[:en]Welcome to the 21st century. In a matter of 50 years, this nation has gone from the industrial age, through the service age and into the information and technology age. Despite dramatic improvements in people’s lives, one thing has not changed: in the world of work, people still get injured just doing their jobs.
These types of injuries are so notoriously difficult and expensive to treat the Occupational and Health Administration (OSHA) requires companies and businesses nationwide to meet specific standards in an attempt to control this epidemic.
A study has recently been completed comparing two different treatments for repetitive motion injuries. This study clearly proves direct, hands-on Rolfing® techniques are much more cost effective than traditional medical approaches. This study involves injuries of the upper extremity that effect the nerves, tendons and muscles of the fingers, hand, wrist, lower and upper arms, shoulder and neck.
In this article I will review: the enormous problems American business has dealing with these injuries; what the exact nature of the injury is, normal medical treatment modalities for repetitive motion injuries, the design of my study, and finally, statistical outcomes proving the enormous savings potential of simple hands-on Rolfing treatment.
THE PROBLEM FOR AMERICAN BUSINESS:
These work-related repetitive motion injuries strike the American workforce with painful efficiency. According to the Bureau of Labor of Statistics, they are now the most commonly reported occupational disease and by far the most expensive sector of workers compensation claims. Although the numbers of these injuries have leveled off in the last few years, a review of the literature quickly affirms that a significant portion of the working population is injured or in pain every day. Especially hard hit are workers such as grocery clerks, assembly workers, carpenters, garment workers, food processors, and individuals performing data entry.
A significant segment of the workforce labors in pain and yet never files a workers compensation claim. Consequently, there is an enormous untapped reservoir of injured workers needing pain relief. In Colorado, almost 40% of the 33,000 lost time workers compensation claims in 1999 were for repetitive motion injuries or sprains and strains, which cost hundreds of millions of dollars annually. In addition, each of these employees was absent from work more than three days because of injury.
Repetitive motion injury is known by a number of different names: cumulative trauma disorder (CTD), repetitive strain injury (RSI), repetitive motion injury (RMI), overuse, or stress. Whatever name the injury has, it refers to an overuse and injury to the muscles, tendons, and nerves. Symptoms may include pain, numbness, tingling, burning, cramping, locking, swelling, weakness, and headaches.
Myofascial pain caused by a repetitive motion injury can be as severe as any pain known. It can be aching and dull, or deep and sharp with intensities that vary from low-grade discomfort that comes and goes, to severe and incapacitating. The pain may be constant, or present only when there is movement. A common misconception about this pain is that it will cure itself. That taking a break from work, a weekend off, ‘ or a vacation will resolve the pain. Unfortunately, this is seldom true. The pain may at times subside and become less severe, even disappearing. However, the injury to tissue is only dormant and will flare up repeatedly to become painful. The fact is, the problem rarely resolves on its own and, more importantly, can and does persist for years as a source of pain and weakness.
In 1981, when the IBM PC was released, 18% of all reported industrial illnesses were repetitive strain injuries. In 1984 that figure grew to 28% and in 1992 to 52%. In 1996 it was estimated that by 2000 these repetitive strain injuries would account for 70% of all reported occupational illnesses. According to the U.S. Bureau of Labor Statistics, the top five industries that dominate j repetitive motion claims are: small assembly, automotive assembly, cut-and-sew industries, meat and poultry processing, grocery workers, and data entry, which has I come on strongly in the past 10 years. 1 Women represent about two thirds of the affected population.
It is clear that repetitive strain injuries are common and painful; what then is the problem? Actually, we are dealing with multiple problems. The first problem is the enormous financial cost of these injuries. The Bureau of Labor Statistics’ most recent figures, compiled from a survey of 3,000 employers across the country, states that each cumulative trauma disorder costs approximately $4,000 to treat. These costs total in excess of $100 billion dollars annually for American businesses. Approximately 20 to 30 billion dollars is spent for actual medical payments and an additional 70 to 80 billion dollars is spent for indirect expenses j such as lost production, paid overtime, hiring and training new workers, and dozens of other “invisible” costs. These ancillary amounts are anywhere from four to seven ; times more than the actual medical dollars spent. These expenses are always present and the employer is often unaware of this; enormous leakage from the bottom line.
Secondly are the human costs extracted by persistent pain. Chronic pain deeply affects people’s lives and the lives of those around ‘ them. If the pain is severe enough or persists long enough, the sufferer will often enter a downward spiral resulting in a loss of normal physical functioning, loss of social and family lives, and a possible loss of job and income. As the pain and the fear of pain increases, it takes center stage in their lives and they simply lose the zest for living. People move around less, participate in fewer activities, and cut back on hobbies and pleasurable pursuits.
A third problem is that current medical treatment techniques for these injuries are often not successful. If normal medical approaches did work, we clearly would no see the astronomical numbers of these un resolved injuries and their financial bur dens; there simply would be no problem Here is what really happens. Pain result! from hypertoned muscles, entrappetted nerves, and/or trigger points. Traditional medical treatment for cumulative traume pain is customarily a schedule of drugs splints, braces, exercises, electrical stimulation, light duty, injections of corticosteroids, and/or surgery. These professional rarely touch the injured tissue for treatment and their chosen methods simply will no break down rigid tissue, release entrappetted nerves or resolve trigger points quently, painful conditions remain unresolved. My approach to resolve these people’s painful symptoms uses Rolfing techniques to loosen the myofascial restrictions that are creating pain and restriction movement.
My approach to working successfully will injured employees involves three steps. The first step is a correct diagnosis of the problem. Is it nerve entrapment, trigger point tight muscles, or something else?
