General Guideline Principles for Lower Abdominal Strains
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 Hip and Groin Disorders.

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.

Introduction of Lower Abdominal Strains

In occupational populations where heavy lifting is involved, lower abdominal strains are common. Patients should have their hernias checked, and if any are discovered, surgical correction should be considered.

Medications of Lower Abdominal Strains

Ibuprofen, naproxen, or other NSAIDs from an earlier generation are suggested as first-line treatments for the majority of patients. For patients who are not candidates for NSAIDs, acetaminophen (or the analogue paracetamol) may be a viable alternative, even if the majority of research indicates it is just marginally less effective than NSAIDs.

There is proof that NSAIDs are less dangerous and just as effective in treating pain as opioids, such as tramadol.

1. Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

   Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are recommended for the treatment of stresses in the lower abdomen.

   Indications: The use of NSAIDs is advised. First, try over-the-counter (OTC) medications to see whether they work.

   Frequency/Duration: Many patients could find it reasonable to use as needed.

   Indications for Discontinuation: Lower abdominal strains becoming better, the medication not working, or side effects appearing that require stopping.

    

2. NSAIDs for Patients at High Risk of Gastrointestinal Bleeding

   NSAIDs for Patients at High Risk of Gastrointestinal Bleeding is recommended Misoprostol, sucralfate, histamine Type 2 receptor blockers, and proton pump inhibitors are commonly used together by individuals who are at high risk of gastrointestinal bleeding.

   Indications: Cytoprotective drugs should be taken into consideration for patients with a high-risk factor profile who also have indications for NSAIDs, especially if a prolonged course of treatment is planned. Patients who have a history of gastrointestinal bleeding in the past, the elderly, diabetics, and smokers are at risk.

   Frequency/Dose/Duration: H2 blockers, misoprostol, sucralfate, and proton pump inhibitors are advised. dosage recommendations from the manufacturer. There aren’t typically thought to be any significant variations in effectiveness for stopping gastrointestinal bleeding.

   Intolerance, the emergence of negative effects, or stopping an NSAID are reasons to stop.

    

3. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

   The advantages and disadvantages of NSAID therapy for pain should be explored with patients who have a history of cardiovascular disease or who have several cardiovascular risk factors. It is advised to start with acetaminophen or aspirin as these medications seem to be the least dangerous in terms of cardiovascular side effects.

    

4. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

   NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended If necessary, non-selective NSAIDs are recommended to COX-2-specific medications. To reduce the chance that an NSAID will negate the protective effects of low-dose aspirin in individuals receiving it for primary or secondary cardiovascular disease prevention, the NSAID should be taken at least 30 minutes after or eight hours before the daily aspirin.

   Treatment of Lower Abdominal Strains with Acetaminophen It is advised – for the treatment of lower abdominal strains, especially in individuals who have NSAID contraindications. All patients with lower abdominal strains, whether they are acute, subacute, chronic, or post-operative, should be considered.

   Dose/Frequency: As per the manufacturer’s recommendations; can be used as required. Over four gm/day, there is evidence of liver toxicity. Signals of Discontinuation pain, side effects, or intolerance are gone.

Treatments of Lower Abdominal Strains

1. Hot and Cold Therapies

   Hot and Cold Therapies are recommended strains in the lower abdomen.

   Indications – Lower abdominal strains are present in all individuals.

   Frequency/Duration – As many as three to five self-applications every day.

   Indications for Discontinuation – Resolution, negative consequences, and noncompliance.

    

2. Heat Therapy of Lower Abdominal Strains

   Heat Therapy of Lower Abdominal Strains is recommended for lower abdominal strains.

   Indications – All patients with lower abdominal Strains.

   Frequency/Duration – As many as three to five self-applications every day.

   Indications for Discontinuation – Resolution, negative consequences, and noncompliance.

Rehabilitation of Lower Abdominal Strains

Rehabilitation of Lower Abdominal Strains is recommended for the treatment of strains in the lower abdomen.

Indications: The majority of patients, but especially those with considerable functional impairments and/or strength deficiencies, may benefit from a course of therapy. Exercise is advised for lower abdominal strains of at least moderate intensity since it can alleviate functional impairments.

Eliminating the exposure(s), using NSAIDs, and time help mild instances resolve most of the time.

Frequency/Dose/Duration –With evidence of continued objective functional Improvement, the total number of visits could be as low as two to three for individuals with modest functional impairments or as high as 12 to 15 for those with more severe deficits.

If there is evidence of functional improvement toward particular objective functional goals (such as increasing range of motion or improving capacity to conduct work activities), more than 12 to 15 visits may be necessary to address persistent functional impairments.

A home exercise regimen should be created as part of the rehabilitation strategy and carried out alongside the therapy.

What our office can do if you have Lower Abdominal Strains

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.