Back Sprain Research Articles

The effect of regional trauma care systems on costs.

To assess cost savings from regional trauma care systems. Multivariate regression analysis is used to isolate the effects of regional trauma care systems on medical costs while controlling for personal and injury characteristics and other factors likely to influence medical costs. Percentage reductions in costs are translated into dollar cost savings with corrections for excluded costs and losses from premature death. Injuries to workers filing workers' compensation lost workday claims. Randomly sampled workers' compensation claims from 17 states filed between 1979 and 1988 (N = 217,000). Medical payments per episode of four injury groups: lower-extremity fractures and dislocations, upper-extremity fractures and dislocations, other upper-extremity injuries, and back strains and sprains. We distinguish hospitalized from nonhospitalized claims. Statistical analyses reveal that states with trauma care systems have 15.5% lower costs per hospitalized injury episode. Savings average $1025 per case in 1988 dollars. Costs per episode for disabling nonhospitalized injury are 10% lower in states with trauma care systems, with savings averaging $75 per case. The largest savings are for back injuries. Extending trauma care systems nationwide could lower annual medical care payments by $3.2 billion. Including productivity losses due to premature death, the savings could total $10.3 billion, 5.9% of national injury costs.

Back Sprain in Industry

A minority of industrial-back-sprain claimants account for most of the cost of industrial back sprain: those whose disability persists into "chronicity", which is defined as 90 days or more off work. The data in this study demonstrate the effects of socioeconomic factors on chronicity. This analysis is based on State of Washington industrial insurance claims for back sprain. For both men and women, three socioeconomic factors significantly affect the risk of chronicity: age, wage, and the family status of being either widowed or divorced with no children. In addition, the Nam-Powers Socioeconomic Index is significant for men. Wage compensation ratio cannot be shown to be a factor in chronicity.

Young long distance runners. Physiological and psychological characteristics.

This study presents the physiological and psychological characteristics and the running histories of 16 subjects who began long distance running at age 4-12 years. Running duration was 3-15 years (mean 8.4 +/- 3.6 yrs). Seven children completed 41 marathons, seven 30-mile races, and eight 60-mile races. The other nine competed at shorter distances. All trained at 30-105 miles/week. Two stress fractures, one back sprain and one knee injury occurred. Athletes who reported injuries from recollection may have underreported some injuries. At age 15.4 +/- 4.2 years bone age was 15.3 +/- 2.6 years and height was at 51 +/- 26.0 percentile. Athletes had larger left ventricular diastolic diameter, higher max O2 uptake, and delayed onset of anaerobic metabolism compared to controls. Psychological profile: IQ = 121 +/- 11, scholastic grade point average (GPA) (n = 13) was less than or equal to 3.0 in four, 3.6-3.9 in four, and 4.0 in five. Cattell 16 personality factor (PF): Seven scored above the 85th percentile on boldness, warmth, conformity, sensitivity, dominance, and high drive with tension. Eight scored above the 93rd percentile for self discipline and emotional stability. Human Figure Drawing showed a distorted body image in seven. Two developed anorexia nervosa, and another girl committed suicide. Thus, high physical fitness and no growth retardation were observed. These runners, however, shared distinct positive and negative personality characteristics. The relatively high incidence of severe psychological disorders possibly suggests a need for psychological screening for young children entering a strenuous training program and for close monitoring for development of psychological problems during the program.

Back Pain Prescription: Out of Bed and Into the Gym.

Bed rest and pain pills, the traditional remedies for back strains and sprains, don't always work. Physicians are looking at alternatives like exercise to get patients out of bed and moving again.

