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Recognizing overuse of physical therapy can aid return to work

Posted On: Jun. 17, 2015 12:00 AM CST

Recognizing overuse of physical therapy can aid return to work

Overuse of traditional physical therapy can add to injured employees' time off work and increase medical costs, but recognizing pitfalls can help employers reduce both, according to third-party administrator and managed care services provider CorVel Corp.

A number of factors can lead to unnecessary physical therapy visits, according to “Breaking Tradition: A New Model for Physical Therapy,” published June 10 by Irvine, California-based CorVel.

More physical therapy visits don't necessarily equate to better treatment, a CorVel spokeswoman said Wednesday.

Overutilization can occur because “the same lumbar sprain injury can affect two people in entirely different ways,” so physicians don't know how many appointments to prescribe in advance.

CorVel's integrated services, which allow the company to oversee all components of patient care, make it possible to flag cases with the potential for prolonged physical therapy, the spokeswoman said.

One thing to remember is an injured worker's “inability to distinguish between objective (good) pain and subjective (bad) pain has limited the capacity in which physical therapy can be successful.” While objective pain occurs after a physical therapy session and leads to physical improvement, subjective pain is felt immediately after an injury occurs, according to “Breaking Tradition.”

Another factor, it says, is evaluation methods: Even if injured workers reach maximum medical improvement after attending 50% of their sessions, they typically aren't evaluated until completing treatment.

“It is important to have a system of communication in place between the treating physician and the physical therapist, consisting of a series of updates as the injured worker progresses toward (maximum medical improvement),” according to “Breaking Tradition.”

Lastly, treatment of pain that's not related to a worker's occupational injury can also lead to prolonged physical therapy, the publication states. When injured workers report pain, it's a physical therapist's “natural tendency is to find their patient relief,” it adds. “In many instances, this can lead to the treatment of a different body part, which is not covered under the prescribed physical therapy. While this may cause temporary relief for the injured worker, it results in additional fees for the employer and more time away from work.”