Owners Manual for Injury Prevention
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About this ebook
Four million workplace injuries a year occur throughout all industries in the United States. Surprisingly, most are from common everyday circumstances that are preventable. Understanding the care and treatment of an injury is critical to prevention. The Owners Manual for Injury Prevention is an invaluable resource for patients and human resource personnel. A user friendly guide to better health.
Bruce Kaler M.D.
Over thirty years clinical experience as a physician in general practice with emphasis in urgent care, family practice, occupational and emergency medicine in both rural and urban settings. My professional experience has not been limited to medicine. I have been a business consultant, registered investment advisor, wine enthusiast and wine merchant. I contniue to practice medicine as well as write about it. I also published a medical mystery novel Turnabout by Bruce Kaler M.D. and nonfiction Owners Manual for Injury Prevention, a user friendly guide to injury management and prevention. Hope you enjoy them both.
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Owners Manual for Injury Prevention - Bruce Kaler M.D.
Introduction
I have always tried to promote healthy life choices for work and play. I believe the choices you make at home, at work and at play, all contribute to your well-being and the fitness and safety of others around you too.
My hope is this book will continue to provide helpful information for you and your family about common medical dilemmas. I want to be your partner, maintaining your health and inspiring you to reach your goals at work or play. After more than thirty years working in medicine one of my most passionate goals is to provide quality medical care while containing costs for you and your family. My professional experience has included general family practice, occupational medicine as well as emergency medicine and urgent care.
The information in this book is a primer for understanding the frequency of common medical problems that occur at work or play. With that understanding, I hope to prevent some of these injuries and facilitate your treatment, should you have an injury, by you being an active and informed participant in your care.
If a medical condition is life- or limb-threatening, or has severe wounds or amputations, patients should go to the emergency room. If the medical condition is non-life-threatening, convenient urgent care can be a less costly and faster alternative to the hospital based facility. Even if you have a family physician, they are often not available when you need to be seen. There is no need to delay unnecessarily when you can have convenient access to quality heath care. However you must make informed decisions about your medical needs. These choices start with understanding common problems and how to prevent them. Should you become injured having some background information about the problem will go a long way to insure you make better choices about your care. Being an informed participant can make a big difference in your successful recovery.
HYPERLINK \l _Contents_1
Contents
HYPERLINK \l _Introduction_1
Introduction
HYPERLINK \l BackInjury
Back Injury
HYPERLINK \l NeckInjury
Neck Injury
HYPERLINK \l HeadInjury
Head Injury
HYPERLINK \l ShoulderInjury
Shoulder Injury
HYPERLINK \l ElbowInjury
Elbow Injury
HYPERLINK \l CarpalTunnelSyndrome
Carpal Tunnel Syndrome
HYPERLINK \l TraumaticHandInjury
Traumatic Hand Injury
HYPERLINK \l AnkleInjury
Ankle Injury
HYPERLINK \l KneeInjury
Knee Injury
HYPERLINK \l FootInjury
Foot Injury
HYPERLINK \l EyeProtection
Eye Protection
HYPERLINK \l HearingConservation
Hearing Conservation
HYPERLINK \l _Ergonomics_1
Ergonomics
HYPERLINK \l DynamicStretching
Dynamic Stretching
HYPERLINK \l LadderSafety
Ladder Safety
HYPERLINK \l LawnmowerSafety
Lawnmower Safety
HYPERLINK \l RespiratorUse
Respirator use
HYPERLINK \l MRSAInfection
MRSA Infection Control
HYPERLINK \l SleepApnea
Sleep Apnea
HYPERLINK \l DeepVeinThrombosis
Deep Vein Thrombosis
HYPERLINK \l _Hernia_1
Hernia
HYPERLINK \l _Allergies_1
Allergies
HYPERLINK \l SunProtection
Sun Protection
HYPERLINK \l ContactDermatitis
Contact Dermatitis
HYPERLINK \l _Burns_1
Burns
HYPERLINK \l StressManagement
Stress Management
Back Injury
Back strain is one of the most common injuries in the workplace or home. Most acute back strains that seek medical advice get better in 12 weeks or less. Nonetheless, some are a great deal more problematic. Health care expenses of $20 billion dollars a year in the United States are for the treatment of back injuries. When the associated loss of productivity and other indirect costs are considered, the total expense may be in excess of $50 billion annually. Since 90% of adults will likely experience a back injury some time in their life, the basis for cost reduction lies in understanding how these injuries happen. Prompt treatment and emphasis on injury prevention is a win-win investment with huge dividends for everyone involved.
Understanding a little about your back can help protect it from injury. Muscular strains of the back account for most causes of back pain. Separating common muscular strain from more important causes of back pain involving the discs, pinched nerve or other musculoskeletal diseases can be difficult. If your pain does not subside with over the counter ibuprofen, rest and icing in a few days, you should consult your health care provider for further evaluation. Sometimes their expertise and additional imaging studies such as X-ray or MRI are necessary to evaluate the source of your pain. Along with a physical therapist and/or chiropractor, a treatment plan tailored to your condition is developed.
Muscular strain of the lower back is clearly the most common presentation. Muscle fibers and the ligaments that hold the vertebra together become microscopically torn and frayed. Theses soft tissues respond with pain, inflammation and muscle spasm. Even worse is damage to the cartilaginous disc between the vertebras that acts as a cushion. These internal shock absorbers between each vertebra in the spinal column can be damaged or torn. Many times the damage is subtle but involves a bulge or protrusion of its spongy substance out to the side, which allows it to put pressure on a nerve branch as it exits the spinal cord. This condition known as a pinched nerve
or herniated disc" is what causes pain, numbness or weakness that travels into the buttocks or down the leg. Also know as sciatica for the sciatic nerve that provides sensory nerves to this region, can lead to much greater functional limitations and challenges to treatment. Poor conditioning, obesity, smoking, prior back injury and incorrect lifting techniques are the most common risks that lead to injury.
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Back injuries are most often preventable. Chronic overuse from years of abuse due to occupational hazards does happen, but acute strains from over exertion still comprise the majority of injuries. Most are muscular in nature and respond to simple conservative treatment measures. Some do require more invasive treatments to repair other damaged components of the back. The latter, which require longer rehabilitation, drive up the total cost. We know that early intervention and aggressive use of the most cost effective modalities can return people to work and activities of daily life faster. OSHA and the National Safety Council have noted that only the common colds and flu account for more time loss from work than back injuries.
Treatment is usually grouped into three areas. The foundation of therapy is time, rest, medication, and physical therapy. This is known as conservative treatment. Medications such as an anti-inflammatory, muscle relaxant and narcotic pain medicine can provide temporary comfort along with cold packs and massage. Mobilization of the injured area as early as possible can be started by simple stretching and basic exercises. Both chiropractor and physical therapist can help as well as teach better body mechanics and plan a daily home exercise program to promote systematic recovery. Thus physical therapy and re-strengthening remains the foundation of treatment throughout the process regardless of severity. Patients will likely need to modify their work responsibilities with restrictions that reflect their temporary weakened condition.
A second more invasive modality used if progress is lacking in selected patients is epidural steroid injections (ESI). Using a fluoroscope or CT scanner to guide a needle to the problem area, ESI can help reduce inflammation by injecting