IR # 97-41
Wednesday, August 6, 1997

Suzanne Marria
(800) 794-6900 ext. 2005

IMC Promulgates Guideline for Medical Treatment of Low Back Injuries

SAN FRANCISCO -- A guideline for treatment of low back problems was adopted on July 3, 1997, affecting the diagnostic testing and treatment practices of thousands of physicians who treat industrial back injuries in California.

This regulation directly impacts workers' compensation cases, at least 25% of which involve treatment of low back problems. The Industrial Medical Council (IMC) directed the two and a half year project of developing and revising the guideline.

"Physicians who recommend more treatment, longer periods of treatment or different forms of treatment than what is recommended under the guideline are expected to explain the need for such variances in each case," said IMC Executive Medical Director Allan MacKenzie, M.D.

The guideline provides an advisory framework for physicians and other stakeholders in the California workers' compensation system about the appropriate and inappropriate types, duration and frequency of various modalities used in treatment of low back injuries during the acute stage (first 30 days) and the subacute stage (31st to 60th day) of recovery.

The guidelines describe the parameters for treatment in common low back injury cases.

"The California workers' compensation system promises to provide any worker who has had a low back injury with all the appropriate medical treatment which is reasonable and necessary to cure or relieve the injury," said Dr. MacKenzie.

"The real key to the success of this guideline is stated in the guideline itself, that is, that a collaborative partnership among the treating physician, employer and injured worker is an essential component of any plan to return the injured employee to work."

The IMC has already adopted four other treatment guidelines, for treatment of occupational asthma, contact dermatitis, post traumatic stress disorder and knee problems. In mid August, treatment guidelines for the neck, shoulder, elbow and hand and wrist problems, including carpal tunnel problems, are expected to be adopted, as well.

Copies of the guideline texts are available from the IMC at 1-800-794-6900.