Offering treatment to target specific workplace issues, Biosymm will ease the transition back to full-time work, safely and quickly.

Highlights:

  • Targeting treatment towards specific requirements of patient’s job results in successful conservative treatment and avoidance of surgery
  • Physiotherapist coordinated progression of suitable work duties based on assessment findings, resulting in a return to patient’s normal job role
  • Biosymm was utilised to provide a second opinion due to worsening condition of patient and the failure of previous treatment
  • Physiotherapist allowed plenty of time for patient to tell their full story, enabling a thorough and detailed subjective history
  • Treatment and workplace interventions were targeted at issues raised by the patient and based off specific assessment findings

A warehouse/retail worker was suffering from ongoing low back pain and neural type pain in her leg following an injury at work. Following six month of treatment and a hospitilisation due to her pain, she was referred to Biosymm due to the lack of improvement in her condition. During the initial consult with the Physio, extended time was provided for the patient to discuss her injury and current pain levels and the frustrations this was causing in her workplace and social life.

To begin with, the patient was referred for scans and a specialist review to provide a clearer diagnosis and guide her rehabilitation plan. The results of the scans on her lower back indicated that the patient may require surgery due to the extent of her initial injury. Following consultation with the patient, her specialist, the treating doctor, the insurer and Biosymm, it was agreed that an eight weeks of conservative rehabilitation would be trialed first, overseen by the Biosymm Physio. Following this, if there was no significant improvement, surgery would be unavoidable and workplace rehabilitation provider would be employed to help seek alternative employment options for the patient.

By allowing the patient adequate time to tell the story of her injury, the Physio was able to determine specific frustrations that the patient had, which could be impacting her recovery. These were:

  • A fear of physical activity due to initial recommendations to “not bend her back,” to avoid lifting and to avoid being in any position for longer than 15 minutes
  • Her current pain and disability levels meant the patient was only working four hours per day three times per week, causing considerable stress about her employment status and financial tension
  • The patient was unable to drive, go shopping or do housework by herself and this was resulting in emotional stress and tension between herself and family.
  • The patient was unable to enjoy her usual social activities, isolating her from friends
  • A cocktail of pain medications was being used to try and control her pain levels.

Following the subjective examination of the patient, the Physio was able to perform a physical examination which surprisingly found that the patient has almost full range of motion in her spine and was able to squat with no pain. She reported being able to walk 20 minutes with no onset of pain and the main findings from the examination were some muscle weakness, nerve related pain and occasional pins and needles in her foot.

ith the patient, her specialist, the treating doctor, the insurer and Biosymm, it was agreed that an eight weeks of conservative rehabilitation would be trialed first, overseen by the Biosymm Physio. Following this, if there was no significant improvement, surgery would be unavoidable and workplace rehabilitation provider would be employed to help seek alternative employment options for the patient.

By allowing the patient adequate time to tell the story of her injury, the Physio was able to determine specific frustrations that the patient had, which could be impacting her recovery. These were:

  • A fear of physical activity due to initial recommendations to “not bend her back,” to avoid lifting and to avoid being in any position for longer than 15 minutes
  • Her current pain and disability levels meant the patient was only working four hours per day three times per week, causing considerable stress about her employment status and financial tension
  • The patient was unable to drive, go shopping or do housework by herself and this was resulting in emotional stress and tension between herself and family.
  • The patient was unable to enjoy her usual social activities, isolating her from friends
  • A cocktail of pain medications was being used to try and control her pain levels.

Following the subjective examination of the patient, the Physio was able to perform a physical examination which surprisingly found that the patient has almost full range of motion in her spine and was able to squat with no pain. She reported being able to walk 20 minutes with no onset of pain and the main findings from the examination were some muscle weakness, nerve related pain and occasional pins and needles in her foot.

Treatment at that point consisted of nerve gliding exercises, muscle release and hip stretches. Her functional capacity was also assessed which showed she was able to lift 5kg between floor and shoulder height and was able to move and drag 8kg. This was used to guide the starting point of her gym program and work activities.

In order to provide a comprehensive treatment plan and not only treat her superficial symptoms, a visit to her workplace was organized by the Biosymm Physio. It was important to spend time with her at work observing what jobs she performed and paying particular attention to how she moved. The Physio was able to work out strategies to help manage her pain and strengthen her back during her normal activities. Potential alternative roles were identified for the short-term as stepping stones to returning to her normal role.

During the workplace visit, the patient was able to discuss her role as an activities coordinator and how passionate she was about it as well as how much enjoyment she received from the role. It was discovered that her employer wanted to permanently change her role to an administration based positon, to protect her from re-injury in the future. Given her passion for the role, this was causing the patient to feel further stress and anxiety around her injury and current condition.

By identifying the physical demands in her role, the Physio was able to set rehabilitation goals directed at the most physically demanding aspects of her job. The goals were:

  • Being able to handle 12kg stock from storage and lift it into and out of the ute for community events
  • Being able to squat, kneel, bend forward, drive and climb stairs
  • Being able to occasionally lift 20kg
  • Being able to do some occasional hammering and digging

Although there were physical restrictions and weaknesses that needed to be addressed by manual therapy and exercise plans, the most important aspect of her treatment was aimed at empowering the patient to tackle her fears in a safe and controlled environment. The Biosymm Physio was determined to help the patient with her fears of physical activity, chronic pain and losing her job. This was achieved by listening to the patient, educating her about pain and demonstrating and coaching through physical activity.

Additionally, recommendations were made to her workplace to improve her workstation ergonomics and the handling of heavy equipment in stairways and into and out of vehicles. These were implemented by her employer and also resulted in the heaviest task in her job, 20kg lifting, being eliminated completely.

The patient and Physio worked together in the clinic, the gym and her workplace for a total of 13 weeks. Fortunately, she was able to avoid surgery and return to her normal job with no pain. She was also able to drive again and perform her normal housework. The patient continued exercising in the gym on her own in order to further improve her overall strength and fitness.