes of severe leg pain with objective signs of nerve root compression and a matching defect on imaging studies. Microdiscectomy or minimally invasive discectomy are alternative procedures that may be done on an outpatient basis and may have shorter recovery periods. However, the indications for these procedures are the same as the indications for open laminectomy.

Source: Medical Disability Advisor



ACOEM

ACOEM's Practice Guidelines, the gold standard in effective medical treatment of occupational injuries and illnesses, are provided in this section to complement the disability duration guidelines.*
 
Low Back Disorders
 
* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before assuming an equivalence.

Source: ACOEM Practice Guidelines






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.