Typical scenario:

2,500-lb car rear ends 30,000-lb bus (net weight, excluding passengers!) at around 5 MPH. Minor dents to both.

Somehow, the massive acceleration/deceleration and the forces of impact mysteriously travel up transmission of bus, take a vertical leap into the air spring cushioned driver’s seat, and end up in the driver’s spine.

Chiropractor and/or injury clinic doc gives diagnosis of “acute lumbosacral strain and sprain, myofasciitis” etc. and declares driver unfit for duty and requiring months of “treatment” at their “clinic.” After, of course, this is preceded by a round or two of lumbar x-rays (radiation be damned – these were young people in general), CT scans, MRI’s etc. and followup x-rays at regular intervals looking for “subluxation.” God forbid the “bulging disc” on MRI, which most people have asymptomatically.

The diagnosis of “bulging disc” was akin to “hitting the jackpot”, worker’s comp-wise.

On exam, the patient would typically exhibit the signs of what I used to term “no objective signs or symptoms to substantiate complaints, and multiple inconsistencies on exam.”

Notably, the “workers comp wriggle” (massive exaggerated movement on light touching of lumbar spine with fingertip), lack of pain while sitting when I extended their calves horizontal to help put on their shoes, but massive pain on 45 degree leg rise while supine, back pain when pressing down on their head while standing, and the like.

The chiropractors and injury docs mysteriouly never had such findings.

On the other hand, one injury doc’s “muscle knots” in a mid 20’s driver who had been under his treatment for a few months was to my exam a far more serious problem: rip roaring diffuse lymphadenopathy, with epitrochlear and even radial fossa nodes of Medical Student size, indicative of – among other things – lymphatic malignancy.

And these guys would win at arbitration (AAA) when we challenged the b.s.

One wonders why worker’s comp is such a financial strain to companies.

As a woman of mature years who suffers from occasional backpain, I have to say that–for some kinds of back pain–light traction can help ease the pain. However, I’ve never used it without also using light exercise, anti-inflams, and cold against the sore spot, so I can’t vouch for its effectiveness alone.

My particular issue is due to an accumulation of stuff that culminates every few months in a fair bit of pain and stiffness which, if left untreated, leads to back spasms. Having seen a wonderful PT, an MD, and a podiatrist (at least part of this is due to my walk having changed due to broken bones in my foot), I have tried a variety of treatments; and *for me*, part of the solution is traction. The PT did something wonderful involving a strap, a position that looks faintly pornographic, and pulling out on hips for about 4 minutes. I don’t understand how it works, unless it’s just getting certain muscles to not be under strain and unkink–but I get very similar results from strategic use of the lower end of a climbing gym in the local elementary school playground. Sometimes hanging from my knees (not all my weight) for a few minutes gets everything back in working order.

I have reluctantly accepted that my back getting sore after I drive for more than 3 hours, stand for more than 2 hours, or sit at my desk for more than 3 hours is just going to be part of my life for now. The best I have been able to do is try to build breaks to stretch, move, and change position into my routine–and accept that the first night after a plane flight is going to be tough.

I’m not surprised that people are desperate to find some magic cure–when my back was spasming, I was literally disabled. But I went to the boring medical doctor, took her advice (and my muscle relaxants) and got back into been functional in short order. The longer-term fix is not perfect, but so much better that I have hope that a year or so may lead to full recovery.

Perhaps something that medical educators need to teach the public is that sometimes there isn’t a quick fix–especially if you’re over 40. Here in the land of fast food, fast cars, and fast forwarding through the recorded ads, people expect bodies to heal in 2 days to a week.

Just my thoughts, Miss Kitt

Yes, individual companies will eventually go out of business, but only after substantial profits have been made. And as soon as one company goes out of business another will take its place.

S