We work with repetitive strain and sports injuries, as well as work-related (see below) and auto injuries. That means we frequently evaluate and treat patients with neck pain, back pain, and upper or lower extremity pain. These conditions are generally called neuro-musculo-skeletal injuries because they involve the nerves, muscles, and joints in the body. Specifically, neuromusculoskeletal injuries also usually involve the connective tissues: tendons, ligaments, fascia, and disks.
People are often familiar with strains and sprains, but another condition they probably should also understand is enthesopathy. Enthesopathy is a painful disorder occurring at the site of attachment of muscles, tendons, and ligaments to bones or joint capsules. These enthesopathies are some of the most common but stubborn injuries people know as:
- Tennis Elbow
- Golfer’s Elbow
- Plantar Fasciitis - foot pain
- Frozen Shoulder - capsulitis
- Groin pull Common Enthesopathies we treat
- Hip Bursitis
- Hamstring pull
- Shin Splints
- Achilles tendonitis
- IT Band Syndrome - lateral thigh/knee pain
- Rotator Cuff Syndrome - shoulder tendonitis
Our formula for the successful treatment of many strains, sprains, tendinopathies, and enthesopathies includes Active Release Techniques, High Power Laser Therapy, LED light therapy, Kinesiology taping, and other modalities such as orthopedic supports and rehabilitative resistance stretching, foam roller work, physio ball exercises, and nutritional support.
A work-related injury is a condition or injury that was caused or aggravated by work activities. Employees should promptly notify their employees when a work-related injury has occurred. Sometimes an injury (called a specific injury) happens in a moment such as a slip and fall, and sometimes an injury (called a cumulative injury) happens over time such as a repetitive strain computer overuse injury.
Most of the time, the employer (or the employer's insurance carrier) will direct the injured worker where to get an initial evaluation. Healthcare providers caring for injured workers must usually be in-network with the worker's compensation insurance Medical Provider Network (MPN). One doctor (MD, DO, DC) will serve as a Primary Treating Physician (PTP) and other providers that give care report to the PTP are called secondary treaters.
Most services provided to injured workers, such as doctor visits, diagnostic imaging, and treatment, require authorization. The PTP must request authorization from the insurance company's Utilization Review (UR) department. Physical medicine treatment for a work-related injury may consist of physical therapy, chiropractic care, and/or acupuncture. Each type of treatment may be authorized up to 24 visits, or more in special circumstances.
Some injured workers can continue working as usual with their injury. Other injured workers may need work restrictions to help assist their recovery and avoid re-aggravation, while other injured workers may need partial or full time off work. Partial or temporary total disability benefits can help offset some of the injured worker's lost wages.
If a DC (Doctor of Chiropractic) is the PTP for a work-related injury, after 24 chiropractic visits if the injured worker still requires more care, they must select a MD or DO for further management of their injury. After treatment, if an injured worker fully recovers from their injury, they have reached pre-injury status. If an injured worker does not fully recover from their injury, and is not likely to improve further, they are permanent and stationary.
An injured worker that is permanent and stationary and has reached maximum medical improvement, may have an impairment that describes a loss of function comparing before the injury to after the injury. If an injured worker had a pre-existing impairment, that loss of function may be apportioned, or subtracted, from their
total impairment. An injured worker that cannot return to their job may be compensated for some retraining or education expenses. Injured workers also can receive provisions for care to treat aggravations or declines in their condition that may occur in the form of future medical.
In the Worker's Compensation system, when a dispute arises concerning such matters as the cause of an injury, partial or temporary total disability, work restrictions, permanent and stationary status, and impairment, a Qualified Medical Evaluator (QME) may be requested to resolve the dispute.
Dr. Gregg Carb has served as a QME, PTP, secondary treater, and in-network MPN provider in the California Worker's Compensation system for several decades and may be able to assist you in the evaluation and/or treatment of a work injury.