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Medical Disability Advisor  >  Low Back Pain  >  Failure To Recover  see more: ACOEM - Low Back Disorders

Low Back Pain

Related Terms

  • Low Back Syndrome
  • Lumbago
  • Lumbosacral Pain

Specialists

  • Chiropractor
  • Family Practice Physician
  • Internal Medicine Physician
  • Neurologist
  • Occupational Medicine Physician
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist
  • Physical Therapist
  • Preventative Medicine Specialist
  • Rheumatologist
  • Sports Medicine Internist

Comorbid Conditions

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Factors Influencing Duration

Factors include occupation, age, and conditioning of the individual. Compliance with treatment and recommended home care will influence the duration. Any conditions affecting the spine could prolong recovery. The individual's need and ability to obtain secondary gains from the pain could lengthen disability time. Psychological assessment is crucial in cases with prolonged disability and no obvious specific spinal disorder.

Duration Trends from Reference Data

DURATION TRENDS
 ICD-9-CM: 724.2  
CasesMeanMinMaxNo Lost TimeOver 6 Months
215394602190.2%1.6%
 
  
 
Percentile:5th25thMedian75th95th
Days:6142965155
 
  
 

DURATION TRENDS
 ICD-9-CM: 724.4  
CasesMeanMinMaxNo Lost TimeOver 6 Months
34466803060.2%4.7%
 
  
 
Percentile:5th25thMedian75th95th
Days:10285491180
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

ICD-9-CM:
724.2 - Lumbago; Low Back Pain; Low Back Syndrome; Lumbalgia
724.4 - Thoracic or Lumbosacral Neuropathy and Radiculopathy, Unspecified; Radicular Syndrome of Lower Limbs
724.5 - Backache, Unspecified; Vertebrogenic (Pain) Syndrome NOS

Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Is this individual's first episode of pain, or is it recurrent?
  • Have infection and cancer been ruled out in the individual?
  • Was adequate testing done for individual to establish the diagnosis?
  • Has an MRI been obtained?
  • Have conditions with similar symptoms been ruled out?
  • Does individual's pain radiate to either leg?
  • Did individual experience a recent fall or stumble?
  • Has a second opinion been obtained from an appropriate specialist?

Regarding treatment:

  • Is individual active in physical therapy?
  • How did individual respond to conservative treatment?
  • Was it necessary for individual to have surgery?

Regarding prognosis:

  • Is individual actively participating in physical therapy and a home exercise program?
  • Has work conditioning been implemented? Was pain behavior noted during work conditioning?
  • Has a work site visit occurred to negotiate a modified-duty return-to-work compromise?
  • Has a functional capacity assessment been done to have a general idea of activity tolerances?
  • Is individual involved in any hobbies or other activities that can strain the back? If overweight, is individual enrolled and participating in a weight loss program?
  • Is individual experiencing secondary gains from low back pain?
  • Is individual experiencing stressful situations that may be intensifying his or her pain? Has a psychological assessment been obtained?

Source: Medical Disability Advisor


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