Original articleThe Effects of Splinting on Outcomes for Epicondylitis
Section snippets
Participants
The patient population in this study consisted of patients receiving primary care for lateral or medial epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32) at any clinic within a nationwide network of 253 occupational medical centers. This network, owned and operated by Concentra Inc, sees approximately 7% of US workers’ compensation patients. Patient records were retrieved from the proprietary internal information management system, which contains
Splinting Main Effect
Table 3 summarizes differences in outcome measures for patients with and without splints. Means and SEs for each outcome measure are presented for splinted versus nonsplinted patients within propensity score subclasses and averaged across subclasses. Significance test results, noted in the last row of the table, refer to the overall mean difference observed for splinting versus not splinting (calculated as a 2-tailed z test, significant at P<.05).
Overall significant differences between splint
Discussion
A treating provider’s main reasons for prescribing a splint are, presumably, to rest the arm and to alleviate pain or discomfort. However, no good correlation between a patient’s subjective pain ratings and his/her ability to work or to perform certain physical activities has been established, nor has a correlation been found between the decrease in symptoms and the rate of return to work.34, 35 In addition, prescribing a splint is likely to necessitate movement restrictions that may further
Conclusions
The challenge in occupational medicine, particularly with respect to workers’ compensation, is for providers to maximize the health and well-being of their patients while showing their cost-effectiveness to employers and payers in the present environment of ever-escalating medical costs. Critical to the success of such efforts is an evaluation of “what works” because cheaper procedures are not cost-effective if they inflate total medical and indemnity costs by prolonging treatment duration and
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