Secondly, I must decide where to work. D( I work directly on the painful area or the tissue in a remote location that may actually be causing the problem? Finally, the very important step that is the special wad that I work. My techniques are very specific, hands-on, deep tissue work. I manipulate the muscle and connective tissues it ways that slowly release tight, entrappetted nerves, tight connective tissue and trigge points.
Early in 2000 I met with the Department o Risk Management of the State of Colorado and arranged to work on their employee with repetitive motion injuries using m, innovative techniques. Their risk management team admitted to a concern they went having about high workers compensational costs and lost work time due to repetitive motion injuries. Additionally, they wanted to offer an effective treatment alternative b their employees. A pilot project was pro posed for a department where 1,500 clerical employees are involved primarily in computer-related and paper handling tasks.
Thirty-three employees were selected who were experiencing work-related upper extremity pain (from the fingertips to the neck). I worked on each employee 20 to 30 minutes per week for six weeks. A medical statistician for the Colorado Department of Workers Compensation collected insurance company data comparing dollars spent to treat repetitive motion injuries using conventional medical techniques to assess the cost of using my company’s Trauma Release TM techniques. The statistician carefully scrutinized the characteristics of each population to insure we were studying comparable groups and that the study results would be absolutely true and reliable. Here are the results of our study.
1. The average cost to treat one repetitive motion case using traditional medical techniques is approximately $1,566. The Cost to treat one client using the Dorn Companies Trauma Release TM techniques is $268 per case. A savings of 83%.
2. Annual department saving is conservatively projected to be $45,000 per year. In 1999 The Department of Revenue of the State of Colorado spent $122,000 on these types of injuries.
3. Savings on time away from work. Employees who leave the workplace for doctor visits are absent on average two and a half to three hours per visit which averages $45 in salary and benefits. The same salary and benefits cost the employer about $9 per visit when the employee sees a Dorn Companies practitioner onsite. Travel time to see a Dorn Companies professional is 90 seconds compared to an average one and a half hours when the employee travels to a doctor. That one and a half-hour time is only for travel; treatment time is an additional one hour.
4. Unmeasured benefits. The Dorn Companies Program is able to relieve pain, either significantly or completely, for seven or eight out of ten employees. My discussions with employees who have received medical treatment for their repetitive motion problems and conversations with occupational medicine physicians and others indicates that traditional medical treatment significantly helps two or three people out of ten. Most employees receiving traditional medical treatment for their injuries are still in pain when they are certified as having maximum medical improvement.
A. Employees appreciate being treated onsite. Participants in the Dorn Companies Program remain on company premises for treatment. There is no need to leave for time-consuming appointments with physicians or physical therapists. Instead, employees leave their work area for about 30 minutes per session. Because we are onsite more problems are discovered, cases opened, and treatment given earlier in the disease process. This keeps most injuries from ever reaching the severe and costly stages. In addition, employees repeatedly expressed gratitude saying the company cares about them because they have brought our program onsite.
B. Employees in our program see almost immediate results. Our techniques are designed to give some measure of relief so the employee returns to their workstation ready to resume their normal duties with more comfort.
C. Headaches. When I started this program headaches were not on my radar screen. No one files a workers compensation claim for a headache. Yet, the majority of the people I treat for repetitive motion injuries complain of moderate to severe headaches that occur across the spectrum from occasionally to daily. According to medical authorities, 90 percent of headaches are the result of tension or stress. And, since I received so many complaints about headaches I started to work with the muscle and connective tissue around the head and neck. I quickly discovered many headaches could be resolved. Amazingly, in many cases, the headaches that started to go away for some people have not returned even weeks later.
D. Companies can become more competitive. Chronic pain can be so distressing, debilitating, and depressing that we can only guess about the numbers of people who quit their jobs because of work related pain. It is only logical to assume that if we can stop the pain we can save companies some of the high costs of employee turnover if they do not have to constantly hire and train new workers.
At this point I would like to relate a couple of success stories. Both of the following individuals had previously filed workers compensation claims and received medical treatment for their injuries. These are the types of stories we frequently encounter as Rolfers. Clients’ tales of being misdiagnosed, misinformed, and mistreated. Somehow, we Rolfers know “the truth” and are often able to help clients overcome their physical problems.
Sharon B., a typist, originally came for help with her numb and tingling hands. She mentioned a seriously inflamed medial epicondyle that had been extremely painful for several years. She did not allow her elbow to touch anything. She did not rest it on a desk or armrest, and when she was in bed her elbow rested on its own pillow. When she first experienced the pain, she tried the workers comp process; her doctor told her there was nothing that could be done. It was suggested she endure the pain as long as possible prior to surgery. She had been living with the pain ever since. I was able to resolve the problem in three 20-minute sessions. One grateful client, one proud Rolfer.
Case number two is Shirley. Shirley had thumb pain 24 hours a day, completely disrupting her life. Her local occupational medicine clinic rubbed ointment on her thumb and bandaged it. Then they tried hot and cold packs, with no effect, followed by a diagnosis of arthritis and pain medication which gave no relief but made her dizzy. Then came a wrist brace and finally a recommendatiori for cortisone shots. After two and a half months, twelve visits and no relief she came to me. Realizing the origin of the problem was not in her thumb, I worked on other areas of her arm and after a couple of sessions was able to resolve the problem.
1. Myofascial repetitive motion injury is an enormously expensive problem for American industry, both financially and in terms of human capital. Business is wasting its most precious resources.
2. Current treatment modalities for these injuries are often ineffective.
3. Dorn Companies Trauma Release Techniques are a safe, effective, cost saving alternative for treating repetitive motion injuries within a business setting. It is a winwin situation. Businesses save money and employees quickly get better.
4. Many hidden benefits accrue to companies and employees who adopt this type of treatment approach for repetitive motion and sprain and strain injuries.