Types of Injectables Used in an Injured Worker’s Pain Management

Recently, we discussed some of the cost trends associated with the use of injectable medications in workers’ compensation as part of a recent report from the Workers Compensation Research Institute (WCRI). Noted within their report were several different types of these medications and how they are being used to treat pain, with many of them gaining traction for multiple uses in an injured worker’s recovery.

“Many of these treatments are only recommended after more conservative treatments have failed and are not meant for sustained use,” said Jennifer Gallagher, Medical Manager at Safety National. “While some individuals can experience immediate relief, long-term success is usually accompanied by a long-term pain management program that consists of improving function and quality of life, rather than complete pain elimination.”

These are a few of the most common injectable medications or procedures used in pain management:

• Calcitonin gene-related peptide (CGRP) medications – These targeted therapies are used in treating or preventing migraines. Work injuries, like head trauma, or the effects of a work injury, such as ongoing stress, pain, or medication overuse, can contribute to migraines.
• Epidural steroid injections – Injected into the space around spinal nerves, this medication can relieve pain that is common in low back injuries, like herniated discs or spinal stenosis. However, most occupational treatment guidelines do not recommend these for routine use due to limited benefits and potential risks.
• Nerve blocks – Used to treat chronic axial back pain, these injections are typically facet block procedures, targeting spinal facet joints or their surrounding nerve supply. Nerve blocks can also be used to treat neuropathic pain or complex regional pain.
• Joint injections – Musculoskeletal disorders commonly involve joint, tendon, and soft tissue injections. Typically involving corticosteroid injections, this category can provide short-term relief for injuries, such as shoulder impingement, carpal tunnel syndrome, and knee osteoarthritis.
• Platelet-rich plasma (PRP) injections – Injecting platelet-rich plasma into an injury area is a regenerative medicine technique that has increased in use over the last few years. While its use is still low compared to other treatments, studies support its selective use in other long-term treatments.
• Botulinum toxin injections – As an FDA-approved treatment for chronic migraine prophylaxis, this may be used in the event that migraines are associated with a work injury. It can also be used to treat spasticity or myofascial pain.
• Biologics – These drugs are most commonly used to treat pre-existing autoimmune conditions, but a work injury can worsen an individual’s condition or cause it to flare. Conditions like rheumatoid arthritis and psoriatic arthritis can benefit from these medications.