Oct 4, 2017 | Patient Resources
Patient education plays a critical role in the shoulder injury recovery process. Make sure it’s being done right.
A shoulder injury can be a traumatic event in and of itself. It can also prompt a whirlwind of phone calls, appointments, tests—and uncertainty about the future. Research suggests that providing patients with a resource to help outline the process and manage expectations may be a game-changer in bolstering both satisfaction and outcomes.
The Relationship Between Patient Education & Outcomes
A recent Gallup study demonstrated that surgery patients who felt they received early patient education —knew what to expect and were prepared for and followed post-procedure instructions—had fewer readmissions, were 33 percent more satisfied with the results, experienced 19 percent fewer problems and reported a higher level of contentment. Altogether, this indicates that patient education can lead to smoother recoveries and potentially lower overall per-patient costs.
That’s why more and more organizations are taking a patient-centric approach to injured worker interactions by incorporating higher levels of communication and engagement with patients prior to and throughout a treatment program. Not only can it improve the quality of care, it can encourage compliance with treatment, reduce the workload of adjusters and case managers and help mitigate psychosocial barriers to recovery.
Educating Patients with Shoulder Injuries
When it comes to shoulder injury cases, there are many misconceptions about the standard treatment program and recovery process. Here are four foundational points to drive home in a patient education program for shoulder injuries.
- You are not alone. Shoulder injuries are the second most common musculoskeletal problem in workers (the first is back pain). The shoulder is made up of four different joints that work together to allow movement of the arms. As we age, the joint and surrounding tendons undergo a natural aging process that can make them more susceptible to injury. Jobs that require repetitive use of the arms above shoulder height or the handling of heavy loads are particularly stressful to the shoulder.
- MRI images should be taken with a grain of salt. Imaging in the initial months after injury is not necessary in most cases unless there is significant trauma. Imaging results can sometimes be misleading. Problems identified on the image may have been present prior to symptoms, and are not really the cause of present pain. Lots of people have ‘wrinkles’ on the outside and inside, that are not necessarily harmful.
- Surgery may not be necessary. Surgery is usually reserved for people who are still having significant problems after a course of physical therapy. A large study found more than three-quarters of patients with chronic, full-thickness rotator cuff tears avoided surgery through a supervised exercise program. In fact, the same study found that the strongest predictor of undergoing surgery—even stronger than the characteristic of the tear itself—was low patient expectations regarding the effects of physical rehabilitation.
- In most cases, a full recovery is expected. For the vast majority of shoulder problems, a complete return to function can be achieved with a combination of temporary activity modification (avoiding heavy or repetitive lifting and sustained overhead use of the arms) and a gradual, supervised exercise program. Shoulder muscles provide stability and control so most problems can be successfully managed with an exercise program. This may require some early coaching and supervision under the guidance of a physical therapist and may take up to 12 weeks to achieve full effect. Sometimes in addition to exercise, medication or an injection may be prescribed to help reduce inflammation and allow for effective exercise. It’s important to stay active and modify work duties, when possible.
To learn more about shoulder injury patient education, download the information sheet “I Have a Shoulder Injury. Now What?”.
Sep 2, 2015 | Patient Resources
As part of our Patient Advocacy Program, MedRisk is committed to informing injured workers on what they can expect when they’re scheduled for workers’ comp-related tests and procedures.
This post is designed to help patients prepare for the questions that come along with an MRI (short for magnetic resonance imaging); you can learn more about general MRI preparation here. Please note that this post should not be considered medical advice; if you have specific questions, you should contact your physician or case manager.
What’s going to happen?
MedRisk asks pre-exam questions prior to scheduling to make sure we match patients with the provider that has the right equipment, capabilities and specialists on hand to handle their unique situations when they arrive.
Similar questions will most likely be asked at the clinic in the form of a paper questionnaire and again as an interview with the radiologist or other imaging center personnel. The questions are designed to ensure the utmost safety and comfort for patients, and responses may impact what kind of preparation is required prior to the MRI procedure.
“Do you have both your kidneys?”
Certain health conditions – such as severe kidney disease, liver disease or diabetes –may prevent a patient from receiving Gadolinium, a contrast material used to enhance images. If a patient has a history of kidney disease or liver transplant, a blood test may be required to determine whether the organs are functioning adequately.
“Do you have cochlear implants?
Many surgically implantable or medical devices are (or contain) metal, and can interact with the electromagnetic current of an MRI in a number of ways. Depending on the strength of the MRI magnet, devices such as cochlear implants may interfere with the exam possibly hindering diagnosis. Even hearing aids and IUDs can interfere with an MRI or visa versa. Additionally, while some types of implants have been tested as acceptable for MRIs, others have not been fully researched and may be contraindicated.
Clips used for brain aneurysms and types of metal coils placed within blood vessels may be made from what’s called ferromagnetic material, which means the electromagnetic pull of an MRI may slightly displace these critical materials. Additionally, the electromagnetic current of an MRI can disrupt or permanently disable devices such as cardiac defibrillators and pacemakers, creating a serious health risk for the patient.
“Have you ever worked with sheet metal?”
Patients who have been injured by a metal object or have metal residue in certain parts of their bodies may require an x-ray prior to an MRI to identify the location of the material. Some metals may heat up uncomfortably during an MRI or move in response to the electromagnetic current potentially posing a health risk if situated too close to an artery or other vital organ.