When back pain becomes disabling: a regional analysis

Back pain is a common condition and in most cases is not disabling. We have investigated disabling back pain that leads to health care utilization, time lost from work, and high costs. Disabling back pain remains of obscure origin because the focus in studying it has been too narrow. Our indicator of disability is the industrial insurance claim rate for back sprain by county (N = 39) in the State of Washington. After controlling for the size of the labor force and the proportion of workers in occupations that are particularly at risk of back sprain, we determined the effect of 3 socioeconomic factors on the claim rate: the unemployment rate, percentage receiving food stamps, and per capita income. For 2 of the 3 years studied, socioeconomic factors accounted for about one-third of the variance in the claim rate. Even though claimants of industrial insurance are employed, the unemployment rate was significantly related to the claim rate in the 3 years studied. Our interpretation is that disability is a symptom of distress. Where there is a rise in job insecurity and an attendant rise in economic insecurity, there is a greater likelihood that back pain will become disabling.

Surfboard‐riding injuries

The results of a study aimed at determining the nature, rate, and cause of traumatic surfing injuries by gathering injury data directly from surfers rather than by retrospective analysis of hospital or first-aid station records are reported. Three hundred and forty-six surfers of varying ages, experience, and competence reported 337 injuries sustained over a two-year period. The most common injuries requiring medical attention or resulting in inability to surf were lacerations (41%) and soft-tissue injuries (35%). The high incidence of back and shoulder sprains and strains has not previously been reported. As the rate of moderate and severe injuries among the sample was calculated to be 3.5 injuries per 1000 surfing days, and because more than 25% of the lacerations were caused by the sharp fin, or by the tail, or by the nose of the surfboard, some safety modifications in board design or structure may be necessary.

Aftercare instruction: acute low back strain and sprain: initial therapy.

Aftercare instruction: acute low back strain and sprain: initial therapy.

Vertebral Anomalies

RECOGNITION in the living subject of anatomical variations in the spine, which are many and have been known for centuries, is ultimately based upon X-ray evidence. Practically all writers seem to agree that comparatively few variations appear in the cervical and dorsal region compared to the greater percentages that occur in the lumbar and sacral segments. The presence of these changes in the vertebral column when traumatism or pseudotraumatism has occurred, may be mistaken for traumatic as well as non-traumatic lesions of the spine, or other pathologic conditions which may be due to trauma or other causes. Many years ago we heard much about railway spine. To-day this same term, used first by Erichsen in 1868, has insinuated itself among a larger class of people, including the medical profession, as the so-called industrial spine. The occurrence of actual or alleged injuries is of great interest to all medical men, especially to the surgeon and roentgenologist. Anomalies and anatomic variations are of particular interest when one is endeavoring to determine the true etiology and prognosis of back sprains or other injuries to the spine. Vertebral anomalies were noted in 1,122 roentgenograms of the lumbar vertebræ and sacrum. This number represented the negative genito-urinary examinations in a consecutive series of approximately 8,000 patients, who were subjected to X-ray examinations in the Scott and White Clinic. During this period, comparatively few roentgenograms were made of the cervical and dorsal spine except following alleged injuries, therefore it will be impossible from our studies to give any definite data regarding the exact percentage of occurrence of vertebral anomalies in these regions. That these cases were sent to the X-ray department for genito-urinary examinations would indicate that the discovery of these anomalies was quite accidental as they could not possibly have any bearing on the well-being of the individuals, and their occurrence is probably of scientific value only. In this connection, I should like to stress that we should continue to report every possible anomaly. I suggest that we speak of these as normal variations of the spine instead of congenital anomalies, because our studies as well as those of many others seem to indicate that individuals having these peculiarities of development are in a way just as normal as those having the standard pattern. I should like to stress also, first, that one should always endeavor to determine if there has been sufficient trauma to produce the alleged injury, and, second, if the violence or trauma was directed in such a manner as to produce the particular lesion. It must be recognized that any attempt to classify accurately the anomalies of the lumbar region from a study of this region alone is unreliable. As an example, 50 of the 1,122 roentgenograms studied showed an increase to 6 in the number of lumbar vertebræ, and, in 13 cases, 4 lumbar vertebræ were noted.