In part one, we discussed the types of workplace accidents and events that can cause a herniated disk. We also discussed the symptoms, possible complications, and diagnostic tests that are reviewed/used when an employee has a herniated disk.
In this part, we discuss the treatments that are used for a herniated disk and how a herniated disk (also spelled “disc”) diagnosis affects your workers’ compensation claim. We’ll fight to restore your health and obtain the workers’ compensation benefits you deserve.
What are the treatments for a herniated disk?
The treatments vary depending on the severity of the disk damage and how many disks are damaged. At the start, workers will need to stop any movements that cause pain – which normally means workers need to stop working. For most people, according to the Mayo Clinic, the treatments include the following:
Medications
The medications for a herniated disc include:
- Nonprescription pain medicines. Workers with mild to moderate pain may consider using some of the following nonprescription medications according to the Mayo Clinic: “Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve).”
- Neuropathic drugs. These medications which require a prescription affect nerve impulses to decrease pain. Neuropathic drugs include gabapentin (Horizant, Neurontin), Pregabalin (Lyrica), duloxetine (Cymbalta), and Venlafaxine (Effexor XR).
- Muscle relaxers. Some workers are prescribed muscle relaxers if they’re experiencing muscle spasms. Some of the side effects of these drugs include fatigue and dizziness.
- Opioids. As the dangers of these pain medications and their addictive qualities have become better known, healthcare professionals generally don’t prescribe opioids except for severe pain when other treatments aren’t working and only under very strict guidelines.
- Epidural Steroid injections. Your doctors may recommend a corticosteroid injection if your other treatments do not provide enough pain relief. A cortisone medication is injected into the area around the spinal nerves. Spinal imaging helps to guide the needle to the correct part of your body. It usually takes a series of 3 injections to get things back on track, assuming they are effective.
Therapy
Your doctors may prescribe physical therapy to help you manage your pain through exercises that are designed to reduce the pain of a herniated disk.
Surgery
If conservative treatments including therapy aren’t improving your symptoms after six weeks, then your doctors may recommend surgery, especially if you experience “poorly controlled pain,” continued weakness and numbness, difficulty walking or standing, and loss of bowel or bladder control.
Surgery often involves removing the “protruding portion of the disk.” Sometimes, the entire disk does need to be removed – which may require that your vertebrae be fused with a bone graft. The bone fusion process can take months. The process involves placing metal hardware in the spine “to provide spinal stability.” Another possible surgery (rarely used) involved implanting an artificial disk.
Herniated disk surgeries include:
- Diskectomy. This surgery removes the part of a disk in the spine that is damaged. “Diskectomy works best for treating pain that travels down the arms or legs from a compressed nerve. The procedure is less helpful for treating pain that’s felt only in the back or neck.” “There are several ways to perform a diskectomy. Many surgeons prefer minimally invasive diskectomy, which uses small incisions and a microscope or tiny video camera for viewing the procedure.”
- Laminectomy. This surgery removes the back arch or part of a spinal bone. “This part of the bone, called the lamina, covers the spinal canal. Laminectomy enlarges the spinal canal to ease pressure on the spinal cord or nerves. Laminectomy is often done as part of a decompression surgery to relieve pressure.”
- Spinal fusion. This surgery “connects two or more bones in any part of the spine. Connecting them prevents movement between them. Preventing movement helps to prevent pain. During spinal fusion, a surgeon places bone or a bonelike material in the space between two spinal bones. Metal plates, screws, or rods might hold the bones together. They then can fuse and heal as one bone.” Of course, it goes without saying that the entirety of the disc material in between the spinal bones is removed so that the bones can fuse.
Alternate therapies
Some workers may find the following treatments helpful, although typically, workers compensation insurance either will not cover or only offer extremely limited coverage for these types of treatments:
- Chiropractic care. “Spinal manipulation has been found to be moderately effective for low back pain that has lasted for at least a month.” Your doctor and chiropractor should review any risk factors.
- Acupuncture. Acupuncture may help ease chronic back and neck pain.
- Massage. This hands-on therapy may provide some temporary relief.
What workers’ compensation benefits can you claim if you have a herniated disk?
Employees who have one or more herniated disks that prevent them from working have the right to file a North Carolina or Virginian workers’ compensation claim if their disk injury is work-related or was otherwise aggravated by a work-related injury. While you’re receiving medical care, you have the right to demand that your employer pay for all your reasonable and necessary medical costs. If you are being held out of work, you generally have the right to receive 2/3rds of your average weekly wages before your herniated disk injury for as long as your doctor continues to hold you out of work or opine that you are unable to return to your job. This is generally limited to 500 weeks maximum.
If your herniated disk still prevents you from working once you’ve reached the point of maximum medical improvement, you will be evaluated to determine if you have a permanent injury. This is usually accomplished via a Functional Capacity Exam (FCE).
In North Carolina, you may also have a separate FCE evaluation to determine the severity (impairment rating) of your spinal injury. Based on the results of that evaluation, you may be entitled to additional wage compensation due to that impairment.
Unfortunately, Virginia does not recognize any impairment rating with regard to the spine in the context of a workers’ compensation case. But North Carolina does.
To be clear, this does not mean that in Virginia, if you hurt your spine at work, you can’t get compensated. It just means that once your weekly checks stop, you would not be entitled to any additional checks based on any impairment rating with regard to a spinal injury.
Note that regardless of the impairment rating if you receive one, unless you are permanently and totally disabled from all work, the maximum you can receive is 500 weeks.
Regardless of the scope and severity of your herniated disk injury, workers’ compensation benefits should include the continued medical care you need to keep your injury as stable as possible.
We’ll help you if your employer requests an independent medical examination (IME) or assigns a nurse case manager to supervise your medical benefits.
Workers’ compensation lawyer Joe Miller has working relationships with many different types of doctors including the doctors who diagnose and treat herniated disks. We’ll explain whether you qualify for workers’ compensation benefits and what those benefits are. We’ve helped many workers just like you obtain the full compensation they deserve when their jobs cause herniated disks and other physical injuries. We’ve been in practice for more than 35 years. Call lawyer Joe Miller, Esq., at 888-667-8295 or complete my online contact form to schedule a free consultation.
Our law firm does have a way for you to provide your details of your accident and injuries if you simply want to do that electronically from the comfort and safety of your home at any time of day or night. To utilize this service, simply click here: New Electronic Case Review.
We’ll get back to you, typically within 24 hours to provide our response as to whether your situation is one where we can provide you with legal representation. If we require more information, we’ll contact you and ask for that information in order to make that determination as to whether we are the best folks to assist you. If we ultimately determine that we cannot represent or assist you, we will not leave you high and dry. We’ll do our best to provide you with other resources to assist you.