“Do you have any body piercing, hair weaves or extensions, tattoos or permanent makeup?”
Body piercings, wigs and hair weaves or extensions will need to be removed prior to an MRI to avoid interference, heating, or ferromagnetic “pull.” Some tattoo pigments may interfere with the quality of an MRI image, and the radiologist and physicians will need to be aware of the location of those areas in advance.
Aug 6, 2015 | Patient Resources
As part of our Patient Advocacy Program, MedRisk is committed to informing injured workers on what they can expect when they’re scheduled for workers’ comp-related tests and procedures.
This post is designed to help patients prepare for an initial evaluation. It should not be considered medical advice; if you have specific questions, you should contact your physician or case manager.
What is it?
In physical therapy or occupational therapy, an initial evaluation is exactly what it sounds like: a first visit with a therapist, who examines and evaluates the injured worker’s condition. The IE allows the therapist to develop a course of treatment, which will contribute to the patient’s eventual return to work.
What to expect
Pre-exam questions
- Before the exam, you should write down any issues, concerns or symptoms you might be having. As much detail as possible should be given – even the smallest pieces of information can help the therapist.
- You should also have a firm grasp of your medical history, and write down any medications you might be taking (and the dosage).
- If you don’t speak English, it’s helpful to bring a bilingual family member or friend, in the event the PT or OT facility does not have a translator ready.
What to wear
- You should wear loose-fitting, comfortable clothing. Avoid high heels, and leave jewelry at home.
- For an upper body injury, wear short sleeves. For a lower body injury, wear or bring shorts.
About the exam
- You can expect the therapist to ask you to describe the injury and how it occurred, as well as any symptoms you might be experiencing. You will also be asked about any other medical conditions you might have.
- The evaluation and some initial treatment typically take about one hour.
Jul 8, 2015 | Patient Resources
As part of our Patient Advocacy Program, MedRisk is committed to informing injured workers on what they can expect when they’re scheduled for workers’ comp-related tests and procedures.
This post is designed to help patients prepare for a FCE (Functional Capacity Evaluation). It should not be considered medical advice; if you have specific questions, you should contact your physician or case manager.
What is it?
An FCE is a set of tests, practices and observations that determine a patient’s physical and functional ability to perform certain tasks. FCEs are most commonly used to determine whether a patient can return to work and safely perform their work duties.
What to expect
Pre-exam questions
- Because an FCE exam involves a number of physical tests, you will be asked to fill out medical paperwork in advance of your exam.
What to wear
- Wear loose fitting comfortable clothes and sneakers.
- Leave your jewelry (rings, watches, earrings, etc.) at home. You’ll be asked to remove them for the exam.
About the exam
- Be prepared to spend about 4-6 hours at the therapy center. You may bring water and a snack, in case you get hungry.
Jun 22, 2015 | Patient Resources
As part of our Patient Advocacy Program, MedRisk is committed to informing injured workers on what they can expect when they’re scheduled for workers’ comp-related tests and procedures.
This post is designed to help patients prepare for an EMG (electromyography) test or NCS (nerve conduction study). It should not be considered medical advice; if you have specific questions, you should contact your physician or case manager.
What is it?
EMGs and NCS measure muscle and nerve response. They are often done during a single exam or visit. The EMG test uses one or more small needles inserted into the muscle to measure response. The NCS uses electrodes that issue small electric shocks to measure nerve response.
What to expect
Pre-exam questions
- You’ll be asked some basic medical questions in advance of your exam.
What to wear
- Wear loose fitting, comfortable clothing. You may be asked to put on a hospital gown, depending on the body part.
- Avoid applying body lotion or powder prior to your EMG/NCS.
- Leave your jewelry (rings, watches, earrings, etc.) at home. You’ll be asked to remove them for the exam.
About the exam
- On average the exam takes 30-90 minutes, depending on response and body part.
Jun 22, 2015 | Patient Resources
As part of our Patient Advocacy Program, MedRisk is committed to informing injured workers on what they can expect when they’re scheduled for workers’ comp-related tests and procedures.
This post is designed to help patients prepare for a CT (short for computerized tomography) scan. It should not be considered medical advice; if you have specific questions, you should contact your physician or case manager.
What is it?
CTs use x-rays and computers to generate a cross-sectional image of a targeted area. They are useful in examining muscle or bone disorders, among other things. Sometimes a CT “with contrast” is prescribed; in these cases, dye is injected to help highlight certain areas.
What to expect
Pre-exam questions
- Because CT machines use x-rays, you’ll be asked a number of questions in advance of your exam. If your doctor has ordered a CT “with contrast,” it is also important for the radiologist and the technician to know if you have iodine allergies.
What to wear
- Wear loose fitting, comfortable clothing. You may be asked to put on a hospital gown, depending on the body part.
- Leave your jewelry (rings, watches, earrings, etc.) at home. You’ll be asked to remove them for the exam.
About the exam
- The CT unit looks like a large doughnut; you lie on a table that moves through the center hole.
- On average, you can expect 15-30 minutes per body part.
- If your doctor prescribed a CT “with contrast,” your nurse or technician will inject the dye prior to your exam.
