General Guideline Principles for Other Tests / Procedures
of Mid and Low Back Injury for workers compensation patients
The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Other Tests / Procedures of Mid and Low Back Injury.
These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.
The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.
Electrodiagnostic Studies (EDX) of Other Tests / Procedures
EDX consists of cognitive evoked potentials, peripheral pulse wave velocity investigations, and needle EMG. The diagnosis of disc herniation or spinal stenosis is typically supported by needle EMG in people with radiculopathy issues and/or back pain.
The presence of acute or chronic radiculopathy can be determined by needle EMG. NCV is performed in addition to injection EMG to exclude any additional possible explanations for Co-morbidity or a different diagnosis involving peripheral symptoms radiculopathy is confirmed by testing the nerves.
It is favored and advised that doctors execute and interpret EDX in the outpatient environment board-certified in rehabilitation and physical medicine or neurology.
- EDX (must include needle EMG and NCV)
EDX (must include needle EMG and NCV) is recommended In certain cases, when clinically appropriate,
Indicators: When a CT or MRI is inconclusive and there are persistent symptoms of pain, tiredness, and/or numbness/paresthesia, neurological impairment with potential for identification may be present. Symptoms like radiculopathy, spinal stenosis, nerve damage, etc. in the legs are meant by this.
In addition to the needle EMG, nerve conduction investigations are performed to establish radiculopathy and to rule out other possible explanations of the symptoms (comorbidity or other diagnoses involving peripheral nerves, such as compression neuropathies).
When suspected radicular pain does not go away or plateau after four to six weeks (to give enough time for EMG abnormalities to form and for conservative treatment to work), when imaging results, such as those from CT or MRI scans, are ambiguous, and when it is suspected through a patient’s physical examination and history that a neurologic situation other than radiculopathy might well be present rather than or in addition to radiculopathy.
EDX (must include needle EMG and NCV) is not recommended for patients having acute or non-acute pain on the back who do not have leg pain or numbness.
- Surface Electromyography (Surface EMG)
Surface Electromyography (Surface EMG) is not recommended.
- Lumbar Discography
Lumbar Discography is not advised for the treatment of acute or non-acute back pain or radicular pain syndromes, whether it is carried out as a stand-alone test or in conjunction with imaging (such as an MRI)
Note: Some indications executing discography on normal discs are related to an enhanced danger of degenerative changes in those discs in the future. However, discography has not been found to improve surgical outcomes.
Complications from lumbar discography can include but are not restricted to, infection, discitis, and post-discogram herniation.
- CT/MRI Discography
CT/MRI Discography is recommended See Lumbar Discography above.
Myeloscopy is not recommended for acute or non-acute back pain, spinal stenosis, radicular pain syndromes or post-surgical back pain problems.
Thermography is not recommended for the assessment of acute or non-acute back pain, or radicular pain patients.
What our office can do if you have workers compensation injuries
We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.
We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.
We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.