Articles Posted in Medical News

Several months ago, we posted a blog entry observing how diagnostic testing, MRI in particular, does not show “pain.” What can be seen on such studies are anatomical conditions which may or may not actually cause pain. We observed how this creates difficulty in litigation, such as a Pennsylvania workers’ compensation case, since an injured worker may testify that he or she suffers pain from an injury, but would be unable to “prove” it.

After the blog entry was posted, I was contacted by Dr. Donald Marks, whose company, Cognitive Engineering, LLC, maintains that they can “show” the pain an injured worker is feeling. Specifically, Dr. Marks stated, “Consider that a functional MRI can show actual activation of the pain centers of the brain, which validates/ illustrates the complaint of pain. I have published on this, and my work has supported two litigations.” You can see more about this concept on Dr. Marks’ website by clicking here.

This is a fascinating, and developing, area of medicine, which we, as attorneys who represent injured workers, will be keeping a close eye on.

Dealing with victims of work-related injuries every day, we understand that many of our clients need pain medications just to get through their days. Some of those prescriptions, however, are going to be changing, in an effort to make them safer.

Many pain medications combine an opioid, such as codeine, oxycodone or hydrocodone, with acetaminophen. In high doses, acetaminophen can cause liver damage, or even liver failure. Trying to combat these dangerous side effects, the U.S. Food & Drug Administration recently announced a limit on the amount of acetaminophen that can be used in these pain medicines (no more than 325 milligrams).

This change will be phased in over a period of three years, and no shortages of pain medicine are anticipated. Over the counter medications containing acetaminophen would not be effected by this action. If you have any questions about this action, or anything regarding the medications you take, you should always discuss such concerns with your doctor or pharmacist.

According to the American Academy of Orthopedic Surgeons, recent advances in hip replacements have made the procedure easier, and made the results last longer. All of the news is not good, however, as these advances may come with potential consequences.

Metal-on-metal hip replacements can dramatically improve a patient’s quality of life, and return an injured worker to gainful employment. Unfortunately, the metal-on-metal hip replacements can also lead to cobalt toxicity. Patients getting metal-on-metal hip replacements may require some monitoring, or testing, after the procedure, to make sure cobalt levels are not unusually elevated.

The type of hip replacement performed, and, of course, whether a patient should even get a hip replacement at all, are discussions we encourage our clients to have with their orthopedic surgeons.

As Pennsylvania Workers’ Compensation attorneys, we see a wide variety of conditions faced by injured workers, from broken arms and legs to Complex Regional Pain Syndrome and Brachial Plexopathy, and everything in between. While the conditions plaguing these injured workers vary widely, there is one constant we see in case after case – chronic pain.

All too often, we see an injured worker become addicted to prescription pain medication. Nobody wants to live in pain, and often the first thing doctors try to relieve symptoms is a pill of one type or another. Many times, as the injured worker recovers from the work injury, and the pain relents, the need for the pain medication disappears. Unfortunately, when the work injury does not get better, and the pain becomes chronic, prescription pain medication may no longer be a viable alternative.

According to a recent article on Medical News Today, there are options aside from pain medication to relieve symptoms. Advances are being made in “neurostimulators,” small devices which are implanted to help block pain impulses from reaching the brain. There is hope that these, and other advances, may lessen the need for giving medications to injured workers in chronic pain.

A recent study published in the New England Journal of Medicine, reported by the Associated Press, found that amateur athletes (and by extension, victims of work injuries in PA), who have torn the anterior cruciate ligament (ACL) in their knee, actually do better by trying to rehab the knee before trying the surgical route.

According to the article, less than half of those in the study needed the ACL surgically repaired within two years. It appears the rehabilitation, alone, was enough in those cases.

“It seems that if you start out with rehabilitation only … you have a good chance of ending up with an equally good outcome as if you had early ACL surgery,” said Richard Frobell, of Lund University Hospital in Sweden, an author of the work.

We are pleased to present a guest blog post from http://www.metropolitanmds.com regarding the use of acupuncture. We thought this may be of benefit to injured workers, who may be interested in exploring alternative areas for pain relief:

Acupuncture is one of the oldest forms of health care and treatments on the planet, but it still serves its purposes even today. Now, while inserting dozens of needles into your body doesn’t seem like the most fun way to treat ailments, acupuncture is a tried and true therapeutic practice that has helped people deal with pain for centuries.

By inserting needles into various pressure points around the body, physical pain and stress can be relieved and even treated using acupuncture. For most, it’s funny to think that sticking needles into the pain areas and pressure points of the body would be the answer, but when it comes to people who suffer from fibromyalgia and chronic fatigue syndrome, it might just be that.

“Water on the knee” is one of those phrases we hear that harkens back to years ago, like lumbago (low back pain) or causalgia (Reflex Sympathetic Dystrophy (RSD); now also known as Chronic Regional Pain Syndrome (CRPS)). Simply put, “water on the knee” is swelling (also called “effusion”) of the knee.

Like lumbago, for years people associated “water on the knee” with aging and related degenerative changes. For lack of a better term, years of wear and tear. A recent article on Medical News Today, however, points out that “water on the knee” is not just a sign of aging or degeneration.

In fact, the article states that trauma and injury can be causes of the knee problem. Interesting, doctors can study the fluid which is drained from the swollen knee, to gain some insight on the condition involved. For example, if the swelling is due to injury or trauma, there may be blood in the fluid. Bacteria in the fluid could point to infection as the source of the swelling. Some types of acids in the fluid may cause doctors to lean toward other causes, such as gout.

In representing injured workers in Pennsylvania, we frequently see hearing loss cases. Many work environments require employees in those areas to be exposed to dangerously high levels of noise. Over a period of time, this can lead to a loss in hearing.

Tinnitus, perceived usually as a “ringing” in the ear, is a condition that can be seen along with a loss of hearing. Workers’ compensation insurance carriers often allege that tinnitus, when present, is not the result of noise exposure at work, but of another cause, such as heredity.

A recent article discussed on www.medicalnewstoday.com suggests that tinnitus is far less likely to be the result of inheriting bad genes than from environmental factors, such as noise exposure at work.

Perhaps the most debilitating of conditions we see in Pennsylvania Workers’ Compensation cases are ones of Complex Regional Pain Syndrome (CRPS) [Formerly known as Reflex Sympathetic Dystrophy (RSD)]. The hallmark of this condition is severe and constant pain. Since there is no cure for CRPS/RSD, all doctors can do is try to relieve and manage the chronic pain.

An article in Medical News Today says that researchers at the Pain Research Institute have found that a low dose of intravenous immunoglobin (IVIG) can provide dramatic pain relief for around five weeks in almost half of the patients surveyed. While the research is still in progress, this certainly represents hope for the many folks inflicted with this horrible condition. Also, by understanding how this drug works on the human body, additional treatments could be developed.