The Realities of Pain Therapies

by Dell Dorn, DORN Companies

We all agree that pain is bad. In the workplace, employees in pain are often less productive and exhibit lower morale. How to treat pain most effectively – and in a fiscally sensible manner – has many employers unsure. There are a myriad of options available to treat pain, but most therapies are used only after the pain or injury has ocurred.

Pain is defined as “acute” if it lasts less than 30 days, “subacute” when it lasts one to six months, and “chronic” when it lasts more than six months. Pain severities warrant different therapy options - typically oral or topical, depending on each employee’s individual needs.

Oral

Oral therapies commonly prescribed for pain management are categorized as:

1. Nonsteroidal anti-inflammatory drugs (e.g., Advil, Aleve, etc.);
2. Narcotics (opioids [e.g., Vicodin, OxyContin, etc.]); and
3. Adjuvants (e.g., antidepressants, local anesthetics, etc.).¹

Nonsteroidal and adjuvants can be effective but often provide limited pain relief.² Opioids often cause complications and side effects, of which the worst side effect is addiction. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide.³ The prolonged treatment schedules and their associated long-term costs render oral therapies very expensive.

Topical

One alternative to oral therapies is the use of compound topical creams, gels, sprays, and rubs. The topical therapies provide relief with few side effects:⁴

1. Localized Treatment: Apply directly to the area in pain.
2. Speed of Effect: Topical therapies take effect within minutes.
3. Customized Therapy: Compounding enables a medication to be tailored to the patient’s specific pain(s).

Many patients like topical therapies because they are easy to use, are applied directly to the site of pain, and have fewer negative side effects.

Pain Prevention and Intervention

While both oral and topical therapies address pain after incurred, neither prevents the pain from reoccurring or happening in the first place. Employers who want more from pain therapy are looking for a program focused not only on preventing the pain, but also intervening to stop the cycle of pain. DORN delivers an onsite pain prevention and intervention program that improves employee productivity and turnover, and reduces the employers’ workers’ comp claims and associated medical costs.

The Pain-Free™ Treatment program by DORN is an effective solution that:

• Improves quality of care with manual therapy treatment for musculoskeletal (MSD) injuries and pain;
• Conveniently is performed onsite, eliminating time away from work;
• Reduces health benefit costs, including medication and prescription costs;
• Is non-OSHA recordable injury treatment;
• Reduces absenteeism, presenteeism, and turnover;
• Improves productivity and morale.

A University of California study found that the DORN Pain-Free Treatment program reduced employee pain levels by 57%, reduced medication/prescription levels by 40%, and reduced absenteeism by 40%.⁵ Additionally, employees felt that their employers cared about them by offering the DORN program. A win-win for pain relief and bottom line improvement.

Cost

One of the biggest issues with today’s oral and topical pain therapies is cost.

Topical therapies can be expensive up front when compared to oral alternatives. In fact, the ingredients to make the compound treatments can cost thousands of dollars and are often denied for payment by insurance providers. And while the up-front costs for opioids are lower, there has been a systemic rise in costs associated with opioid use (and misuse).

An alarming data point showing the difference between opioid and non-opioid costs is with workers’ compensation claims (Table 1). ⁶

NOTE: Cost values in Table 1 may or may not consider severity of injuries.

When comparing the cost of oral and topical therapies with a prevention/intervention therapy, the cost differences are even more dramatic. The DORN Pain-Free Treatment program is a proven low cost solution with a guaranteed 60 day ROI.

Conclusion

While oral and compound topical therapies are effective for various therapy needs, neither addresses the root cause of the pain. Certainly no single therapy offers the greatest pain relief, for any type of pain, but the DORN Pain-Free Program effectively addresses MSD pain. The most dramatic difference between the three forms is cost.

Opioids cost patients, families, employers, insurance companies, and the broader U.S. healthcare system more than compound topical analgesics. The topical therapies can be very costly. Payers responsible for issuing reimbursements, based on costs and medical necessity, need to encourage prevention/intervention therapy alternatives to drive down those costs while addressing the root cause of the pain. Employers focused on both their short and long-term costs and employee care should contact DORN to discuss the advantages of the Pain-Free Treatment program.

This blog post was adapted from a recent article from WorkComp Central, "The Painful (and Shocking) Realities of Pain Therapies." You can read their full original article here: https://www.workcompcentral.com/columns/show/id/587a4ce3cba357137e77f00c59c533b4454d9da8

References

1. "The Painful (and Shocking) Realities of Pain Therapies," WorkComp Central, August 2015
2. Clinical Advisor, 2011
3. World Drug Report, unodc.org, 2012
4. “Transdermal Lidocaine and Ketamine for Neuropathic Pain: A Study of Effectiveness and Tolerability,” The Open Neurology Journal, 2012
5. “Preliminary Trial on the Effectiveness of Early Intervention Manual Therapy in Reducing Costs of Presenteeism Due to Musculoskeletal Pain”, IHPM Journal, 2007
6. “The Soaring Cost of the Opioid Economy,” The New York Times, July 22, 2013